Electronic vs manual vital sign monitoring

Optional compatible weight scales e. Study Objective The primary purpose of this study was to understand the difference between the time it takes to manually collect, document, transcribe, and have access to vital signs data in an EMR and the time it takes to collect, document, and have access to the data using Welch Allyn CVSM automated connectivity to the EMR. Clinicians were also asked to provide feedback on satisfaction and ease of use of the technology and software.

A secondary objective of this study was to determine clinician satisfaction with the Welch Allyn CVSM and automated vitals collection process. This time was measured for both the manual process and the automated process across patients in each process category. A comparison of the times from the manual collection and entry of vital signs and the automated collection and entry of vital signs was completed. The study design included observation of vital signs monitoring collection or capture by clinicians, in this case registered nurses working for the physicians.

Each clinician that was fully trained and participated in our study completed a post-study survey to assess clinician satisfaction and a direct comparison of the two processes. Three registered nurses who signed informed consent from the Oshawa Clinic recorded the vital signs for patients who agreed to participate in the study. Study participants were patients over the age of 18 who had the ability to provide informed consent for participation in the study or had informed consent given by their legally authorized representative.

The patients must not have shown any signs of severe pain or physical trauma, severe emotional distress, or agitation in order to be eligible for the study. Patients were introduced to the study while waiting in the clinic waiting room and asked if they were willing to participate in the study, and given an opportunity to sign an informed consent letter.

During regular daily practice at the clinic, the registered nurse typically collects the vital signs before the patient has been assigned to a particular physician.

This practice was followed for the study and as a result the study design did not affect the sequencing of patients seeking treatment. Completion occurred either at the time the data were sent from the Welch Allyn device or the time save was selected after manual data entry to the EMR. If only one or two readings are considered without adequate rest, a white coat effect would interfere with recordings, as seen with the first two readings taken by BpTRU device.

Manual BP recording is highly dependent to environment condition. BP will be detected higher when taken by physicians instead of nurses, in treatment settings in comparison to non-treatment settings and at office instead of home. The results of this study suggested that manual method in measurement of BP frequently show higher BP, especially in patients admitted to hospitals - affecting up to 15 mmHg higher - and is strongly associated with age, sex, different disease, and obesity.

Based on this study, we cannot completely trust to automatic findings in measurement of BP in hospital setting and especially in critical conditions, and manual method should be considered as a reference standard. Conflicts of Interest. National Center for Biotechnology Information , U.

ARYA Atheroscler. Ahmad Mirdamadi 1 and Mostafa Etebari 2. Author information Article notes Copyright and License information Disclaimer.

Correspondence to: Mostafa Etebari, Email: moc. Received Jan 3; Accepted Sep 4. This article has been cited by other articles in PMC. Introduction Accuracy of blood pressure BP measurement in clinical settings is one of the most concerns despite of considerable promotion in measurement techniques. Results During the enrollment period, adults were seen in the CCU, ICU, and emergency department, and agreed to participate in our study.

Open in a separate window. Discussion Based on our knowledge, this is the first independent, prospective, observational study on the potential association between BP measurement method and BP levels in Iran. Conclusion The results of this study suggested that manual method in measurement of BP frequently show higher BP, especially in patients admitted to hospitals - affecting up to 15 mmHg higher - and is strongly associated with age, sex, different disease, and obesity.

Footnotes Conflicts of Interest Authors have no conflict of interests. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Measurement of blood pressure in the office: Recognizing the problem and proposing the solution.

How long shall the patient rest before clinic blood pressure measurement? Am J Hypertens. Giles TD, Egan P. Pay adequately for what works: The economic undervaluation of office and ambulatory blood pressure recordings. J Clin Hypertens Greenwich ; 10 4 —9. Prevalence of white coat effect in treated hypertensive patients in the community.

Females ages 12 and older, in general, tend to have faster heart rates than do males. Athletes, such as runners, who do a lot of cardiovascular conditioning, may have heart rates near 40 beats per minute and experience no problems. As the heart forces blood through the arteries, you feel the beats by firmly pressing on the arteries, which are located close to the surface of the skin at certain points of the body.

The pulse can be found on the side of the neck, on the inside of the elbow, or at the wrist. For most people, it is easiest to take the pulse at the wrist. If you use the lower neck, be sure not to press too hard, and never press on the pulses on both sides of the lower neck at the same time to prevent blocking blood flow to the brain.

When taking your pulse:. Using the first and second fingertips, press firmly but gently on the arteries until you feel a pulse.

Count your pulse for 60 seconds or for 15 seconds and then multiply by four to calculate beats per minute. If your doctor has ordered you to check your own pulse and you are having difficulty finding it, consult your doctor or nurse for additional instruction. The respiration rate is the number of breaths a person takes per minute. The rate is usually measured when a person is at rest and simply involves counting the number of breaths for one minute by counting how many times the chest rises.

Respiration rates may increase with fever, illness, and other medical conditions. When checking respiration, it is important to also note whether a person has any difficulty breathing. Normal respiration rates for an adult person at rest range from 12 to 16 breaths per minute.

Blood pressure is the force of the blood pushing against the artery walls during contraction and relaxation of the heart. Each time the heart beats, it pumps blood into the arteries, resulting in the highest blood pressure as the heart contracts. When the heart relaxes, the blood pressure falls. Two numbers are recorded when measuring blood pressure. The higher number, or systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood through the body.

The lower number, or diastolic pressure, refers to the pressure inside the artery when the heart is at rest and is filling with blood. Both the systolic and diastolic pressures are recorded as "mm Hg" millimeters of mercury. This recording represents how high the mercury column in an old-fashioned manual blood pressure device called a mercury manometer or sphygmomanometer is raised by the pressure of the blood.

Today, your doctor's office is more likely to use a simple dial for this measurement. High blood pressure , or hypertension, directly increases the risk of heart attack, heart failure, and stroke. With high blood pressure, the arteries may have an increased resistance against the flow of blood, causing the heart to pump harder to circulate the blood. Elevated blood pressure is systolic of to and diastolic less than Stage 1 high blood pressure is systolic is to or diastolic between 80 to What are Vital Signs?

Heart Rate Pulse Heart rate, or pulse, is the number of times a heart beats per minute bpm. To take heart rate: 1. Wash your hands. Make sure that individual is at rest before you begin. With an analog clock or watch, wait until the second hand is on the Begin counting the beats of the pulse.

Respiration Rate Respiration rate, sometimes referred to as breathing rate, is the number of breaths taken per minute. To take respiration rate: 1. Document respiration rate, noting any observations such as wheezing.

Body Temperature Put simply, body temperature is the amount of heat in the body. To take body temperature using a digital thermometer: 1. Press button to set the thermometer. Place thermometer under tongue and instruct individual to close mouth. Wait several minutes, remove thermometer when beeping indicates the reading is complete. Clean and sterilize the thermometer. Blood Pressure Blood pressure is a reading of how effectively the oxygenating blood is moving through the blood vessels of the circulatory system.

To take blood pressure using a stethoscope, cuff and aneroid monitor: 1. Check to make sure that the blood pressure monitor is in good working order. Place fingers on the underside of the elbow to locate pulse called the brachial pulse. Turn the knob on the air pump clockwise to close the valve. Pump air, inflating the arm cuff until the dial pointer reaches As the dial pointer falls, watch the number and listen for a thumping sound.

Note the number shown where the first thump is heard systolic pressure. Note the number shown where the last thump is heard diastolic pressure.