This project is a two-stage exploratory observational mixed methods study consisting of a quantitative survey and in-depth semi-structured qualitative interviews. This project is a two-stage exploratory observational mixed methods study consisting of a quantitative survey and in-depth semi-structured qualitative interviews.
Portsmouth Hospitals NHS Trusts (PHT) developed VitalPACTM, an electronic patient surveillance system where the frequency of vital signs observations is calculated by an Early Warning Score (EWS) protocol. The system assures that patients be observed more frequently, allowing for the identification of early physiological changes that indicate deterioration. Since implementation, regular audits have consistently shown significant differences in adherence to the observation protocol during the night shift, between wards within the same clinical directorate and between medical and surgical specialties.
Based on the hypotheses that compliance of observations would be influenced by:
- Nurse’s experience
- Knowledge of the EWS protocol
- Beliefs regarding the importance of sleep and the predictability of deterioration
- Attitudes regarding the importance of prioritising and completing vital signs observations in relation to all the other nursing tasks that need to be done
Our study aimed to:
- Ascertain the knowledge, beliefs, choices and practices of healthcare staff concerning performing vital signs observations at night on general medical and surgical wards
- Ascertain factors associated with ward level observation compliance and individual self-reported compliance
Results of the study will inform a review of the hospital guidelines regarding night time observations in order to:
- Identify improvement areas and
- Deliver a short training workshop to nurses and staff to increase adherence of night time observations according to established policies
A second study should follow to determine the impact of missed night observations on selected patient outcomes
Project Team
Dr Paul Schmidt (Portsmouth Hospitals NHS Trust)
Dr Alejandra Recio-Saucedo
Dr Antonello Maruotti
Dr Greta Westwood
Dr Meredith Paul (Portsmouth Hospitals NHS Trust)
Carole Fogg
Jo Hope
Professor Peter Griffiths
& members of the Deteriorating patient group at Portsmouth Hospital NHS Trust
Project Funder
CLAHRC Wessex
Conferences and events
Portsmouth Research & Innovation Conference, Portsmouth, UK, 15 June 2016
Seminar presentation organized by CLAHRC Wessex Fundamental care theme, University of Southampton, Faculty of Health Sciences, January 2016