The global elements of vital signs' assessment: a guide for clinical practice
The assessment of vital signs is critical for safe, high-quality care. Vital signs' data provide valuable insight into the patient's condition, including how they are responding to medical treatment and, importantly, whether the patient is deteriorating. Although abnormal vital signs have been associated with poor clinical outcomes, research has consistently found that vital signs' assessment is often neglected in clinical practice. Factors contributing to this include nurses' knowledge, clinical judgement, culture, tradition and workloads. To emphasise the importance of vital signs' assessment, global elements of vital signs' assessment are proposed. The elements reflect key principles underpinning vital signs' assessment and are informed by evidence-based literature.
Vital signs' assessment is a key component of safe, high-quality care and a fundamental nursing priority. Trends in vital sign data provide early warning of impending sepsis and respiratory failure, and can independently predict mortality (Churpek et al, 2014; Nielsen et al, 2015). Furthermore, vital signs' data is important for medical emergency teams and early warning scores to function effectively, but only if there is adherence to vital sign monitoring protocols (Hands et al, 2013).
Despite their clinical importance, research has consistently found that vital signs' assessment is often inaccurate, incomplete or falsified (Ludikhuize et al, 2012; Philip et al, 2013; Cooper et al, 2014). The reasons for this are not clear, but nurses' knowledge, skills and clinical judgement, culture, tradition and ritual, along with laziness and workload have been identified as contributing factors (Hogan, 2006; Yeung et al, 2012; Philip et al, 2013; Burchill et al, 2015; Cardona-Morrell et al, 2016). It has therefore been recommended that nurses need ongoing education to improve their attitudes towards vital sign monitoring (Mok et al, 2015).
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