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Are patients fulfilling MET criteria recognized?
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine volume 17, Article number: O19 (2009)
Introduction
The aim of this study was to estimate to which extent patients with abnormal vital signs (defined as modified MET criteria [1, 2]) on general wards had their vital signs monitored and documented and to establish if staff concern for patients influenced the level of monitoring and was predictive of increased mortality.
Methods
Prospective observational study at Herlev University Hospital, Copenhagen, Denmark. Study personnel measured vital signs on all patients present on five wards during the evening and interviewed nursing staff about patients with abnormal vital signs. Subsequently, patient records were studied.
Results
A total of 155 patients with abnormal vital signs were identified, and nursing staff was interviewed about 139 patients. In 61 of these 139 patients, one or more vital signs were measured by the evening nursing staff. The respiratory rate was not measured by nursing staff. In 86 cases staff decided to intervene because of abnormal vital signs measured by study personnel. A total of 77% of patients had vital signs documented in their records on the day of the observation. The documentation of vital signs was significantly higher when staff expressed concern for a patient in the patient record (95% vs. 65%, chi(2): p < 0.001), but 30-day mortality did not differ significantly (15% vs. 10%, chi(2): p = 0.40).
Conclusion
More than half of the patients fulfilling MET criteria were not recognized by staff, because the vital signs were not measured. In two out of three patients, nursing staff decided to intervene when notified of abnormal vital signs measured by study personnel, indicating a need to reevaluate monitoring routines at general wards.
References
- 1.
Fuhrmann L, Hesselfeldt L: Ugeskr Laeger. 2009, 171 (7): 502-6. (article in danish).
- 2.
Buist M, Bernard S: Resuscitation. 2004, 62: 137-41. 10.1016/j.resuscitation.2004.03.005.
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Correspondence to R Hesselfeldt.
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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Hesselfeldt, R., Fuhrmann, L., Lippert, A. et al. Are patients fulfilling MET criteria recognized?. Scand J Trauma Resusc Emerg Med 17, O19 (2009) doi:10.1186/1757-7241-17-S3-O19
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Keywords
- Observational Study
- Respiratory Rate
- Emergency Medicine
- Vital Sign
- Nursing Staff
