How Routine are Routine Vital Signs?

Abstract

BACKGROUND AND OBJECTIVES: Frequent measurement of vital signs has been associated with disruptions to sleep and increased nursing workload. Since vital signs are often measured at the same frequency regardless of patient acuity, there may be inappropriate prioritization of limited resources. We sought to understand what hospitalists report as the default frequency of routine vital sign measurement in hospitalized pediatric patients at academic institutions. METHODS: We surveyed pediatric hospital medicine leadership at Association of American Medical Colleges-affiliated medical schools on their perception of routine vital signs in general medicine inpatients. RESULTS: Survey requests were sent to individuals representing 140 unique hospitals. Responses were received from 74 hospitalists, representing a 53% response rate. Routine vitals were most commonly characterized as those collected every 4 hours (78%; 95% confidence interval, 67%–87%), though at least 1 in 5 hospitalists reported obtaining all or select vital signs (eg, blood pressure) less frequently. Strategies to decrease vital sign frequency varied. CONCLUSIONS: Our results suggest routine vital signs are not a normative concept across all patient populations in pediatrics. We further identify several conditions under which deviation from routines are sanctioned.