Original Research: Signs and Symptoms of Chest Diseases |

Flash Mob ResearchResident-Directed Study of Respiratory Rate: A Single-Day, Multicenter, Resident-Directed Study of Respiratory Rate

Matthew W. Semler, MD; Daniel G. Stover, MD; Andrew P. Copland, MD; Gina Hong, MD; Michael J. Johnson, MD; Michael S. Kriss, MD; Hannah Otepka, MD; Li Wang, MS; Brian W. Christman, MD; Todd W. Rice, MD, FCCP
Author and Funding Information

From the Department of Medicine (Drs Semler, Stover, Christman, and Rice) and Department of Biostatistics (Ms Wang), Vanderbilt University School of Medicine, Nashville, TN; Department of Medicine (Dr Copland), Stanford University Medical Center, Stanford, CA; Department of Medicine (Dr Hong), Pritzker School of Medicine, The University of Chicago, Chicago, IL; Department of Medicine (Dr Johnson), University of Virginia School of Medicine, Charlottesville, VA; Department of Medicine (Dr Kriss), Northwestern University Feinberg School of Medicine, Chicago, IL; and the Department of Medicine (Dr Otepka), Washington University School of Medicine, St Louis, MO.

Correspondence to: Todd W. Rice, MD, FCCP, Vanderbilt University Medical Center, T-1218 Medical Center N 2650, Nashville, TN 37232-2650; e-mail: todd.rice@vanderbilt.edu

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.

Chest. 2013;143(6):1740-1744. doi:10.1378/chest.12-1837
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Background:  Vital signs are critical data in the care of hospitalized patients, but the accuracy with which respiratory rates are recorded in this population remains uncertain. We used a novel flash mob research approach to evaluate the accuracy of recorded respiratory rates in inpatients.

Methods:  This was a single-day, resident-led, prospective observational study of recorded vs directly observed vital signs in nonventilated patients not in the ICU on internal medicine teaching services at six large tertiary-care centers across the United States.

Results:  Among the 368 inpatients included, the median respiratory rate was 16 breaths/min for the directly observed values and 18 breaths/min for the recorded values, with a median difference of 2 breaths/min (P < .001). Respiratory rates of 18 or 20 breaths/min accounted for 71.8% (95% CI, 67.1%-76.4%) of the recorded values compared with 13.0% (95% CI, 9.5%-16.5%) of the directly observed measurements. For individual patients, there was less agreement between the recorded and the directly observed respiratory rate compared with pulse rate.

Conclusions:  Among hospitalized patients across the United States, recorded respiratory rates are higher than directly observed measurements and are significantly more likely to be 18 or 20 breaths/min.

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