title: Flash mob research: a single-day, multicenter, resident-directed study of respiratory rate.
abstract: BACKGROUND
  Vital signs are critical data in the care of hospitalized patients, but the accuracy with which respiratory rates are recorded in this population remains uncertain. We used a novel flash mob research approach to evaluate the accuracy of recorded respiratory rates in inpatients.
  
  
  METHODS
  This was a single-day, resident-led, prospective observational study of recorded vs directly observed vital signs in nonventilated patients not in the ICU on internal medicine teaching services at six large tertiary-care centers across the United States.
  
  
  RESULTS
  Among the 368 inpatients included, the median respiratory rate was 16 breaths/min for the directly observed values and 18 breaths/min for the recorded values, with a median difference of 2 breaths/min (P &lt; .001). Respiratory rates of 18 or 20 breaths/min accounted for 71.8% (95% CI, 67.1%-76.4%) of the recorded values compared with 13.0% (95% CI, 9.5%-16.5%) of the directly observed measurements. For individual patients, there was less agreement between the recorded and the directly observed respiratory rate compared with pulse rate.
  
  
  CONCLUSIONS
  Among hospitalized patients across the United States, recorded respiratory rates are higher than directly observed measurements and are significantly more likely to be 18 or 20 breaths/min.
authors.affiliation: Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Semler
authors.affiliation: Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Stover
authors.affiliation: Department of Medicine, Stanford University Medical Center, Stanford, CA.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Copland
authors.affiliation: Department of Medicine, Pritzker School of Medicine, The University of Chicago, Chicago, IL.
authors.forename: Gina
authors.initials: G
authors.lastname: Hong
authors.affiliation: Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Johnson
authors.affiliation: Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kriss
authors.affiliation: Department of Medicine, Washington University School of Medicine, St Louis, MO.
authors.forename: Hannah
authors.initials: H
authors.lastname: Otepka
authors.affiliation: Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Christman
authors.affiliation: Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Electronic address: todd.rice@vanderbilt.edu.
authors.forename: Todd W
authors.initials: TW
authors.lastname: Rice
mesh_terms: D035843:Biomedical Research / Q000379:methods; D016009:Chi-Square Distribution; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D007297:Inpatients; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D008297:Male; D011446:Prospective Studies; D056152:Respiratory Rate; D018709:Statistics, Nonparametric; D014481:United States