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Vital signs are vital for a reason

Healthcare assistants need to record patient observations accurately and consistently, writes Robin Lewis

In many acute clinical areas, physiological measurements are undertaken regularly by healthcare assistants (HCAs), but are often regarded as a routine task with a low priority.

Evidence suggests that patient deterioration, which can be detected by changes in vital signs, is still not always recognised or acted on by staff.

Guidelines from the National Institute for Health and Clinical Excellence advise that hospital patients should have their vital signs measured on initial assessment, and at identified intervals thereafter depending on the person's particular condition.

Vital signs are respiration rate, oxygen saturation, pulse rate, blood pressure, temperature and level of consciousness. An indepth knowledge of normal physiological parameters and an ability to measure these safely and effectively are essential.

A track-and-trigger early warning scoring system is now recommended universally to identify the early signs of patient deterioration. The aim of this type of system is to detect changes or trends in a patient's vital signs, and to ensure that these are dealt with appropriately by the ward team.

Staff must be competent in recording patient information and vital signs, recognising abnormal values and intervening at a level appropriate to the patient's condition.

The HCA's role in the team is usually that of recorder. In the chain of response to the deteriorating patient, the recorder measures and records vital signs together with the early warning score. These measurements must be carried out and recorded accurately and consistently, using appropriate equipment and documents.

If the patient's condition is causing concern, the HCA's responsibility is to record values in the nursing notes and to communicate this information to a qualified professional clearly and accurately, so that timely and appropriate help can be given.

About the author
Robin Lewis is a research fellow at Sheffield Hallam University

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