title: Why don't nurses monitor the respiratory rates of patients?
abstract: Early warning systems (EWS) are being introduced to acute ward areas across the country to support the early recognition of patients at risk of developing a critical illness. All the systems are based on the monitoring of physiological observations of pulse, blood pressure, temperature, respirations and consciousness level. The main problem identified when attempting to introduce an early warning system to the acute general ward areas in one hospital was the general paucity of monitoring of patients observations by the nursing team. Respiratory rate was identified as the one parameter which nursing staff recorded less than 50% of the time. This qualitative study used focus groups in an attempt to understand the reasons behind the paucity in patient observation practice and explore the nurses' values and beliefs about patient monitoring within the context of care. The study identified four major factors associated with the paucity of patient monitoring: organization of nursing care activities, development of nursing observation skills, clinical decision making processes and equipment management issues.
authors.affiliation: Critical Care Outreach Service, Pennine Acute NHS Trust, North Manchester General Hospital.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Hogan
mesh_terms: D001291:Attitude of Health Personnel; D001795:Blood Pressure Determination / Q000451:nursing; D001831:Body Temperature; D002983:Clinical Competence; D003243:Consciousness; D016638:Critical Illness / Q000451:nursing*; D003657:Decision Making; D042241:Early Diagnosis; D004509:Education, Nursing, Continuing; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods / Q000451:nursing*; D009042:Motivation; D009730:Nursing Assessment / Q000379:methods*; D009728:Nursing Assistants / Q000193:education / Q000523:psychology*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology*; D019370:Observation / Q000379:methods; D011674:Pulse; D036301:Qualitative Research; D012119:Respiration; D012307:Risk Factors; D012720:Severity of Illness Index