Wangdi Sherab, Guragai Kashap, Namgay Pema, Dorji Jamyang, Wangchuk Kesang
Emergency Department, Eastern Regional Referral Hospital, Mongar, Bhutan
Emergency Department, Eastern Regional Referral Hospital, Mongar, Bhutan.
BMJ Open Qual. 2025 May 30;13(Suppl 1):e003151. doi: 10.1136/bmjoq-2024-003151.
Vital signs are key indicators of a patient's physiological status. It includes blood pressure, temperature, pulse rate, respiration rate and oxygen saturation (SPO). Derangements in vital signs are associated with an increased risk of morbidity and mortality, and thus serve as important indicators for risk stratification and early detection of clinical deterioration. Despite this, several studies have indicated that vital signs are not consistently recorded, which can have a significant impact on the effectiveness of the rapid response system. A baseline study in our emergency room showed that the rate of complete assessment and documentation is only 40%.
A quality improvement initiative was undertaken to improve the initial vital signs assessment and documentation in the Emergency Department of a Regional Referral hospital for a duration of 10 weeks. Our team implemented four cycles of intervention which were based on a baseline survey, analysis of plan-do-study-act cycles, previous similar projects and discussion within the group.
The interventions included sensitisation about the vital signs, making monitoring equipment easily available and redesigning areas for assessment and documentation.
The rate of complete assessment and documentation of vital signs increased significantly from 40% to 97% at the end of the 10 week period.
生命体征是患者生理状态的关键指标。它包括血压、体温、脉搏率、呼吸频率和血氧饱和度（SPO）。生命体征紊乱与发病和死亡风险增加相关，因此是风险分层和临床病情恶化早期检测的重要指标。尽管如此，多项研究表明生命体征记录并不一致，这可能对快速反应系统的有效性产生重大影响。我们急诊室的一项基线研究表明，完整评估和记录的比例仅为40%。
在一家区域转诊医院的急诊科开展了一项质量改进举措，为期10周，以改善初始生命体征评估和记录。我们的团队基于基线调查、计划-执行-研究-行动循环分析、以往类似项目以及小组内讨论，实施了四个干预周期。
干预措施包括提高对生命体征的认识、使监测设备易于获取以及重新设计评估和记录区域。
在10周结束时，生命体征的完整评估和记录率从40%显著提高到了97%。
