title: The factors that affect the frequency of vital sign monitoring in the emergency department.
abstract: BACKGROUND
  Vital signs are an important component of the nursing assessment and are used as early warning signs of changes in a patient's condition; however, little research has been conducted to determine how often vital signs are monitored in the emergency department. Additionally, it has not been determined what personal, social, and environmental factors affect the frequency of vital sign monitoring. The purpose of this study was to examine what factors may influence the time between recording vital signs in the emergency department.
  
  
  METHODS
  We performed a descriptive, retrospective chart review of 202 randomly selected adult ED patients' charts from representative times to capture a variety of ED levels of occupancy in an urban, Midwestern, teaching hospital. Descriptive and hierarchical regression analyses were used.
  
  
  RESULTS
  The strongest predictor of the increased time between vital signs from the personal health factors was lower patient acuity (Emergency Severity Index). This relationship remained strong even when social factors and environmental factors were included. Increased length of stay and fewer routes of medications also had significant relationships to the increased time between vital sign monitoring.
  
  
  CONCLUSIONS
  These findings are clinically important because greater time between vital sign recordings can lead to errors of omission by not detecting changes in vital signs that could reveal changes in the patient's condition. The findings of this study provide direction for future research focusing on determining whether higher frequency of vital signs surveillance contributes to higher quality care and linking quality of care to missing vital signs/inadequate monitoring.
authors.affiliation: Cleveland, OH. Electronic address: kimj74@gmail.com.
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: Johnson
authors.affiliation: Cleveland, OH.
authors.forename: Chris
authors.initials: C
authors.lastname: Winkelman
authors.affiliation: Cleveland, OH.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Burant
authors.affiliation: Cleveland, OH.
authors.forename: Mary
authors.initials: M
authors.lastname: Dolansky
authors.affiliation: Cleveland, OH.
authors.forename: Vicken
authors.initials: V
authors.lastname: Totten
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D062072:Patient Acuity; D012189:Retrospective Studies; D013997:Time Factors; D055986:Vital Signs / Q000502:physiology*; D055815:Young Adult
keywords: Crowding; Emergency Severity Index; Emergency department; Frequency of vital signs; Monitoring; Vital signs