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Keywords:

  • Vital signs;
  • acute care transfer;
  • patient discharge;
  • early diagnosis;
  • rehabilitation;
  • rehabilitation nursing;
  • sleep deprivation

Abstract

Purpose

To investigate the role of nighttime vital sign assessment in predicting acute care transfers (ACT) from inpatient rehabilitation.

Design

Retrospective chart review.

Methods

Fifty patients unexpectedly discharged to acute care underwent chart review to determine details of each ACT.

Findings

Seven of 50 ACT possessed new vital sign abnormalities at the 11 pm vital sign assessment the night before ACT. None of these seven underwent ACT during the night shift the abnormalities were detected. Two of 50 ACT were transferred between 11 pm and 6:59 am; both demonstrating normal vital sign at the 11 pm assessment. During study period, an estimated 5,607 11 pm vital sign assessments were performed.

Conclusions

Nighttime vital sign assessments do not seem to be a good screening tool for clinical instability in the rehabilitation hospital.

Clinical Relevance

Eliminating sleep disturbance is important to the rehabilitation inpatient as inadequate sleep hinders physical performance. Tailoring vital sign monitoring to fit patents' clinical presentation may benefit this population.