(Press-News.org) Nighttime frequency of vital signs monitoring for low-risk medical inpatients might be reduced, according to a research letter by Jordan C. Yoder, B.A. and colleagues at the University of Chicago.
Overnight vital signs are collected frequently among hospitalized patients regardless of their risk of clinical deterioration and these vital checks may have negative effects on low-risk patients such as patient distress and sleep deprivation, according to the study.
In total, 54,096 patients were included in the study, accounting for 182,828 patient-days and 1,699 adverse events between November 2008 and August 2011. Researchers investigated whether the Modified Early Warning Score (MEWS) could identify low-risk patients who might forgo overnight vital sign monitoring.
The median (midpoint) evening MEWS was 2. The adverse event rate increased with higher evening MEWS. However, the frequency of vital sign disruptions was unchanged, with a median of two vital sign checks per patient per night and at least one disruption from vital sign collection 99.3 percent of the nights regardless of MEWS category. Almost half of all nighttime vital sign disruptions (45 percent) occurred in patients with a MEWS of 1 or less.
"Given these findings, further study of approaches to tailor vital sign collection based on risk of clinical deterioration is warranted and may help improve patient experience and safety in hospitals," the study concludes.
(JAMA Intern Med. Published online July 1, 2013. doi:10.1001/jamainternmed.2013.7791. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: An author made a conflict of interest disclosure. The authors made a variety of funding disclosures. Please see article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Vital sign collection based on patient risk for clinical deterioration
ELSE PRESS RELEASES FROM THIS DATE:
Early childhood respiratory infections may be potential risk factor for type 1 diabetes mellitus
Respiratory infections in early childhood may be a potential risk factor for developing type 1 diabetes mellitus (T1D), according to a study published by JAMA Pediatrics, a JAMA Network publication. The incidence of T1D is increasing worldwide, although its etiology is not well understood. Infections have been discussed as an important environmental determinant, according to the study background. Andreas Beyerlein, Ph.D., from the Institute of Diabetes Research, Munich, Germany, and colleagues sought to determine whether early, short-term or cumulative exposures to ...
New generation electronic games boosts kids' physical activity at home
Most electronic games are no better than watching TV in terms of the body movement and energy expenditure involved, say the authors. Kids in developed countries spend an estimated 38 to 90 minutes a day playing these games. But what has not been clear is whether the newer generation "active" games, such as Sony PlayStation EyeToy and Move, dance mats, and Microsoft Xbox Kinect, are any better. The Australian researchers compared the impact of removing traditional electronic games, involving a game pad, from the home or replacing them with more active newer generation ...
1 in 5 UK NHS staff report bullying by colleagues
One in five UK NHS staff report bullying by colleagues, with almost half saying they have witnessed bullying, in the past six months, indicates research published in the online journal BMJ Open. Managers are the most common source of bullying, with workload pressures and organisational culture contributory factors, the study reveals. The findings are based on the responses of almost 3000 NHS staff (46% response rate) to a validated questionnaire (NAQ-R), designed to tease out exposure to negative and bullying behaviours. The 12 item General Health Questionnaire (GHQ-12) ...
Long term night shifts linked to doubling of breast cancer risk
Shift work has been suggested as a risk factor for breast cancer, but there has been some doubt about the strength of the findings, largely because of issues around the assessment of exposure and the failure to capture the diversity of shift work patterns. Several previous studies have also been confined to nurses rather than the general population. In this study, the researchers assessed whether night shifts were linked to an increased risk of breast cancer among 1134 women with breast cancer and 1179 women without the disease, but of the same age, in Vancouver, British ...
Supersense: It's a snap for crocs
Previously misunderstood multi-sensory organs in the skin of crocodylians are sensitive to touch, heat, cold, and the chemicals in their environment, finds research in BioMed Central's open access journal EvoDevo. These sensors have no equivalent in any other vertebrate. Crocodylians, the group that includes crocodiles, gharials, alligators and caimans, have particularly tough epidermal scales consisting of keratin and bony plates for added protection. On the head, these scales are unusual because they result from cracking of the hardened skin, rather than their shape ...
Treating TB: What needs to be done to improve treatment rates
People with tuberculosis (TB) in China often delay going to see a doctor for more than two weeks, finds research in BioMed Central's open access journal BMC Medicine. Reasons for this include a poor understanding of TB, increasing costs of treatment not covered by health insurance, and using traditional approaches first. Even after going to a clinic there were still delays in treatment, especially in rural areas, due to a lack of qualified medical staff. Worldwide TB remains a leading cause of death, and China has the second largest TB epidemic with the most number of ...
Study examines out-of hospital stroke policy at Chicago hospitals
Implementing an out-of hospital stroke policy in some Chicago hospitals was associated with significant improvements in emergency medical services use and increased intravenous tissue plasminogen activator (tPA) use at primary stroke centers, according to a study published by JAMA Neurology. The study evaluated the relationship between a citywide policy recommending pre-hospital triage of patients with suspected stroke to transport them to the nearest primary stroke center and use of intravenous tPA use. The therapy is used to restore blood flow through blocked arteries ...
Identifying climate impact hotspots across sectors
It identifies the Amazon region, the Mediterranean and East Africa as regions that might experience severe change in multiple sectors. The article is part of the outcome of the Intersectoral Impact Model Intercomparison Project (ISI-MIP) that will be featured in a special issue of PNAS later this year. "Overlapping impacts of climate change in different sectors have the potential to interact and thus multiply pressure on the livelihoods of people in the affected regions," says lead-author Franziska Piontek of the Potsdam Institute for Climate Impact Research. "This is ...
Placental cells may prevent viruses from passing from mother to baby, says Pitt/MWRI team
PITTSBURGH, July 1, 2013 – Cells of the placenta may have a unique ability to prevent viruses from crossing from an expectant mother to her growing baby and can transfer that trait to other kinds of cells, according to researchers at Magee-Womens Research Institute (MWRI) and the University of Pittsburgh School of Medicine. Their findings, published in the early online version of the Proceedings of the National Academy of Sciences, shed new light on the workings of the placenta and could point to new approaches to combat viral infections during pregnancy. It is imperative ...
Psychology influences markets
When it comes to economics versus psychology, score one for psychology. Economists argue that markets usually reflect rational behavior—that is, the dominant players in a market, such as the hedge-fund managers who make billions of dollars' worth of trades, almost always make well-informed and objective decisions. Psychologists, on the other hand, say that markets are not immune from human irrationality, whether that irrationality is due to optimism, fear, greed, or other forces. Now, a new analysis published in the XX issue of the Proceedings of the National Academy ...