• Wenqi Mok, Wenru Wang, Simon Cooper, Emily Neo Kim Ang, and Sok Ying Liaw.
• Khoo Teck Puat Hospital, Singapore 768828, Singapore.
• Int J Qual Health Care. 2015 Jun 1; 27 (3): 207-13.

ObjectiveTo develop and determine the psychometrics properties of an instrument (V-scale) and to explore nurses' attitudes towards vital signs monitoring in the detection of clinical deterioration in general wards.DesignScale development with psychometric testing and a descriptive quantitative survey.SettingTertiary acute care hospital.ParticipantsA total of 614 general ward nurses.FindingsPrincipal component analysis revealed a 16-item instrument in a five-factor solution (key indicators, knowledge, communication, workload and technology) that explained 56.27% of the variance. The internal consistency was sufficient with Cronbach's alpha of 0.71 and strong item subscale correlations (0.56-0.89). The test-retest reliability was adequate with an Intraclass Correlation Coefficient (ICC) of 0.85. Many nurses (56.9%) erroneously perceived blood pressure changes as the first indicator of deterioration, and 46% agreed that an altered respiratory rate was the least important indicator. Most nurses (59.8%) also reported relying on oxygen saturation to evaluate respiratory dysfunction, and 27.4% indicated that they make quick estimates of the respiratory rate. Current practices for vital signs monitoring were considered to be time consuming (21.0%) and overwhelming (35.3%). Nurses' attitudes were most significantly influenced by whether they had a degree qualification followed by whether they worked in a general ward with a specialty and had >5 years of experience.ConclusionsThis exploratory study provides evidence for the psychometric properties of the V-scale. It reveals a need for continuous professional development to improve ward nurses' attitudes towards vital signs monitoring. Vital signs monitoring needs to be prioritized in workload planning.© The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

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