Chest
Original ResearchSigns and Symptoms of Chest DiseasesFlash Mob Research: A Single-Day, Multicenter, Resident-Directed Study of Respiratory Rate
Section snippets
Study Design
This was a single-day, multiinstitution, observational study. Internal medicine chief residents from six academic centers established a collaborative network that obtained institutional review board approval at each center, developed a research protocol, and engaged and trained residents in the conduct of this large-scale clinical study. Data were collected on any internal medicine (general or subspecialty service) patient who was primarily managed by resident physicians (teaching service).
Results
Vital sign measurements were collected from 368 patients from the six participating centers. The median respiratory rate was 16 breaths/min (IQR, 14-20 breaths/min) for directly observed measurements and 18 breaths/min (IQR, 18-20 breaths/min) for recorded measurements, with a median difference of 2 breaths/min (P < .001). Of the 361 sets of vital signs with both recorded and directly observed respiratory rate data, 71.8% (95% CI, 67.1%-76.4%) of the recorded values were 18 or 20 breaths/min
Discussion
Although skepticism regarding the accuracy of respiratory rate measurement is not new, this study represents, to our knowledge, the first prospective, multicenter examination of recorded respiratory rates in hospitalized patients, and it was accomplished using a novel flash mob research methodology.9., 11., 12. Anticipating that the manual measurement required to assess respiratory rate introduces a bias not shared by the automatically measured vital signs, we investigated the hypothesis that
Acknowledgments
Author contributions: Drs Semler and Stover had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Semler: contributed to the study concept and design; data acquisition, analysis, and interpretation; statistical analysis; drafting of the manuscript; and critical revision of the manuscript for important intellectual content.
Dr Stover: contributed to the study concept and design; data acquisition, analysis,
References (21)
- et al.
Emergency department hypotension predicts sudden unexpected in-hospital mortality: a prospective cohort study
Chest
(2006) - et al.
Predicting cardiac arrest on the wards: a nested case-control study
Chest
(2012) - et al.
Identification of deteriorating patients on general wards; measurement of vital parameters and potential effectiveness of the Modified Early Warning Score
J Crit Care
(2012) - et al.
Long-term effect of introducing an early warning score on respiratory rate charting on general wards
Resuscitation
(2005) - et al.
Clinical antecedents to in-hospital cardiopulmonary arrest
Chest
(1990) - et al.
The vexatious vital: neither clinical measurements by nurses nor an electronic monitor provides accurate measurements of respiratory rate in triage
Ann Emerg Med
(2005) - et al.
Comparison of the heart and breathing rate of acutely ill medical patients recorded by nursing staff with those measured over 5 min by a piezoelectric belt and ECG monitor at the time of admission to hospital
Resuscitation
(2011) - et al.
Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support
J Biomed Inform
(2009) - et al.
Accuracy of respiratory rate monitoring using a non-invasive acoustic method after general anaesthesia
Br J Anaesth
(2012) - et al.
Respiratory rate predicts cardiopulmonary arrest for internal medicine inpatients
J Gen Intern Med
(1993)
Cited by (57)
Implementation of a Continuous Patient Monitoring System in the Hospital Setting: A Qualitative Study
2024, Joint Commission Journal on Quality and Patient SafetyBiomarker-Based Assessment Model for Detecting Sepsis: A Retrospective Cohort Study
2023, Journal of Personalized MedicineHow registered nurses are measuring respiratory rates in adult acute care health settings: An integrative review
2023, Journal of Clinical Nursing
Drs Semler and Stover contributed equally to this work.
Funding/Support: This work was supported by the National Heart, Lung and Blood Institute, National Institutes of Health [HL105869] to Dr Rice.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.