Pediatric vital signs monitoring in hospital wards: Recognition systems and factors influencing nurses' attitudes and practices

To describe: 1) systems in place for recognition and response to deteriorating children in Italy, 2) attitudes and practices of registered nurses (RN) towards vital signs (VS) monitoring in pediatric wards, 3) the associations of nurses attitudes and pratices with nurses' and organizational cha...

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Bibliographic Details
Published in:Journal of pediatric nursing 2023-11, Vol.73, p.e602-e611
Main Authors: Thekkan, Kiara Ros, Genna, Catia, Ferro, Federico, Cecchetti, Corrado, Dall'Oglio, Immacolata, Tiozzo, Emanuela, Raponi, Massimiliano, Gawronski, Orsola, Querciati, Alessandra, Ciaralli, Italo, Renzetti, Tommaso, Pomponi, Manuel, Gargano, Daniele, Cirulli, Luisa, Roberti, Marco, Portanova, Anna, Iula, Angela, Bevilacqua, Patrizia, Bergadano, Anna, Zimermann, Daniela, Calza, Simona, Leo, Rossana, Schreiber, Silvana, Buchini, Sara, La Bianca, Regina, Volta, Laura, Manzoni, Sara, Morandi, Francesco, Lubrano, Riccardo, Rocco, Gennaro
Format: Article
Language:English
Subjects:
Attitude of Health Personnel
Attitudes
Child
Cross-Sectional Studies
Health Knowledge, Attitudes, Practice
Hospitals
Humans
Nurses
Nursing Staff, Hospital
Pediatric nursing
Physiologic monitoring
Surveys and Questionnaires
Vital Signs
Workload
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Summary:To describe: 1) systems in place for recognition and response to deteriorating children in Italy, 2) attitudes and practices of registered nurses (RN) towards vital signs (VS) monitoring in pediatric wards, 3) the associations of nurses attitudes and pratices with nurses' and organizational characteristics. A multicentre cross-sectional correlational study. Data were collected between January–May 2020 using: an adapted version of the ‘Survey on Recognition and Response Systems in Australia’, and the ‘Ped-V Scale’. Descriptive and adjusted linear regression analysis was performed, accounting for clustering. Ten Italian hospitals participated, 432 RNs responded to the Ped-V scale (response rate = 52%). Five (50%) hospitals had a VS policy in place, three hospitals (30%) had a Pediatric Early Warning System (PEWS), almost all hospitals had a system in place to respond to deteriorating children. Following multivariate regression analysis, having a PEWS was significantly associated with Ped-V scale ‘Workload’, ‘Clinical competence’, ‘Standardization’ dimensions; gender was associated with ‘key indicators’ and pediatric surgical ward with ‘Clinical competence’. The use of VS policies and PEWS was not consistent across hospitals caring for children in Italy. Nurses' attitudes and practices (i.e., perception of workload, and clinical competence) were significantly lower in hospitals with increased complexity of care/PEWS. Gender was significantly associated with knowledge scores. System strategies to improve nurses' attitudes and practices towards VS monitoring and education are warranted to support effective behaviors towards VS monitoring, their interpretation, and appropriate communication to activate the efferent limb of the rapid response system. •In Italy, pediatric early warning systems and vital signs guidelines are not systematically in place•The Ped-V Scale measures attitudes towards vital signs accuracy, communication, and knowledge•Exploring attitudes towards vital signs monitoring is essential for quality improvement•Having a pediatric early warning system is associated with increased standardization of care•Gender is associated with less knowledge about key indicators of deterioration
ISSN:0882-5963
1532-8449
DOI:10.1016/j.pedn.2023.10.041