Vital sign monitoring

The monitoring of vital signs is a crucial component of observing and overseeing human health conditions. Alterations in vital signs serve as reliable indicators for assessing an individual's well-being, aiding healthcare providers in monitoring the evolution or improvement of diseases. Additionally, they are valuable in promptly monitoring acute conditions, such as trauma or infections.

While there are many other ways in which the health and wellbeing of an individual can be measured (eg specialised monitoring), vital sign monitoring is by far the most important in ruling in, or ruling out, the need for more extensive or invasive monitoring and testing.

The purpose of vital sign monitoring depends on the situation a patient is in and includes:

• during the nursing assessment (Mok et al, 2015)
• setting a baseline, eg prior to surgery
• monitoring chronic disease, eg high blood pressure (hypertension)
• monitoring acute disease, eg acute kidney injury
• monitoring recovery from illness,

Nurses must be familiar with various methods of undertaking vital sign monitoring as they may need to vary how they undertake this activity according to the needs of the patient as well as the availability of equipment. Not many areas have well defined policies for the frequency of vital sign monitoring, which is often left to the discretion of the nursing team (Cardona-Morrell et al, 2016). Nevertheless, nurses should be familiar with any relevant local policies and procedures.

Nurses must understand the baseline measurements for vital signs in a healthy individual. What is 'normal' for an individual may vary as a result of the individual’s:

• age
• underlying health conditions
• body size
• weight
• fitness
• gender

Nurses must take account of the presentation of the person whose vital signs they are recording and pay attention to what they see and what the person communicates, as well as what they measure objectively. The

The equipment required to undertake monitoring will depend on the situation in which the nurse is working, what monitoring the patient needs and the equipment available to them. To undertake the basic vital sign monitoring familiar to all nurses, the nurse will need:

• A sphygmomanometer
  • If not electric, a stethoscope with a diaphragm face
  • The correct sized cuff (Irving et al, 2016)
• A thermometer
  • Thermometer sheathing eg for tympanic, electric oral or rectal thermometers (where needed)
• A watch or other means of measuring time
• The means of cleaning/disinfecting equipment between uses
• The patient record

The nurse should ensure they gain consent before monitoring vital signs by explaining to the patient the nature of the procedure as well as why it is being undertaken. Nurses should undertake hand hygiene prior to monitoring vital signs to prevent the transmission of infection.

For all vital sign recordings it is better that the patient is rested in order to ensure the results reflect their readings at rest (Dobson and Simpson, 2022). The nurse must address any privacy and dignity issues associated with the procedure. 

The following procedures are the more common means of monitoring vital signs.