Abnormal Vital Sign Recognition and Provider Notification in the Pediatric Emergency Department

Introduction: Vital signs measurements aid in the early identification of patients at risk of clinical deterioration and determining the severity of illness. Health care providers rely on registered nurses to document vital signs and communicate abnormalities. The purpose of this project was to improve the provider notification process regarding abnormal vital signs in a pediatric emergency department. Method: A best practice advisory (BPA) was piloted by the advanced practice providers in the pediatric emergency department. To evaluate the effects of the BPA, a mixed-methods study was employed. Results: Implementation of the BPA improved the provider notification process and enhanced clinical decision making. The percentage of patients discharged home with abnormal respiratory rates (10.9% vs. 5.9%, p=.31), abnormal temperatures (15.6% vs. 7.5%, p=.14), and abnormal heart rates (25% vs. 11.9%, p=.11) improved. Discussion: Creation and implementation of the BPA improved the abnormal vital sign communication process to providers at this single institution.