Eliminating errors in vital signs documentation.

This study compared two methods of documenting vital signs: a traditional method where staff wrote vital signs on paper then keyed into an electronic medical record and a wireless system that downloaded vital signs directly into an electronic medical record. The study design was pretest and posttest. Sixty-four sets of vital signs were evaluated prior to the implementation of a wireless download system and 66 sets of vital signs were evaluated after. To compare the error rates for the two methods, χ tests were used, and t tests were used to compare the elapsed time. Questionnaires relating to the clinicians' experiences were analyzed qualitatively. The paper vital signs recording had an error rate of 18.75% and the wireless system has an error rate of 0% (P < .001). The mean (SD) elapsed time from when the vital signs were taken until they were available in the electronic medical record was 38.53 (32.87) minutes for the paper method and 5.06 (6.59) minutes for the wireless method (P < .001). The electronic vital signs documentation system resulted in significantly fewer errors and shorter elapsed time when compared with the paper system.

Differential effects of cardiovascular and resistance exercise on functional mobility in individuals with advanced cancer: a randomized trial.

OBJECTIVE: To compare the effects of resistance and cardiovascular exercise on functional mobility in individuals with advanced cancer. DESIGN: Prospective, 2-group pretest-posttest pilot study with randomization to either resistance or cardiovascular exercise mode. SETTING: Comprehensive community cancer center and a hospital-based fitness facility. PARTICIPANTS: Volunteer sample of individuals (N=66; 30 men; 36 women; mean age, 62y) with advanced cancer recruited through the cancer center, palliative care service, rehabilitation department, and a local hospice. INTERVENTIONS: Ten weeks of individualized resistance or cardiovascular exercise, prescribed and monitored by oncology-trained exercise personnel. MAIN OUTCOME MEASURES: Functional mobility was assessed using the Short Physical Performance Battery (SPPB); self-reported pain and fatigue were assessed secondarily using visual analog scales. Data were analyzed using a split plot 2×2 analysis of variance (α=.05). RESULTS: Fifty-two patients (78.8%) completed the study: 23 (67.7%) of 34 patients in the resistance arm and 29 (90.6%) of 32 patients in the cardiovascular arm. No participant withdrew because of study adverse events. Ten-week outcomes (n=52) included a significant increase in SPPB total score (P<.001), increase in gait speed (P=.001), and reduction in fatigue (P=.05). Although cardiovascular exercise participants had a modestly greater improvement in SPPB total score than resistance training participants (F1,49=4.21, P=.045), the difference was not confirmed in a subsequent intention-to-treat analysis (N=66). CONCLUSIONS: Individuals with advanced cancer appear to benefit from exercise for improving functional mobility. Neither resistance nor cardiovascular exercise appeared to have a strong differential effect on outcome.