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Relationship Between Nighttime Vital Sign Assessments and Acute Care Transfers in the Rehabilitation Inpatient

Authors

  • Anthony J. Pellicane MD

    Corresponding author
    1. Department of Physical Medicine and Rehabilitation at the Rehabilitation Institute of Michigan in the Detroit Medical Center, Wayne State University, Detroit, MI, USA
    • Correspondence

      Anthony J. Pellicane, MD, Adventist Rehabilitation Hospital of Maryland, 9909 Medical Center Drive, Rockville, MD 20850.

      E-mail: apellicane@hotmail.com

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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.

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