Observation charts with overlapping blood pressure and heart rate graphs do not yield the performance advantage that health professionals assume: an experimental study

Christofidis, Melany J., Hill, Andrew, Horswill, Mark S. and Watson, Marcus O. (2013) Observation charts with overlapping blood pressure and heart rate graphs do not yield the performance advantage that health professionals assume: an experimental study. Journal of Advanced Nursing, 70 3: 610-624. doi:10.1111/jan.12223


Author Christofidis, Melany J.
Hill, Andrew
Horswill, Mark S.
Watson, Marcus O.
Title Observation charts with overlapping blood pressure and heart rate graphs do not yield the performance advantage that health professionals assume: an experimental study
Journal name Journal of Advanced Nursing   Check publisher's open access policy
ISSN 0309-2402
1365-2648
Publication date 2013-08-26
Year available 2013
Sub-type Article (original research)
DOI 10.1111/jan.12223
Volume 70
Issue 3
Start page 610
End page 624
Total pages 15
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell
Collection year 2014
Language eng
Formatted abstract
Aim: To investigate whether overlapping blood pressure and heart rate graphs improve chart-users’ ability to recognize derangements in these vital signs on hospital observation charts.

Background: Many health professionals prefer blood pressure and heart rate graphs to overlap. One justification is the use of a visual cue called the ‘Seagull Sign’ to detect physiological abnormalities.

Design: A 3 9 2 9 2 mixed-design experiment, with three independent variables: participant group, graph format (separate vs. overlapping) and alerting system (integrated colour-based track-and-trigger system present vs. absent).

Methods: Over 64 experimental trials, ‘Seagull-trained’ nurses and novices randomly assigned to receive ‘Seagull training’ or remain untrained, viewed sequences of blood pressure and heart rate observations recorded on four different chart design extracts. The designs represented a crossing of the graph format and alerting system variables. For each design, eight cases contained normal data and eight contained an abnormal systolic blood pressure or heart rate observation (half of which yielded a Seagull Sign on overlapping plots). Participants (tested between January–May 2011) judged whether observations were physiologically normal or abnormal.

Results: Across all cases, participants from all groups responded faster and made fewer errors when blood pressure and heart rate observations were graphed separately, especially when a track-and-trigger system was present. Even for
‘Seagull-trained’ participants viewing ‘Seagull Sign available’ cases, no advantage of overlapping graphs was found.

Conclusions: These findings suggest that overlapping graphs do not yield the performance advantage that many health professionals assume, either for novices or experienced nurses, even when the Seagull Sign is used.
Keyword Deterioration
Human factors
Nursing
Observation chart
Seagull Sign
Shock index
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 26 August 2013.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
School of Psychology Publications
 
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Created: Mon, 15 Jul 2013, 21:28:44 EST by Jeannette Watson on behalf of School of Civil Engineering