Understanding respiratory rate as a predictor of clinical deterioration and mortality

Respiratory rate (RR) is a fundamental physiological observation and a key component of early warning systems used to identify deterioration in hospitalised adults. Accurate RR measurement and interpretation, alongside other clinical observations and timely escalation of abnormal findings, are essential to ensure safe patient care. However, despite its clinical importance, RR remains one of the least reliably measured vital signs in practice and it is frequently estimated rather than counted accurately. This article explores the evidence on RR as a predictor of clinical deterioration and mortality, with relevance to nurses working across acute, emergency, surgical, medical and specialist care settings, as they will be involved in the assessment and monitoring of acutely unwell and potentially deteriorating patients. The author also discusses how to improve RR measurement in practice, emphasising the importance of strengthening awareness of the prognostic significance of RR and enhancing routine monitoring to support earlier recognition of deterioration and improved patient outcomes.