An observational study of monitoring of vital signs in children admitted to Kenyan hospitals: an insight into the quality of nursing care?

Measurement and correct interpretation of vital signs is part of routine clinical care. Repeated measurement enhances early recognition of deterioration, may help prevent morbidity and mortality and is a standard of care in most countries. To examine documentation of vital signs by clinicians for ad...

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Bibliographic Details
Published in:Journal of global health 2018-06, Vol.8 (1), p.010409-010409
Main Authors: Ogero, Morris, Ayieko, Philip, Makone, Boniface, Julius, Thomas, Malla, Lucas, Oliwa, Jacquie, Irimu, Grace, English, Mike
Format: Article
Language:English
Subjects:
Body Temperature
Child, Preschool
Documentation - statistics & numerical data
Female
Global health
Heart Rate
Hospitals - statistics & numerical data
Humans
Infant
Kenya
Male
Medical records
Mortality
Nursing care
Nursing Care - standards
Observational studies
Patient Admission
Pediatrics
Quality of Health Care
Respiratory Rate
Studies
Vital Signs
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Summary:Measurement and correct interpretation of vital signs is part of routine clinical care. Repeated measurement enhances early recognition of deterioration, may help prevent morbidity and mortality and is a standard of care in most countries. To examine documentation of vital signs by clinicians for admissions to paediatric wards in Kenyan hospitals, to describe monitoring frequency by nurses and explore factors influencing frequency. Vital signs information (temperature, respiratory and pulse rate) for the first 48 hours of admission was collected from case records of children admitted with non-surgical conditions to 13 Kenyan county hospitals between September 2013 and April 2016. A mixed effect negative binomial regression model was used to explore whether the severity of illness (indicated by danger signs or severe diagnostic episodes) is associated with increased vital signs observation frequency. We examined 54 800 admission episodes with an overall mortality 6.1%. Nurse to bed ratios were very low (1:10 to 1:41 across hospitals). Admitting clinicians documented all or no vital signs in 57.0% and 8.4% cases respectively. For respiratory and pulse rates there was pronounced even end-digit preference (an indicator of incorrect information) and high frequency recording of specific values (  
ISSN:2047-2978
2047-2986
DOI:10.7189/jogh.08.010409