References
The enduring neglect of vital signs assessment: a concept map of contributing factors
Abstract
Vital signs assessment is a critical component of clinical monitoring and a crucial nursing responsibility. Contemporary and past research has found, however, that this assessment is often neglected and remains an enduring problem. Research has identified various contributing or causal factors but, to date, there has been no attempt to show how these factors interrelate. A concept map highlighting these relationships is presented in this article. The map can be used as a tool for developing educational resources to address the enduring neglect of vital signs assessment.
Vital signs assessment is an important nursing function that allows early identification of the deteriorating patient (Kamio et al, 2018). The regular monitoring of vital signs can alert the nurse to any developing clinical events, thus allowing timely detection of deterioration and improved patient outcomes (Brown et al, 2014; Richard et al, 2018). Up to 80% of patients exhibit a deterioration in vital signs in the 24 hours prior to an adverse event (Trocki and Craig-Rodriguez, 2020). The presence of three or more critically abnormal vital signs has been associated with a higher mortality risk (Bleyer et al, 2011).
Vital signs assessment and escalation of care is fundamental to patient safety and the first step in patient rescue (Bucknall et al, 2017). However, research has found that only half of patients who meet the criteria for emergency medical review are actually reviewed because nurses do not call for assistance (Bucknall et al, 2013; Bingham et al, 2015). In an Australian study, patients who fulfilled emergency medical review criteria at the time of vital sign assessment were more likely to die in hospital or within 30 days (Bucknall et al, 2013).
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