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Maybe nighttime vitals are not needed for low risk patients

Hospitals traditionally take patients’ vital signs every four hours, including during the night.  This news article reports on a study done at the University of Chicago in which patients were assigned a modified early warning score (MEWS) at 11 pm.  Patients judged to be at low risk of clinical deterioration during the night, according to this ranking, were permitted to sleep through the night uninterrupted.  About 45 percent of inpatients were found to be in this low-risk category.  At the low-risk MEWS ranking of 0 or 1, there was found to be less than a 1 percent chance of an adverse event.

This article also comments on the practice of waking inpatients up for lab draws at 4 in the morning.  Physicians order these early morning lab tests so that the results will be ready by the time that they arrive to make rounds beginning at 7 am.  The author suggests doing the blood work at 10 pm, which means that the results are a little older for the next morning’s rounds, but allows the patient to have uninterrupted sleep.

Source: Maguire, P.  Rethinking nighttime vitals: a study makes a case for letting some sleeping patients lie.  Today’s Hospitalist;11(10):14-15, Oct. 2013.  Click here for access to this article: http://m.todayshospitalist.com/articles_readMobile.php?cnt=1745  Posted by AHA Resource Center (312) 422-2003, rc@aha.org

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