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 patientís 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 nurseís 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