Barriers To Obtaining A Full Set Of Vital Signs In The Emergency Department
INTRODUCTION: Vital signs are essential in the evaluation of patients in the Emergency Department (ED), yet they may be incompletely measured or recorded. The objective of this study was to identify perceived barriers to collecting and entering vital signs at the ED triage station within 10 minutes of patient arrival.
METHODS: Anonymous paper surveys consisting of demographic questions and a ranking matrix for 13 items were administered to nurses and technicians at one hospital ED. Data were entered in REDCap and analyzed in SAS v9.4. Categorical data was reported as frequency (percent). Unranked items were scored as 13, and the average of the ranks were ordered from greatest perceived barrier to least as identified by average rank.
RESULTS: Thirty-nine usable survey responses were returned (response rate = 39%). Sixty-four percent of respondents were nurses and 36% were technicians. The most frequently ranked responses were: 1) the patient was uncooperative with attempts to obtain vital signs or with the triage process (74%); 2) missing or broken equipment (59%); and 3) the patient was too ill or injured to complete vital signs (49%). Seventy-four percent reported collecting a full set of vital signs for more than 80% of patients triaged.
DISCUSSION: We identified the most frequent barriers to obtaining vital signs within ten minutes of patient arrival in the ED. The most common perceived barrier was uncooperative patients. This information can be used to direct future interventions that improve complete, early acquisition of vital signs in the ED.