{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T10:08:48Z","timestamp":1768644528584,"version":"3.49.0"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Continuous monitoring of vital signs is introduced at general hospital wards to detect patient deterioration. Interpretation and response currently rely on experience and expert opinion. This study aims to determine whether consensus exist among hospital professionals regarding the interpretation of vital signs of COVID-19 patients. In addition, we assessed the ability to recognise respiratory insufficiency and evaluated the interpretation process.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We performed a mixed methods study including 24 hospital professionals (6 nurses, 6 junior physicians, 6 internal medicine specialists, 6 ICU nurses). Each participant was presented with 20 cases of COVID-19 patients, including 4 or 8 hours of continuously measured vital signs data. Participants estimated the patient\u2019s situation (\u2018improving\u2019, \u2018stable\u2019, or \u2018deteriorating\u2019) and the possibility of developing respiratory insufficiency. Subsequently, a semi-structured interview was held focussing on the interpretation process. Consensus was assessed using Krippendorff\u2019s alpha. For the estimation of respiratory insufficiency, we calculated the mean positive\/negative predictive value. Interviews were analysed using inductive thematic analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We found no consensus regarding the patient\u2019s situation (\u03b1 0.41, 95%CI 0.29\u20130.52). The mean positive predictive value for respiratory insufficiency was high (0.91, 95%CI 0.86\u20130.97), but the negative predictive value was 0.66 (95%CI 0.44\u20130.88). In the interviews, two themes regarding the interpretation process emerged. \u201cInterpretation of deviations\u201d included the strategies participants use to determine stability, focused on finding deviations in data. \u201cInability to see the patient\u201d entailed the need of hospital professionals to perform a patient evaluation when estimating a patient\u2019s situation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The interpretation of continuously measured vital signs by hospital professionals, and recognition of respiratory insufficiency using these data, is variable, which might be the result of different interpretation strategies, uncertainty regarding deviations, and not being able to see the patient. Protocols and training could help to uniform interpretation, but decision support systems might be necessary to find signs of deterioration that might otherwise go unnoticed.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0286080","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T17:23:25Z","timestamp":1685035405000},"page":"e0286080","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Interpretation of continuously measured vital signs data of COVID-19 patients by nurses and physicians at the general ward: A mixed methods study"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6332-1325","authenticated-orcid":true,"given":"Harri\u00ebt M. R.","family":"van Goor","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martine J. 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