vital signs
CRITICAL CARE
Critical care: the eight vital signs of patient monitoring
Malcolm Elliott and Alysia Coventry
O
ne of the traditional roles of nurses involves surveillance.This might include watching patients for changes in their condition, recognising early clinical deterioration and protection from harm or errors (Rogers et al, 2008). For over 100 years, nurses have performed this surveillance using the same vital signs: temperature, pulse, blood pressure, respiratory rate and in recent years, oxygen saturation (Ahrens, 2008). Prompt detection and reporting of changes in these vital signs are essential as delays in initiating appropriate treatment can detrimentally affect the patient’s outcome (Chalfin et al, 2007).
Patients admitted to acute hospitals today are sicker than in the past, as they have more complex health problems and are far more likely to become seriously ill during their admission
(Ryan et al, 2004). In addition, patients who were once too sick to be operated on are now undergoing complex surgical procedures. This, coupled with the increasing demand for beds, means that ward nurses are often caring for patients who previously would have been cared for in a high-dependency or intensive care unit (Butler-Williams and Cantrill, 2005).
Furthermore, system factors such as skill mix, nurse:patient ratios and bed shortages significantly impact on the quality of nursing care delivered in these environments.
This challenging situation is further complicated by increasing patient survival rates, which have resulted in an increasingly complex and older patient population (James et al, 2010). Patients aged 65 and older, for example, have twice the risk of younger adults of developing peri-operative complications. They are also more likely to be admitted as emergencies and undergo emergency surgery (Romano et al, 2003). Diminished reserves in cognitive, renal and hepatic function also contribute to older patients
Critical care: the eight vital signs of patient monitoring
Malcolm Elliott and Alysia Coventry
O
ne of the traditional roles of nurses involves surveillance.This might include watching patients for changes in their condition, recognising early clinical deterioration and protection from harm or errors (Rogers et al, 2008). For over 100 years, nurses have performed this surveillance using the same vital signs: temperature, pulse, blood pressure, respiratory rate and in recent years, oxygen saturation (Ahrens, 2008). Prompt detection and reporting of changes in these vital signs are essential as delays in initiating appropriate treatment can detrimentally affect the patient’s outcome (Chalfin et al, 2007).
Patients admitted to acute hospitals today are sicker than in the past, as they have more complex health problems and are far more likely to become seriously ill during their admission
(Ryan et al, 2004). In addition, patients who were once too sick to be operated on are now undergoing complex surgical procedures. This, coupled with the increasing demand for beds, means that ward nurses are often caring for patients who previously would have been cared for in a high-dependency or intensive care unit (Butler-Williams and Cantrill, 2005).
Furthermore, system factors such as skill mix, nurse:patient ratios and bed shortages significantly impact on the quality of nursing care delivered in these environments.
This challenging situation is further complicated by increasing patient survival rates, which have resulted in an increasingly complex and older patient population (James et al, 2010). Patients aged 65 and older, for example, have twice the risk of younger adults of developing peri-operative complications. They are also more likely to be admitted as emergencies and undergo emergency surgery (Romano et al, 2003). Diminished reserves in cognitive, renal and hepatic function also contribute to older patients