A Prospective Study of Nighttime Vital Sign Monitoring Frequency and Risk of Clinical Deterioration

The routine practice of collecting vital signs every 4 hours in hospitalized ward patients has been perpetuated since as early as 1893, but there is little evidence to support this tradition1. Although vital signs can be indicative of impending clinical deterioration, routine nighttime vital sign monitoring adds to the already fragmented sleep of inpatients. Sleep disruptions are prevalent among ward patients and are associated several negative health outcomes, including elevated blood pressures and delirium2,3. Overnight vital sign checks not only are an especially bothersome disruptor but also can deplete crucial health care resources. Track and trigger systems, such as the Modified Early Warning Score (MEWS), have been used to identify high-risk patients for critical interventions4. The present study investigated whether the MEWS could identify low-risk-patients who might forgo overnight vital sign monitoring.