Dr Miriam Stoppard on the change to the NEWS protocol – checks to spot signs in hospital of deterioration – and how this could benefit patients positively
How often do you think your vital signs should be checked when you’re in hospital? My reply would be more often than they are now.
So what’s the ideal frequency? That depends on how ill you are.
And now a new study, led by researchers at Portsmouth University, goes a long way to give us answers.
Usually a patient’s blood pressure, temperature, pulse and other vital signs are checked every few hours.
In most UK hospitals, this is done to spot signs of deterioration – a protocol called NEWS – and to decide when vital signs need to be measured next.
It was designed by the Royal College of Physicians and states the more abnormal a patient’s vital signs, the more frequent checks should be.
However, checking too often can interfere with patients’ rest and sleep.
Nurses also need to plan their time to look after patients who need care.
Until now, there’s been little evidence to say how long the time between observations should be.
This new study was led by Professor Jim Briggs at Portsmouth with Prof Peter Griffiths of Southampton University, and also included Oxford University researchers. The team analysed 400,000 anonymous patient records from general wards at two hospitals between 2018 and 2021.
Both use electronic systems to record the data and calculate an “early warning score”.
They looked at the time between observations and how this affected the risk of any deterioration in patients’ condition being missed.
Prof Briggs said: “Obviously, taking observations more frequently can reduce the risk.
“But that has to be offset by the extra nursing staff workload incurred and the disturbance to the patient, especially at night. The findings show that existing practice to observe higher-risk patients more often is objectively justified.”
The study found patients with a low overall risk score could have their vital signs monitored less often, without being in danger of serious harm.
The investigators say this could free up nursing time so patients with a higher score could be monitored more often and this can be achieved without employing more staff.
Co-investigator Prof Griffiths, a former clinical nurse, believes: “Existing resources could be redeployed within a changed protocol to achieve better outcomes for some patients without compromising the safety of the rest.”
He feels the findings will help to optimise patient care and improve nursing efficiency.
“By identifying opportunities to reduce unnecessary monitoring for lower-risk patients, we can free up nursing time to focus on those who need more frequent observations, ultimately enhancing patient safety and care quality across our organisations.”
