There is some disagreement between colleagues as to how regularly they should be attending on medically stable, long-term inpatients. Looking for any research/evidence that may be able to assist.
Yes there are disagreements.Though it is checked every 8th hourly in such patients, it is planned to suit patients freedom and time of rest.In some cases it is also checked 12th hourly i.e.at 8 am and 8 pm allowing patient to rest between 10 PM and 7AM.So should we not monitor patient at least once in the night? Do we disturb patient's sleep? Personally and professionally my opinion remains firm on checking such patient's most vital of the vital signs at least every 6th hrly.Simply because they are patients NOT outside your health facility BUT they are inside your hospital and are therefore your "Inpatients".Their every moment of well being is entrusted to us "Nurses" .Back in early 1970s when I was a student ,though there was a standing instruction of not to disturb stable long term patients in the night ,merely to check their vital signs, there was a practice among senior nurses of asking student nurses to quietly check radial pulse of sleeping patient in medical wards.To my shock once on such rounds at 2 am.I felt a warm wrist under the blanket but it was without a pulse..Upon examination ,he was found to be "Just dead ". Ever since then, in all the hospitals I have implemented continuation of the "Good Old Practice" .Remarks such as "Patient Sleeping" for not checking pulse and respiration are banned.
Thank you for your answer Snehalata. The particular patients I have in mind are the ones that have been on the ward for several months and are completely medically stable. Of course, they are checked at least hourly overnight to ensure they are still breathing. Any patients with observations outside normal range have them attended more frequently, or if their condition deteriorates in any way. I appreciate your response, you're the first to mention this practice and you certainly do have a point.
In assisting nursing students in their clinical setting at the local nursing home several years ago the staff would checks vitals once weekly and prn.
I can understand q8h inpatient, although having been a patient more then once I hate it. Once a person in in a long term care facility and that becomes their home be it temporary, rehab, or permanent, SNF, that becomes their home. We do not check our vital signs at home so why do this so frequently in a facility. Once daily, unless there is a problem I think s enough. If the person is not feeling well, or is going to therapy then they should be taken more. Doing frequent vital signs can make a person feel that there is a problem.
Thanks for your posts, everyone. I appreciate all your feedback and I agree with all of you! I'm just going to have to chat with all the people complaining and just tell them all to exercise their own common sense! Thanks again
Interesting and very useful information. How honest and true information on vital signs are our nursing staff provide? One should think of, the more we ask our staff, like asking them to keep a q4h checks on vital signs, the less and negative information is recorded. We, ourselves are the cause for the false statement of vital signs. So, how can we make our staff say honestly say of the true information?
Here it is some resources related to vital signs and possible nursing diagnoses
http://www.nursediscovery.com/publication-2/
Regards
Intan
To answer my own question, here is the link for an extract of an article I received from Medscape.
http://archinte.jamanetwork.com/article.aspx?articleid=1705722
Hi Sarah, I'm really glad I've come across your post. I'm currently exploring patient sleep within inpatient mental health environments. Although, we do not check vital signs throughout the night (unless clinically indicated) we do check on patients every hour or even every 15 minutes if the risk is high. The observation policy is there to maintain safety but severely impacts sleep and therefore patient recovery. I will use this paper to support my findings. Thank you for sharing.
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