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Description
Orthostatic vital signs (OVS) are commonly performed to evaluate for hypovolemia and syncope in the pediatric population. A current practice survey conducted at a pediatric hospital identified a large discrepancy in practice vs current literature available. A total of 94 participants including nurses, paramedics, and patient care technicians revealed two significant variable points: positioning and timing. Most staff members record OVS when the patient is supine, sitting, then standing. The time between each position change also ranges from immediately recorded to waiting over 5 minutes after each position change. In contrast, current literature identifies pediatric patients should assume a supine position for 5 minutes before capturing the initial set of vitals. The patient then moves to a standing position for 1 minute before taking another set of vitals. After an additional 3 minutes standing, a final set of vitals will be recorded to trend how the body is compensating (Elsevier, 2022). Heart rate has also been identified to be a more accurate measurement of compensation, thus should be recorded with each blood pressure (Naccarato et al., 2012). At the studied hospital, no standardized documentation is required in the electronic medical record systems, making the data difficult to view. Current interventions include staff education, designated documentation location, and ease of access to policy-driven practice by linking guidelines to the orders. Future evaluation includes a post-survey to analyze how staff respond to the interventions and determine if accurate and reliable data are utilized when diagnosing orthostasis in order to streamline care.
Publication Date
2023
Recommended Citation
Bui, Allison; Blackmon, Colin; and Brown, Erian, "Standardizing Orthostatic Vital Signs to Align with Best Practices" (2023). 2023. 27.
https://scholarlycollection.childrens.com/nursing-anf2023/27
