change management, deteriorating patient, nursing assessment, practice standardization, quality improvement



  1. Derby, Kelly M. MS, APRN, CNS
  2. Hartung, Natalie A. MBA, RN
  3. Wolf, Sherry L. MS, APRN, CNS
  4. Zak, Heather L. MS, APRN, CNS
  5. Evenson, Laura K. MS, RN, ACNS-BC


Purpose: The purpose of this project was to standardize vital sign (VS) monitoring throughout a patient's stay in the hospital, including at admission, following transitions to different levels of care, reassessment of abnormal VS results, daily monitoring, and before dismissal. The population of focus was adult general and progressive care patients.


Description of the Project: Standards for VS monitoring, documentation, and provider notification were established. Unit routines, nursing procedural guidelines, and order sets were updated with the new standards. Nursing staff received Web-based education. Compliance with the new standards was monitored monthly, and data were shared with nursing leadership. Leadership reviewed the data with nursing staff to identify opportunities and recognize achievements.


Outcomes: Overall, improvement in VS documentation was achieved. Continued opportunities exist for monitoring and reassessment of a full set of VSs after an abnormal result.


Conclusion: Establishing a minimum standard of VS frequency and documentation allows for all healthcare providers to trend and monitor a patient's clinical status. Variability in patient care can be diminished by establishing minimum standards of VS monitoring.