Frequency of vital sign assessment and clinical deterioration in an Australian emergency department

Lambe, Katherine, Currey, Judy and Considine, Julie 2016, Frequency of vital sign assessment and clinical deterioration in an Australian emergency department, Australasian emergency nursing journal, vol. 19, no. 4, pp. 217-222, doi: 10.1016/j.aenj.2016.09.001.

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Title Frequency of vital sign assessment and clinical deterioration in an Australian emergency department
Author(s) Lambe, Katherine
Currey, JudyORCID iD for Currey, Judy
Considine, JulieORCID iD for Considine, Julie
Journal name Australasian emergency nursing journal
Volume number 19
Issue number 4
Start page 217
End page 222
Total pages 6
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-11
ISSN 1574-6267
Keyword(s) emergency nursing
emergency department
risk assessment
patient safety
vital signs
patient assessment
clinical deterioration
Summary BACKGROUND: Understanding of clinical deterioration of emergency department patients is rapidly evolving. The aim of this study was to investigate the frequency and nature of vital sign collection and clinical deterioration in emergency care.

METHODS: A descriptive exploratory approach was used. Data were collected from the records of 200 randomly selected adults with presenting complaints of abdominal pain, shortness of breath, chest pain and febrile illness from 1 January to 31 December 2014 at a 22 bed emergency department in Melbourne, Australia.

RESULTS: When controlled for length of stay, heart rate was the most frequently assessed vital sign per hour (median=0.9) whilst Glasgow Coma Score was the least frequently assessed vital sign per hour (median=0.5). Clinical deterioration (one or more vital signs fulfilling hospital medical emergency team activation criteria during emergency department care) occurred in 14.5% of patients. Of the 5466 vital sign measures, 19.6% were abnormal, 1.9% indicated clinical deterioration.

CONCLUSIONS: Clinical deterioration occurred in one in seven patients, and one in five vital signs documented were outside of accepted normal ranges. Thus, emergency department physiological status has implications for patient safety and nursing practice, in particular clinical handover for patients requiring hospital admission.
Language eng
DOI 10.1016/j.aenj.2016.09.001
Field of Research 111002 Clinical Nursing: Primary (Preventative)
1110 Nursing
1117 Public Health And Health Services
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, College of Emergency Nursing Australasia
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