Missed opportunities? An observational study of vital sign measurements

To determine the frequency of monitoring of patient vital signs in two wards of a tertiary hospital.

A retrospective observational study of patient charts from two wards was conducted for a 48-hour period (Sunday and Monday, 23 and 24 October 2005). All vital sign readings from all patient charts were collected.

1597 unique vital signs were recorded in 62 patients. Frequency of documentation was significantly lower for respiratory rate than for all other vital sign measurements: respiratory rate, 1.0 reading/day, versus blood pressure, 5.0 readings/day; heart rate, 4.4 readings/ day; and temperature, 4.2 readings/day (P < 0.001 for all comparisons). Comparisons between blood pressure, heart rate and temperature frequency measurements showed no statistical differences, but there were significant differences in overall collection frequency between the medical and the surgical ward (3.0 v 5.0 readings/day, P < 0.001).

Blood pressure, heart rate and temperature were the most diligently recorded vital signs, but documentation of respiratory rate was poor. Failure to perform vital sign measurements may underpin the failure to recognise patients in general wards whose condition is deteriorating.