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Factors associated with the frequency of respiratory rate measurement by hospital nurses: a multicentre cross-sectional study

12 May 2022
16 min read
Volume 31 · Issue 9



Although the respiratory rate (RR) is a sensitive predictor of patient deterioration, it is often neglected. Moreover, only a few studies have investigated the factors that cause health professionals to disregard RR.


This cross-sectional study aimed to elucidate the factors affecting the frequency of RR measurement by the nurses.


An original questionnaire, comprising 18 factors extracted from previous studies, was administered to nurses from nine hospitals.


Of the 644 eligible nurses, 592 (92%) completed the questionnaire. The adjusted odds ratios and 95% confidence intervals of the factors of importance, educational experiences, shortened-count method use, negative experiences, and inconvenience were 2.24 (1.13–4.45), 2.26 (1.20–4.26), 0.61 (0.42–0.91), 0.45 (0.29–0.70), and 0.41 (0.26–0.65), respectively.


Education, feedback systems, and automation are the primary issues that need attention. Prioritising these factors could provide a practical guide for optimising the frequency of RR measurement.

Respiratory rate (RR), one of the four traditional vital signs measurable in almost any medical setting, could be a crucial early indicator of patient deterioration (National Institute for Health and Care Excellence, 2007). An abnormal RR can be indicative of the early stages of patient deterioration (Gravelyn and Weg, 1980; McFadden et al, 1982; Fieselmann et al, 1993). Hence, the RR has been incorporated in many clinical prediction models, such as the Simple Triage And Rapid Treatment for medical emergencies and disasters (START) (Benson et al, 1996), early warning score (EWS) for establishing rapid response systems (Morgan et al, 1997; Smith et al, 2019), CURB-65 for severity scale for pneumonia (British Thoracic Society Standards of Care Committee 2001), and Acute Physiology and Chronic Health Evaluation II (APACHE II) for severity assessment of patients in the intensive care unit (Knaus et al, 1985). All of which indicates that health professionals should assess the RR thoroughly.

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