Setting the Next Vital Sign Observation Interval as a Learning Objective in Simulation-Based Nursing Education: A...

Area of Science:

• Nursing Education
• Clinical Judgment
• Patient Safety

Background:

• Abnormal vital signs are key indicators of in-hospital clinical deterioration.
• Nurses' decision-making processes for rechecking vital signs after detecting abnormalities are not well understood.
• Understanding these decisions can inform simulation-based education.

Purpose of the Study:

• To investigate how nurse characteristics (experience, training) affect the interval set for the next vital sign observation after detecting abnormal values.
• To explore the potential of using "setting the next observation interval" as a learning objective in simulation.

Main Methods:

• Prospective observational study with 27 nurses using a patient simulator in three scenarios (normal, low-urgency, moderate-risk).
• Nurses indicated the appropriate interval (in hours) for the next vital sign observation.
• Statistical analyses (Mann-Whitney U, multiple regression) explored associations between nurse characteristics and observation intervals.

Main Results:

• In moderate-risk scenarios, greater clinical experience and prior experience recognizing deterioration were linked to shorter observation intervals.
• Advanced Life Support (ALS) training was associated with shorter intervals in low-urgency scenarios but not independently in moderate-risk scenarios.
• Clinical experience and prior deterioration recognition experience were independently associated with shorter intervals in adjusted models for moderate-risk scenarios.

Conclusions:

• The decision to shorten vital sign observation intervals is influenced by experiential aspects of clinical judgment.
• Simulation-based education incorporating "setting the next observation interval" may enhance nurses' clinical judgment for early deterioration recognition.
• Findings suggest a need for further confirmatory studies and curriculum development in nursing education.