Table 1: Reviewed studies.

Study	Sample	Method	Key findings
Ansell et al. [22]	Ten Registered Nurses from wards in three New Zealand hospitals	Semi-structured telephone interviews	· RR is missed if the patient looks stable or has been hospitalized long term · As RR cannot be measured by a machine, it takes more time to assess than other signs · Nurses are often interrupted when trying to measure RR · Experienced RNs believed they could visually assess a patient’s condition · Not measuring RR in some wards was a culture not questioned by staff
Philip et al. [23]	13 nurses, 20 junior doctors, 3 student nurses and 5 health care assistants on medical and surgical wards at one British hospital	Anonymous, self-reported questionnaire	· Most respondents believed RR is a very good indicator of patient acuity · Common reasons for not assessing RR for at least 30 seconds were lack of or perceived lack of time, laziness and lack of training or knowledge · Staff reported patients who had abnormal RRs despite a normal rate being documented · Most respondents felt that RR is not counted for at least 30 seconds when it is assessed · Many staff think that RR is estimated or guessed
Hogan [24]	RNs, Health Care Assistants and student nurses at one British hospital	Focus groups	· Patient assessment was seen as a part of routine, ritualistic practice perpetuated by a task-orientated culture · Basic education about vital signs was inconsistent and sometimes learnt by observing others · Individual nurse’s clinical judgement determined the frequency of vital signs assessment · There was a lack of clear guidance on who should measure vital signs on ward patients