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