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Ward and shift level nurse staffing, vital signs observations and patient outcomes: observational study using routinely collected data

Not Applicable
Completed
Conditions
Adult inpatient general wards in a large acute care hospital trust
Not Applicable
Registration Number
ISRCTN17930973
Lead Sponsor
niversity of Southampton
Brief Summary

2019 Results article in https://www.ncbi.nlm.nih.gov/pubmed/31562161 results (added 01/10/2019) 2019 Other publications in https://pubmed.ncbi.nlm.nih.gov/29978584/ (added 10/07/2023) 2018 Other publications in https://pubmed.ncbi.nlm.nih.gov/30461112/ (added 10/07/2023) 2019 Other publications in https://pubmed.ncbi.nlm.nih.gov/30782743/ (added 10/07/2023) 2018 Results article in https://pubmed.ncbi.nlm.nih.gov/30516947/ (added 10/07/2023)

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
100000
Inclusion Criteria

All adult inpatients in general wards of a large acute care hospital within a period of 6 months will be included.
Data for the study will be derived from a database of records made using the VitalPAC system, which enables nurses to record clinical data on hand held devices at the bedside. We will also use data from the Patient Administration System (PAS) and hospital laboratory records to determine rates of mortality and to adjust for patient level variation in risk. E-rostering (available from 2012 onwards) will provide workforce data from approximately 100,000 shifts available for the study.

Exclusion Criteria

All adult inpatients in general wards will be included. ITU, maternity and paediatric units are not considered.

Study & Design

Study Type
Observational
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Missed vital signs observations. A missed observation is defined as an observation that is not performed before the next observation is due. The planned frequency of observations is determined from a national protocol based on NEWS values, which identifies risk of adverse outcome.
Secondary Outcome Measures
NameTimeMethod
1. Rate of missed observations in high risk sub-groups, defined by elevated NEWS score<br>2. Absolute delay (time from observation becoming due until an observation is taken)<br>3. Relative delay (time from observation becoming due until an observation is taken expressed as a proportion of the scheduled observation frequency in minutes)<br>4. Deaths<br>5. Cardiac arrests <br>6. Unanticipated ICU admissions <br>7. Records of other assessments in electronic vital signs system
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