Abstract:
Introduction: Monitoring vital signs is essential to discovering and responding to patient
deterioration. The value of vital sign recording influences clinical decision making. Delay to
respond from abnormal vital signs among critically ill patients may cause hemodynamic
instability leading to unplanned ICU admission, cardiac arrest, and deaths. Hence general
ward nurses need to have positive attitudes, good practices, and good decision making.
Aim: To assess the vital signs recording attitudes, practices and clinical decision making for
the care of critically ill patients in general wards at Muhimbili National Hospital (MNH) in
Dar es Salaam, Tanzania.
Methodology: The study was hospital based descriptive cross-sectional that involved 240
general ward nurses who were selected using convenience non probability sampling
technique. It was conducted at Muhimbili National Hospital. Structured questionnaires were
used to collect data, and SPSS version 20 was used for data analysis. Univariate data were
analysed using descriptive statistics while Bivariate and multivariate were analyzed using
logistic regression models. Results were presented in forms of tables.
Results: Majority of participants 55.8% were working in medical wards and most of them
36.7% had worked from 2 to 3 years. Above half of respondents 54.2% had positive attitude
regarding the usefulness of vital signs. There was a statistical significance association in
experience from 2 – 3 years with attitudes (AOR: 16.759 95%CI (5.72- 49.15; P value
=0.000). also, there was a statistical significance association in medical wards with attitudes
(AOR: 0.04 CI 95% CI (0.01-0.10); p value =0.000). Majority of the nurses 52.5% had poor
practices. There was a statistical significance association in experience from 2 – 3 years with
practice (AOR= 0.015; 95%CI (0.002-0.11; P= 0.000). Majority of the nurses 52.1% had poor
decision making. There was no statistical significance association in demographic data with
decision making P value > 0.05.
Conclusion: Even if the majority of the participants scored highly in their attitudes, they
scored poorly in practices and decision making when identifying and managing these patients.
Recommendations: Clinical supervision and educational input will improve the quality of
vital signs for the care of critically ill patients in general wards.
