Understanding the effects of overnight vital signs monitoring on sleep duration and disruptions in hospitalized children: A scoping review

Abstract

Problem: Overnight vital signs are typically taken every four hours on pediatric acute care units, despite limited evidence supporting the efficacy of this practice. Vital signs are often ordered and collected without considering the patient's clinical status or potential impact that they may have on sleep. We sought to understand the impact that overnight vital sign monitoring has on sleep duration and disruptions among hospitalized children in an acute care setting.

Eligibility criteria: We conducted a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols extension for scoping reviews (PRISMA-ScR). Studies were included if they addressed the relationship between vital signs monitoring and sleep among children hospitalized in an acute care unit.

Sample: Eleven studies from 2012 to 2022 were included in the final review.

Results: Vital signs monitoring is the most common sleep disruptor among hospitalized children in acute care units and early evidence suggests that minimizing overnight vital signs may be a safe intervention for clinically stable children. Methods for measuring sleep duration and disruptions are heterogenous and validated tools are not often used. Finally, nurses report comfort with forgoing overnight vital signs when their patient's clinical status is stable.

Conclusion: Despite a lack of evidence regarding the efficacy of every 4 h vital signs, overnight vital signs monitoring is consistently the greatest disruptor to sleep for hospitalized children.

Implications: Nurses should play a central role in guiding vital signs monitoring that maintains safety and improves sleep in hospitalized children.

Keywords: Nursing assessments; Sleep; Sleep interventions; Vital sign monitoring; Vital signs.