Question

  

TABLE 2. Patient Factors Compelling Nurses to Repeat Vital Signs Attitudes toward PO VS assess- ment were not congruent with the most recent research related to use- fulness of regimented assessment. A large majority of participants be- lieved the pattern of PO VS assess- ment they chose was based on evi- dence and was an accurate reflec- tion of the patient's condition Research on the usefulness of regi- mented VS assessment and the accuracy of VS as a reflection of patient condition contradicts these beliefs (Martin, Alkhoury, O'Connor Kyriakides, & Bonadies, 2010 Mert et al, 2012; Salottolo et al., 2013; Storm-Versloot et al., 2014). Many Change in mental status Prior abnormal vital signs Poor color Report of critical laboratory value Treatment with high-alert medication Patient or family request Note: Scored from 1 (most compelling) to 7 (least compelling) TABLE 3. Clinician Factors Compelling Nurses to Repeat Vital Signs VS in a regimented fashion would protect them in a lawsuit because the patient appeared to be moni- tored regularly. Court rulings and experts refute this belief by affirm- ing data collection alone is not suf- Physician order Nicholson, 2010). Findings are highly suggestive of the value nurs- es place on ritualized practice as part of nursing culture (Henderson & Fletcher, 2014) Part of nursing assessment the patient has been checked on Practice I learned in school Note: Scored from 1 (most compelling) to 7 (least compelling) limited. The sample is limited to one health system, the majority of responses coming from nurses at operative VS assessment, the majo Discussion ity of participants (n 121, 85%) believed the PO VS regimen they t chose in the earlier section of the survey was drawn from evidence- that based practice guidelines. A small majority of participants indicated a 2005). Unfortunately, these findings was developed using similar atti- belief Vs assessment a ealso may indicate practice has not tude and practice surveys as the intervals is often unnecessary for kept pace with changing patient out- model, it was subjected only to face selected groups of patients (n-82, comes from improved anesthesia validity. Despite inclusion of ASA 58%) and the frequency of repeat- management miele et al., 2015) or class definitions and examples in ing PO VS should not be uniform available evidence (Fernandez &the survey, the variation in acuity for all patients (n-73, 51%). A large Griffiths, 2005; Zeitz & McCutcheon, levels in each hospital and unit may majority (n 122, 8696) believed PO 2006). This persistent practice may make it difficult for some nurses to Vs are an accurate reflection of the impact patient outcomes because differentiate between ASA classes. patient's condition. Many perceived repeating VS regularly as beneficialment to them and the institution in case of a lawsuit (n122, 86%), with a Findings suggest ritual and tradi the tion continue to be the reason for the center. Response rate was low, as practice of regimented PO VS assess often is the case with survey ment; that practice has not changed research with nurses (VanGeest & compared to earlier research (Zeitz, Johnson, 2011). While the survey t may contribute to unno Nursing Implications 2015). This is not to imply patient are completed; rather, assessment practices documented in previous According to the available re- for PO VS assessment practice suggest each patient should have an individual- ized assessment based on current condition rather than a standard- believing in the importance of VS documentation to demonstrate a staff member had looked at the patient (n-87, 61%). not studies remain the norm (Zeitz, 2005; ized approach. Traditional, ritual- ized practices of PO VS assessment

1. Summarize “What can we do” and/or nursing strategies to address the problem of PO VS assessment?

Answer 1

Basically it's our duty to take care of the patient . In our assessment we do a complete physical assessment from top to bottom ,which include vital signs , auscultation , palpation , percussion ,etc . We do the vital sign assessment every one hourly in the intensive care unit and two hourly in wards depending upon the policy of hospitals . Instead of these timings we do the assessment when the patient shows any indications in terms of breathing difficulty , anxiety ,chest pain etc or when the patient is critically ill . Physician order vital sign assessment is not such a big problem ,he might have ordered it based on some rationale only and also check the comfort of patient when you do the assessment so frequently as some times patients get irritated due to disturbance and in some people it causes anxiety because the patients think that something is wrong with them .