Intermountain Primary Children's Hospital, 100 Mario Capecchi Dr, Salt Lake City, UT 84113, United States of America.
J Pediatr Nurs. 2023 Nov-Dec;73:e10-e18. doi: 10.1016/j.pedn.2023.07.002. Epub 2023 Jul 11.
Overnight vital signs are typically taken every four hours on pediatric acute care units, despite limited evidence supporting the efficacy of this practice. Vital signs are often ordered and collected without considering the patient's clinical status or potential impact that they may have on sleep. We sought to understand the impact that overnight vital sign monitoring has on sleep duration and disruptions among hospitalized children in an acute care setting.
We conducted a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols extension for scoping reviews (PRISMA-ScR). Studies were included if they addressed the relationship between vital signs monitoring and sleep among children hospitalized in an acute care unit.
Eleven studies from 2012 to 2022 were included in the final review.
Vital signs monitoring is the most common sleep disruptor among hospitalized children in acute care units and early evidence suggests that minimizing overnight vital signs may be a safe intervention for clinically stable children. Methods for measuring sleep duration and disruptions are heterogenous and validated tools are not often used. Finally, nurses report comfort with forgoing overnight vital signs when their patient's clinical status is stable.
Despite a lack of evidence regarding the efficacy of every 4 h vital signs, overnight vital signs monitoring is consistently the greatest disruptor to sleep for hospitalized children.
Nurses should play a central role in guiding vital signs monitoring that maintains safety and improves sleep in hospitalized children.
尽管有限的证据支持这种做法的有效性，但儿科急症护理单元通常每四个小时测量一次夜间生命体征。生命体征通常是在不考虑患者临床状况或可能对睡眠产生影响的情况下进行医嘱和采集的。我们试图了解夜间生命体征监测对急性护理环境中住院儿童的睡眠持续时间和干扰的影响。
我们使用系统评价和荟萃分析报告规范扩展（PRISMA-ScR）进行了范围综述。如果研究涉及生命体征监测与急性护理单元住院儿童睡眠之间的关系，则将其纳入研究。
最终综述纳入了 2012 年至 2022 年的 11 项研究。
生命体征监测是急性护理单元住院儿童中最常见的睡眠干扰因素，早期证据表明，最大限度地减少夜间生命体征监测可能是临床稳定儿童的安全干预措施。测量睡眠持续时间和干扰的方法具有异质性，并且通常不使用经过验证的工具。最后，当患者的临床状况稳定时，护士报告愿意放弃夜间生命体征监测。
尽管每 4 小时测量一次生命体征的效果缺乏证据，但夜间生命体征监测始终是住院儿童睡眠的最大干扰因素。
护士应在指导生命体征监测方面发挥核心作用，以确保住院儿童的安全并改善其睡眠。
