Observation af kritisk syge patienter

Lone Fuhrmann; Rasmus Hesselfeldt; Anne Lippert; Anders Perner; Doris Ostergaard

Observation af kritisk syge patienter

Translated title of the contribution: Observation of critically ill patients

Lone Fuhrmann, Rasmus Hesselfeldt, Anne Lippert, Anders Perner, Doris Ostergaard

Department of Clinical Medicine

5 Citations (Scopus)

Abstract

INTRODUCTION: The aim of this study was to estimate to which extent patients with abnormal vital signs on general wards had their vital signs monitored and documented and to establish if staff concern for patients influenced the level of monitoring and was predictive of increased mortality. MATERIAL AND METHODS: Prospective observational study at Herlev Hospital, Copenhagen, Denmark. Study personnel measured vital signs on all patients present on five wards during the evening and night and interviewed nursing staff about patients with abnormal vital signs. Subsequently, patient records were studied. RESULTS: A total of 155 patients with abnormal vital signs were identified, and staff was interviewed about 139 patients. In 61 of these 139 patients, some vital signs were measured by staff, but the respiratory rate was not measured. In 86 cases staff decided to intervene because of abnormal vital signs measured by study personnel. A total of 77% of patients had vital signs documented in their records on the day of the observation. The previous day, vital signs were documented in 70% of records and on the day after in 66%. The documentation of vital signs was significantly higher when staff expressed concern for a patient in the patient record (95% vs. 65%, chi(2): p < 0.001), but 30-day mortality did not differ significantly (15% vs. 10%, chi(2): p = 0.40). CONCLUSION: In more than half of the patients, the abnormal vital signs were not identified by staff because the vital signs were not measured. In two out of three patients, staff decided to intervene because of abnormal vital signs measured by study personnel, indicating a need to reevaluate monitoring routines at general wards.
Udgivelsesdato: 2009-Feb

Translated title of the contribution	Observation of critically ill patients
Original language	Danish
Journal	Ugeskrift for læger
Volume	171
Issue number	7
Pages (from-to)	502-6
Number of pages	5
ISSN	0041-5782
Publication status	Published - 2009

Cite this

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title = "Observation af kritisk syge patienter",

abstract = "INTRODUCTION: The aim of this study was to estimate to which extent patients with abnormal vital signs on general wards had their vital signs monitored and documented and to establish if staff concern for patients influenced the level of monitoring and was predictive of increased mortality. MATERIAL AND METHODS: Prospective observational study at Herlev Hospital, Copenhagen, Denmark. Study personnel measured vital signs on all patients present on five wards during the evening and night and interviewed nursing staff about patients with abnormal vital signs. Subsequently, patient records were studied. RESULTS: A total of 155 patients with abnormal vital signs were identified, and staff was interviewed about 139 patients. In 61 of these 139 patients, some vital signs were measured by staff, but the respiratory rate was not measured. In 86 cases staff decided to intervene because of abnormal vital signs measured by study personnel. A total of 77% of patients had vital signs documented in their records on the day of the observation. The previous day, vital signs were documented in 70% of records and on the day after in 66%. The documentation of vital signs was significantly higher when staff expressed concern for a patient in the patient record (95% vs. 65%, chi(2): p < 0.001), but 30-day mortality did not differ significantly (15% vs. 10%, chi(2): p = 0.40). CONCLUSION: In more than half of the patients, the abnormal vital signs were not identified by staff because the vital signs were not measured. In two out of three patients, staff decided to intervene because of abnormal vital signs measured by study personnel, indicating a need to reevaluate monitoring routines at general wards. Udgivelsesdato: 2009-Feb",

author = "Lone Fuhrmann and Rasmus Hesselfeldt and Anne Lippert and Anders Perner and Doris Ostergaard",

note = "Keywords: Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Critical Illness; Female; Hospital Mortality; Humans; Male; Medical Records; Middle Aged; Monitoring, Physiologic; Prognosis; Prospective Studies; Young Adult",

year = "2009",

language = "Dansk",

volume = "171",

pages = "502--6",

journal = "Ugeskrift for Laeger",

issn = "0041-5782",

publisher = "Almindelige Danske Laegeforening",

number = "7",

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TY - JOUR

T1 - Observation af kritisk syge patienter

AU - Fuhrmann, Lone

AU - Hesselfeldt, Rasmus

AU - Lippert, Anne

AU - Perner, Anders

AU - Ostergaard, Doris

N1 - Keywords: Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Critical Illness; Female; Hospital Mortality; Humans; Male; Medical Records; Middle Aged; Monitoring, Physiologic; Prognosis; Prospective Studies; Young Adult

PY - 2009

Y1 - 2009

N2 - INTRODUCTION: The aim of this study was to estimate to which extent patients with abnormal vital signs on general wards had their vital signs monitored and documented and to establish if staff concern for patients influenced the level of monitoring and was predictive of increased mortality. MATERIAL AND METHODS: Prospective observational study at Herlev Hospital, Copenhagen, Denmark. Study personnel measured vital signs on all patients present on five wards during the evening and night and interviewed nursing staff about patients with abnormal vital signs. Subsequently, patient records were studied. RESULTS: A total of 155 patients with abnormal vital signs were identified, and staff was interviewed about 139 patients. In 61 of these 139 patients, some vital signs were measured by staff, but the respiratory rate was not measured. In 86 cases staff decided to intervene because of abnormal vital signs measured by study personnel. A total of 77% of patients had vital signs documented in their records on the day of the observation. The previous day, vital signs were documented in 70% of records and on the day after in 66%. The documentation of vital signs was significantly higher when staff expressed concern for a patient in the patient record (95% vs. 65%, chi(2): p < 0.001), but 30-day mortality did not differ significantly (15% vs. 10%, chi(2): p = 0.40). CONCLUSION: In more than half of the patients, the abnormal vital signs were not identified by staff because the vital signs were not measured. In two out of three patients, staff decided to intervene because of abnormal vital signs measured by study personnel, indicating a need to reevaluate monitoring routines at general wards. Udgivelsesdato: 2009-Feb

AB - INTRODUCTION: The aim of this study was to estimate to which extent patients with abnormal vital signs on general wards had their vital signs monitored and documented and to establish if staff concern for patients influenced the level of monitoring and was predictive of increased mortality. MATERIAL AND METHODS: Prospective observational study at Herlev Hospital, Copenhagen, Denmark. Study personnel measured vital signs on all patients present on five wards during the evening and night and interviewed nursing staff about patients with abnormal vital signs. Subsequently, patient records were studied. RESULTS: A total of 155 patients with abnormal vital signs were identified, and staff was interviewed about 139 patients. In 61 of these 139 patients, some vital signs were measured by staff, but the respiratory rate was not measured. In 86 cases staff decided to intervene because of abnormal vital signs measured by study personnel. A total of 77% of patients had vital signs documented in their records on the day of the observation. The previous day, vital signs were documented in 70% of records and on the day after in 66%. The documentation of vital signs was significantly higher when staff expressed concern for a patient in the patient record (95% vs. 65%, chi(2): p < 0.001), but 30-day mortality did not differ significantly (15% vs. 10%, chi(2): p = 0.40). CONCLUSION: In more than half of the patients, the abnormal vital signs were not identified by staff because the vital signs were not measured. In two out of three patients, staff decided to intervene because of abnormal vital signs measured by study personnel, indicating a need to reevaluate monitoring routines at general wards. Udgivelsesdato: 2009-Feb

M3 - Tidsskriftartikel

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SN - 0041-5782

VL - 171

SP - 502

EP - 506

JO - Ugeskrift for Laeger

JF - Ugeskrift for Laeger

IS - 7

ER -