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

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%46.5%) 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.