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Do nursing textbooks accurately describe pulse oximetry? An audit of current literature

11 June 2020
Volume 29 · Issue 11



The assessment of a patient's vital signs is a critical nursing task. Despite this, research has found that many nurses have a poor understanding of pulse oximetry.


As undergraduate students rely heavily on textbooks as an educational resource, an audit was conducted of nursing texts to determine the quality of pulse oximetry descriptions.


The audit was guided by questions based on the findings of research examining nurses' understanding of pulse oximetry. Two researchers used these questions to appraise textbook content.


A convenience sample of 32 contemporary nursing textbooks was appraised. Text descriptions of pulse oximetry varied from brief to more extensive, with the content ranging from superficial to detailed.


Superficial, inconsistent or misleading information within basic nursing textbooks may be one factor associated with nurses' knowledge deficits about pulse oximetry. Academics and nurse educators should appraise core content of textbooks carefully before recommending textbooks to nursing students.

The accurate assessment and interpretation of vital signs is essential for detecting clinical deterioration (Turkington et al, 2014). These vital signs include blood pressure, pulse, respiratory rate, temperature and oxygen saturation. Despite their importance, however, the clinical assessment of these signs is frequently neglected even though most deterioration is detectable in the hours before a serious adverse event (Ludikhuize et al, 2012). The failure to thoroughly assess vital signs may explain why many nurses are often unaware that their patients are deteriorating and why nurses tend to call for assistance relatively late in a crisis (Genardi et al, 2008; De Meester et al, 2013).

Little research attention has been given to the neglect of vital signs assessment and interpretation (Rose and Clarke, 2010). Possible reasons may include perceived lack of time or education, staffing levels, and nurses' reliance on intuition (Hogan, 2006; Odell et al, 2009; Philip et al, 2013). In one study of 614 general ward nurses, attitudes towards vital signs monitoring were influenced by nurses' qualifications and years of clinical experience (Mok et al, 2015). Of concern is that these nurses had limited understanding of the key indicators of clinical deterioration and were also unaware of their knowledge deficits (Mok et al, 2015).

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