Vital Signs Recording Practices and Use in Decision Making For the Care of Critically Ill Patients in General Wards: Descriptive Study in Dar Es Salaam, Tanzania

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.