title: Relationship between nighttime vital sign assessments and acute care transfers in the rehabilitation inpatient.
abstract: OBJECTIVE
  To investigate the role of nighttime vital sign assessment in predicting acute care transfers (ACT) from inpatient rehabilitation.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Fifty patients unexpectedly discharged to acute care underwent chart review to determine details of each ACT.
  
  
  RESULTS
  Seven of 50 ACT possessed new vital sign abnormalities at the 11 pm vital sign assessment the night before ACT. None of these seven underwent ACT during the night shift the abnormalities were detected. Two of 50 ACT were transferred between 11 pm and 6:59 am; both demonstrating normal vital sign at the 11 pm assessment. During study period, an estimated 5,607 11 pm vital sign assessments were performed.
  
  
  CONCLUSIONS
  Nighttime vital sign assessments do not seem to be a good screening tool for clinical instability in the rehabilitation hospital.
  
  
  CONCLUSIONS
  Eliminating sleep disturbance is important to the rehabilitation inpatient as inadequate sleep hinders physical performance. Tailoring vital sign monitoring to fit patents' clinical presentation may benefit this population.
authors.affiliation: Department of Physical Medicine and Rehabilitation at the Rehabilitation Institute of Michigan in the Detroit Medical Center, Wayne State University, Detroit, MI, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Pellicane
mesh_terms: D006801:Humans; D009551:Night Care / Q000379:methods*; D010360:Patient Transfer / Q000379:methods*; D012047:Rehabilitation Centers; D019145:Rehabilitation Nursing / Q000379:methods*; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000517:prevention & control / Q000534:rehabilitation*; D055986:Vital Signs
keywords: Vital signs; acute care transfer; early diagnosis; patient discharge; rehabilitation; rehabilitation nursing; sleep deprivation