School of Health Sciences, University of Southampton, Southampton, UK.
National Institute for Health Research Applied Research Collaboration (NIHR ARC) Wessex, Southampton, UK.
J Clin Nurs. 2020 Jul;29(13-14):2053-2068. doi: 10.1111/jocn.15202. Epub 2020 Feb 3.
To synthesise evidence regarding the time nurses take to monitor and record vital signs observations and to calculate early warning scores.
While the importance of vital signs' monitoring is increasingly highlighted as a fundamental means of maintaining patient safety and avoiding patient deterioration, the time and associated workload involved in vital signs activities for nurses are currently unknown.
Systematic review.
A literature search was performed up to 17 December 2019 in CINAHL, Medline, EMBASE and the Cochrane Library using the following terms: vital signs; monitoring; surveillance; observation; recording; early warning scores; workload; time; and nursing. We included studies performed in secondary or tertiary ward settings, where vital signs activities were performed by nurses, and we excluded qualitative studies and any research conducted exclusively in paediatric or maternity settings. The study methods were compliant with the PRISMA checklist.
Of 1,277 articles, we included 16 papers. Studies described taking vital signs observations as the time to measure/collect vital signs and time to record/document vital signs. As well as mean times being variable between studies, there was considerable variation in the time taken within some studies as standard deviations were high. Documenting vital signs observations electronically at the bedside was faster than documenting vital signs away from the bed.
Variation in the method(s) of vital signs measurement, the timing of entry into the patient record, the method of recording and the calculation of early warning scores values across the literature make direct comparisons of their influence on total time taken difficult or impossible.
There is a very limited body of research that might inform workload planning around vital signs observations. This uncertainty means the resource implications of any recommendation to change the frequency of observations associated with early warning scores are unknown.
综合有关护士监测和记录生命体征观察结果并计算早期预警评分所需时间的证据。
虽然生命体征监测的重要性日益凸显，是维护患者安全和避免病情恶化的基本手段，但目前尚不清楚护士进行生命体征活动所需的时间和相关工作量。
系统评价。
截至 2019 年 12 月 17 日，我们在 CINAHL、Medline、EMBASE 和 Cochrane Library 中使用以下术语进行了文献检索：生命体征；监测；监测；观察；记录；早期预警评分；工作量；时间；护理。我们纳入了在二级或三级病房进行的研究，其中护士进行生命体征活动，并排除了定性研究和仅在儿科或产科环境中进行的任何研究。研究方法符合 PRISMA 清单的要求。
在 1277 篇文章中，我们纳入了 16 篇论文。研究描述了测量/收集生命体征和记录/记录生命体征所需的时间。由于研究之间的平均时间存在差异，而且某些研究中的时间差异也很大，标准差很高，因此记录生命体征观察结果在床边进行比在床边之外进行要快。
文献中生命体征测量方法、进入患者记录的时间、记录方法和早期预警评分值的计算存在差异，使得直接比较它们对总时间的影响变得困难或不可能。
关于生命体征观察工作量规划的研究非常有限。这种不确定性意味着，改变与早期预警评分相关的观察频率的任何建议的资源影响是未知的。
