Relationships between healthcare staff characteristics and the conduct of vital signs observations at night: Results of a survey and factor analysis.

Alejandra Recio‐Saucedo,Carole Fogg,Antonello Maruotti,Peter Griffiths,Greta Westwood,Gary B Smith,Paul Schmidt,Paul Meredith

doi:10.1002/nop2.179

Abstract

AimTo explore the association of healthcare staff with factors relevant to completing observations at night.DesignOnline survey conducted with registered nurses, midwives, healthcare support staff and student nurses who had worked at least one night shift in a National Health Service hospital in England.MethodsExploratory factor analysis and mixed effects regression model adjusting for role, number of night shifts worked, experience and shift patterns.ResultsSurvey items were summarized into four factors: (a) workload and resources; (b) prioritization; (c) safety culture; (d) responsibility and control. Staff experience and role were associated with conducting surveillance tasks. Nurses with greater experience associated workload and resources with capacity to complete work at night. Responses of student nurses and midwives showed higher propensity to follow the protocol for conducting observations. Respondents working night shifts either exclusively or occasionally perceived that professional knowledge rather than protocol guided care tasks during night shifts.

Highlights

The underlying reasons for the reduced frequency of measurement of vital signs on general wards at night are unclear and require ex‐ ploration (Buist & Stevens, 2013)
Descriptive analysis of the online survey revealed that 54% of staff disagreed with the statement that taking a set of vital signs observa‐ tions at night is very disruptive to sleep, which is consistent with most staff agreeing that they would wake patients up to conduct observa‐ tions
The findings reported here were examined in a qualitative study aimed at exploring factors related to adherence with the early warning score systems (EWS) pro‐ tocol at night

Summary

Introduction

The underlying reasons for the reduced frequency of measurement of vital signs on general wards at night are unclear and require ex‐ ploration (Buist & Stevens, 2013). Vital signs measurement can be time‐consuming (Mok, Wang, Cooper, Ang, & Liaw, 2015; Yeung, Lapinsky, Granton, Doran, & Cafazzo, 2012), especially when staffing is reduced (Hogan, 2006); challenges are further compounded by alterations in staff skill mix (Wheatley, 2006). These obstacles may lead to reduced compliance with proto‐ cols. Rou‐ tine night‐time vital sign monitoring interferes with sleep and sleep disruptions are associated with several adverse clinical outcomes (Sharda, Carter, Wingard, & Mehta, 2001; Yoder, Yuen, Churpek, Arora, & Edelson, 2013)

Objectives

Findings

Discussion

Conclusion