Impact of the coronavirus pandemic on the patterns of vital signs recording and staff compliance with expected monitoring schedules on general wards

RESUSCITATION

卷:158

Article

Kostakis, Ina¹  Smith, Gary B.²  Prytherch, David¹  Meredith, Paul³  Price, Connor¹  Chauhan, Anoop^4,5,6 

[1] Univ Portsmouth, Ctr Healthcare Modelling Informat, Portsmouth, Hants, England

[2] Bournemouth Univ, Fac Hlth & Social Sci, Ctr Postgrad Med Res Educ CoPMRE, Bournemouth, Dorset, England

[3] Portsmouth Hosp Univ NHS Trust, Res & Innovat Dept, Portsmouth, Hants, England

[4] Portsmouth Hosp Univ NHS Trust, Res & Innovat, Portsmouth, Hants, England

[5] Portsmouth Hosp Univ NHS Trust, Portsmouth, Hants, England

[6] Univ Portsmouth, Resp Med, Portsmouth, Hants, England

关键词: Monitoring;    Vital signs;    Deterioration;    Protocol;    Rapid response system;   

DOI  :  10.1016/j.resuscitation.2020.11.014

来源: Elsevier

【 摘 要 】

Introduction: Coronavirus disease 2019 (COVID-19) placed increased burdens on National Health Service hospitals and necessitated significant adjustments to their structures and processes. This research investigated if and how these changes affected the patterns of vital sign recording and staff compliance with expected monitoring schedules on general wards. Methods: We compared the pattern of vital signs and early warning score (EWS) data collected from admissions to a single hospital during the initial phase of the COVID-19 pandemic with those in three control periods from 2018, 2019 and 2020. Main outcome measures were weekly and monthly hospital admissions; daily and hourly patterns of recorded vital signs and EWS values; time to next observation and; proportions of 'on time', 'late' and `missed' vital signs observations sets. Results: There were large falls in admissions at the beginning of the COVID-19 era. Admissions were older, more unwell on admission and throughout their stay, more often required supplementary oxygen, spent longer in hospital and had a higher in-hospital mortality compared to one or more of the control periods. More daily observation sets were performed during the COVID-19 era than in the control periods. However, there was no clear evidence that COVID-19 affected the pattern of vital signs collection across the 24-h period or the week. Conclusions: The increased burdens of the COVID-19 pandemic, and the alterations in healthcare structures and processes necessary to respond to it, did not adversely affect the hospitals' ability to monitor patients under its care and to comply with expected monitoring schedules.

【 授权许可】

Free