Frequency of observations (FOBS)
Research type
Research Study
Full title
Safer and more efficient vital signs monitoring to identify the deteriorating patient: An observational study towards deriving evidence-based protocols for patient surveillance on the general hospital ward
IRAS ID
253229
Contact name
Jim Briggs
Contact email
Sponsor organisation
University of Portsmouth
ISRCTN Number
ISRCTN10863045
Clinicaltrials.gov Identifier
10863045, ISRCTN
Duration of Study in the UK
2 years, 6 months, 0 days
Research summary
Taking measurements of heart rate, blood pressure, temperature and other “vital signs” is an important part of care for nearly all patients in hospital. Staff and patients often refer to this as taking observations. Changes in observations are used to track recovery and can show when someone’s condition is getting worse and needs urgent attention. When changes are spotted early, medical staff can often prevent serious deterioration, provide early treatment and avoid serious consequences including death. However, taking observations can be burdensome to patients, interfering with rest and sleep, which are also important to recovery. Frequent observations also cause more work for nursing staff. At the moment, there is little evidence to guide hospital staff on how frequently to take observations.
In the UK, the Royal College of Physicians and the National Institute for Clinical Excellence recommend that vital signs observations are combined into a single score (NEWS) that shows when the measurements are abnormal. There is now some evidence to support using the NEWS score to identify patients at increased risk of cardiac arrest, death or unexpected transfer to intensive care, so that staff can take preventative action. The guidance is also that the higher the NEWS score, the more often a patient should be observed. Although it is recommended that people with higher scores need more frequent observation, there is no direct evidence for this. We need to find out how often we need to monitor patients. Moreover, some observations could be unnecessary or too far apart to be useful in spotting deterioration.
Our study aims to address this by developing a protocol for how frequently observations should be made.
REC name
South Central - Berkshire Research Ethics Committee
REC reference
19/SC/0190
Date of REC Opinion
7 May 2019
REC opinion
Favourable Opinion