Supporting the detection of patient deterioration: observation chart design affects the recognition of abnormal vital signs

Preece, Megan H. W., Hill, Andrew, Horswill, Mark S. and Watson, Marcus O. (2012) Supporting the detection of patient deterioration: observation chart design affects the recognition of abnormal vital signs. Resuscitation, 83 9: 1111-1118. doi:10.1016/j.resuscitation.2012.02.009

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Author Preece, Megan H. W.
Hill, Andrew
Horswill, Mark S.
Watson, Marcus O.
Title Supporting the detection of patient deterioration: observation chart design affects the recognition of abnormal vital signs
Journal name Resuscitation   Check publisher's open access policy
ISSN 0300-9572
1873-1570
Publication date 2012-09-01
Sub-type Article (original research)
DOI 10.1016/j.resuscitation.2012.02.009
Volume 83
Issue 9
Start page 1111
End page 1118
Total pages 8
Place of publication Shannon, Co. Clare, Ireland
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Aim: To evaluate the effect of observation chart design on the ability of health professionals and novice chart users to recognise patient deterioration.

Methods: Participants were 45 health professionals (doctors and nurses) and 46 novices. Each participant completed 48 trials in which they viewed realistic patient observations recorded on six hospital observation charts of differing design quality. Each chart design was used on eight trials, four times with normal data and four times with abnormal data. On each trial, the participant's task was to identify any abnormal observation or else to indicate that all observations were normal (based on normal physiological ranges given in the instructions). The main outcome measures were participants’ error rates and response times for detecting abnormal observations on each of the six charts.

Results: There was a significant effect of chart type on error rates (p < 0.001), but health professionals made the same number of errors as novices (p = 0.43). Chart type also had a significant effect on response times (p < 0.001). Health professionals responded faster overall than novices (p = 0.006); however, a significant interaction between chart type and participant group (p = 0.02) indicated that the health professionals’ advantage was confined to the two most rudimentary charts. No significant differences were found between doctors and nurses on either measure.

Conclusions: Our findings suggest that observation chart design has a substantial impact on the decision accuracy and response times of both health professionals and novices in recognising abnormal patient observations.
Keyword Observation charts
Human factors
Patient deterioration
Human performance
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
School of Psychology Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 22 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 24 times in Scopus Article | Citations
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Created: Tue, 20 Mar 2012, 01:10:09 EST by Mr Andrew Hill on behalf of School of Psychology