Nursing Students' Skills of Monitoring, Measuring, Reporting and Attitudes towards Vital Signs in the Clinical Practice Process: An Observational Evaluation

Nursing Students' Skills of Monitoring, Measuring, Reporting and Attitudes towards Vital Signs in the Clinical Practice Process: An Observational Evaluation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Nursing Students' Skills of Monitoring, Measuring, Reporting and Attitudes towards Vital Signs in the Clinical Practice Process: An Observational Evaluation Arife Şanlıalp Zeyrek, Özlem Fidan, Safiyenur Akın, Aydan Çapar This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6502579/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Monitoring of vital signs is one of the most frequently practiced skills of nursing students in clinical practice. These findings are of critical importance in terms of evaluating the health status of individuals and early detection of clinical deterioration. This study aimed to examine nursing students' attitudes toward vital sign measurement, vital sign measurement skills, and abnormal finding reporting behaviors during clinical practice. Methods This descriptive and observational study was conducted with a sample of 63 second-year nursing students studying at the Faculty of Health Sciences of a university located in western Turkey. Data were collected using the following instruments: the Participant Information Form, the Vital Signs Scale, and the Vital Signs Measurement Assessment Observation Form. The study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for reporting observational studies. Results The attitudes of the nursing students participating in the study towards measuring vital signs were found to be above the middle level. The analysis revealed that the majority of the students measured body temperature (100%), blood pressure (92.2%), and oxygen saturation (92.2%). However, pulse (34.4%) and respiration (37.5%) counts were not performed by approximately one-third of the students. It is noteworthy that students reported all abnormal findings in body temperature and oxygen saturation measurements to the nurses. However, no notification was made for abnormal findings detected in respiratory and pulse assessments. Furthermore, only 15.8% of students reported any abnormal findings concerning blood pressure measurements to the nursing staff. Conclusions The present study revealed that nursing students' attitudes toward measuring vital signs were, in general, positive. However, the study also identified deficiencies in pulse and respiratory assessments. Furthermore, the study found that the reporting rates of abnormal findings varied according to the type of measurement. There were also deficiencies in reporting, especially in critical parameters such as pulse, respiration, and blood pressure. These findings underscore the necessity for the refinement of educational programs to enhance nursing students' competencies in vital sign assessment and the reporting of abnormal conditions. Vital signs Nursing students Skill Clinical Attitudes BACKGROUND Vital signs are critical for assessing the health status of individuals and early detection of clinical deterioration [ 1 ]. It is well-established that abnormalities in vital signs in patients typically manifest several hours before the onset of physiological deterioration. Specifically, changes in respiratory rate are widely regarded as the most significant indicator of physiological deterioration [ 2 ]. Consequently, the regular monitoring of vital signs is essential to reflect the current state of the patient's health and to identify potential clinical deterioration in advance [ 3 ]. Accurate measurement, recording, and interpretation of vital signs facilitate early interventions, inform the determination of appropriate treatment and patient care, and prevent complications [ 3 – 5 ]. The monitoring of vital signs constitutes a key part of nursing care and is the responsibility of the nurse [ 4 , 6 ]. A nurse must possess a comprehensive understanding of both normal and abnormal variations in vital signs, in addition to the ability to discern when to implement requisite precautions [ 7 ]. However, numerous studies have indicated that vital signs are not regularly measured, recorded, or interpreted correctly in clinical settings [ 8 – 12 ]. Mok et al. (2015) reported that although nurses appear to monitor vital signs regularly, their critical role in detecting patients' deteriorating conditions is often overlooked [ 13 ]. This finding underscores the necessity of cultivating nurses' competencies to meticulously monitor, assess, and intervene in vital signs, a process that ought to be integrated into their professional training curricula [ 5 ]. The measurement of vital signs is among the most frequently assigned tasks to nursing students in clinical practice, as these procedures are generally non-invasive [ 14 ]. However, it has been found that nursing students' knowledge and skills in assessing vital signs are generally inadequate, and they also have difficulties in recognizing abnormal conditions early [ 14 , 15 ]. This may be attributed to a lack of appreciation for the significance of vital signs, which can hinder students' ability to report to nurses in a timely manner. This, in turn, may result in missed opportunities for early intervention, potentially leading to clinical deterioration. Moreover, due to their limited experiential knowledge, nursing students may fail to notice critical signs of clinical deterioration, which may further jeopardize patient safety [ 7 ]. Deficiencies in students' ability to measure, record, and interpret vital signs in clinical practice may compromise the quality of patient care and patient safety [ 10 ]. Consequently, nursing students must enhance their knowledge and attitudes regarding accurate measurement, documentation, interpretation of abnormal findings, and timely reporting to experienced healthcare professionals [ 14 ]. Research indicates that nurses and students exhibit a favorable disposition toward vital signs monitoring [ 5 , 16 , 17 ]. However, it has also been observed that there are inadequacies in their ability to detect and manage patients whose condition deteriorates in the clinical setting and that they have difficulty transferring the theoretical knowledge they have learned to clinical practice [ 18 ]. This discrepancy underscores the necessity for effective strategies that will enable nursing students to seamlessly integrate their theoretical knowledge and skills in clinical settings, fostering a positive attitude toward vital signs monitoring. A review of the extant literature reveals a paucity of observational studies that rigorously examine whether nursing students can effectively apply their theoretical knowledge about vital signs skills in the clinical setting. Recognizing the pivotal role of precise vital signs monitoring in patient care, this study was undertaken to assess nursing students' competencies in vital signs monitoring and their attitudes towards vital signs in clinical practice. Aim The study was conducted to investigate nursing students' attitudes toward vital signs measurement, their skills in measuring vital signs, and their behaviors in reporting abnormal findings. Research questions What is the level of nursing students' attitudes towards the measurement of vital signs? Is there a relationship between nursing students' attitudes toward the measurement of vital signs and sociodemographic data? What is the level of nursing students' follow-up of vital signs? What is the level of nursing students' ability to perform the steps of measuring vital signs in clinical practice? What is the level of students' ability to recognize abnormal vital signs and report these findings to nurses? METHODS Design, setting, and participants This is a descriptive and direct observational study. The population of the study consisted of 120 second-year nursing students studying at a university in western Turkey in the spring semester of 2023–2024. The inclusion criteria were taking the Fundamentals of Nursing course, taking the Internal Medicine or Surgical Disease Nursing course, doing clinical practice in the wards, and volunteering to participate in the study. Exclusion criteria included not having taken the Fundamentals of Nursing course, not taking the internal medicine course or the surgical diseases nursing course, having performed clinical practices in operating rooms, emergency, intensive care, and outpatient clinics, and not volunteering to participate in the study. Individuals who did not complete the scales in their entirety were excluded from the study. The objective of the study was to reach the entire population, and thus, no sample was selected. The study was completed with 63 students who met the inclusion criteria. The study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for reporting observational studies [ 19 ]. Data collection tools Data were collected using the Participant Information Form, Vital Signs Scale (V-scale), and Vital Signs Measurement Skill Assessment Observation Form. Participant information form A form was developed to assess the socio-demographic characteristics of the participants. This form was prepared by conducting a thorough review of the relevant literature [ 13 , 14 ]. The form included questions such as age, gender, academic achievement status, the service where the students did their internship, whether they chose nursing voluntarily, their satisfaction with being a nurse, the frequency and adequacy of taking vital signs, the adequacy of theoretical and laboratory training on vital signs, and the adequacy of support received from the instructor and nurses in training vital signs skills in the clinic. Vital Signs Scale (V-scale) The V-scale was developed by Mok et al. (2015), and the Turkish validity and reliability were performed by Ertuğ (2018) [ 20 , 21 ]. The scale was developed to measure nurses' attitudes towards vital signs measurement. The scale consists of 16 items and five subdimensions: Workload, Technology, Communication, Information, and Basic Indicators. Workload is defined as the effort and time expended on vital signs. Technology refers to the impact of respiratory rate counting in electronic vital signs monitoring. The term "communication" is used to denote the process of recording vital signs that are deteriorating. Knowledge, in this context, signifies the capacity to interpret vital signs accurately. Key indicators refer to vital signs that are of particular importance in indicating a deterioration in the patient's condition. The scale utilizes a 5-point Likert-type assessment, ranging from "strongly disagree" to "strongly agree." The total score ranges from 16 to 80. Scores at the lower end of the scale are indicative of nurses' negative attitudes toward vital signs, while higher scores represent positive attitudes. The original Cronbach alpha value of the scale was determined to be 0.71 [ 20 ]. In a subsequent study, Ertuğ (2018) identified a Cronbach's alpha value of 0.76 [ 21 ]. It is noteworthy that the instrument was initially designed for nurses; consequently, Fidan and Şanlıalp Zeyrek (2025) adapted some questions of the scale to nursing students in their study [ 22 ]. The result of this adaptation process yielded a Cronbach's alpha value of 0.76, which is consistent with the initial findings. Vital Signs Measurement Skill Assessment Observation Form The observation form was designed to evaluate students' ability to measure vital signs during clinical practice. The study included observation of the following skills: taking body temperature, taking blood pressure, assessing radial artery pulse, assessing respiration, and assessing oxygen saturation. The form further assessed the students' capacity to monitor vital signs and to report any abnormalities to the nursing staff according to the measurement results. The form was developed based on the practical application steps of fundamental nursing skills outlined in the book "Basic Nursing Skills" by Göçmen Baykara et al. (2021) [ 23 ]. The content validity of the form was evaluated by five experts in the relevant field (five faculty members of the Department of Nursing Principles). Accordingly, the experts examined whether the scope of the form adequately covered the targeted skills and the level of clarity, comprehensibility, and appropriateness of each item. The necessary revisions were made. The Content Validity Index (CVI) value, calculated as a result of the experts' evaluations of each implementation step, was found to be 0.90. This finding demonstrated the usability of the observation form as a reliable and valid tool (see supplementary file). Data collection In the hospital where the study was conducted, vital signs measurements are typically performed at 9:00, 12:00, 13:00, and 15:00 in the majority of clinics. However, the frequency of measurement may be subject to variation in specific clinical circumstances, including general condition disorders, blood transfusion, and the postoperative period. On clinical practice days, vital signs measurement is conducted by nursing students, with follow-up checks by the clinical nurse or supervising instructor. The observation was conducted by two faculty members who had received training in data collection through direct observation and who specialized in the field of nursing principles. The observers determined the vital signs measurement times of the clinics and planned the time for the students to be observed and the measurement times. In order to avoid the Hawthorne effect, students were informed that only a general observation would be made, and it was not specified that the skill steps related to vital signs measurement would be evaluated. The students were instructed to measure body temperature using a non-contact infrared thermometer, blood pressure with an aneroid manometer, pulse rate by manual wrist or neck counting, and oxygen saturation with pulse oximetry devices. It is noteworthy that all devices utilized in this study are routinely subjected to daily calibration and accuracy checks by the institution. Prior to the observation process, both verbal and written informed consent was obtained from all participants. To assess interobserver agreement, each student was assessed simultaneously by two different observers. The observations focused on the students' adherence to vital signs procedures, the completion of the required steps in the correct order for each measurement (correct, incorrect/incomplete, not performed), the maintenance of the measurement records, and the reporting of any abnormal findings to the nurses as a result of the measurements. Each student's observation period lasted approximately 10–15 minutes. Following the observation, the students were asked to complete the Participant Information Form and the V-Scale. The completion of these forms and scales took approximately 10 minutes. Statistical analysis All statistical analyses were performed using SPSS 27.0 (IBM SPSS Statistics 27 software (Armonk, NY: IBM Corp.)). Continuous variables were defined by the mean ± standard deviation, minimum- maximum values, and categorical variables were defined by number and percent. The relationships between continuous variables were analyzed using Pearson correlation analysis. The significance test of the difference between two means and one-way analysis of variance was used to examine the differences between groups. The differences between categorical variables were analyzed using Chi-square analysis. The Kappa coefficient was used to evaluate interobserver agreement. RESULTS Table 1 presents the data on the comparison of the sociodemographic characteristics of nursing students and the total and subscale scores of the V-scale. The majority of the participants were female, with a mean age of 20.60 ± 1.11 years and a mean academic score of 2.84 ± 0.44. The departments where students performed clinical practice were thoracic diseases (38.1%), orthopedics (22.2%), neurosurgery (20.6%), and cardiovascular surgery (19%). A significant proportion of the participants expressed satisfaction with their decision to pursue studies in the nursing department, with 77.8% reporting satisfaction and 68.3% indicating a deliberate choice of the nursing profession. During clinical practice, 76.2% of the students reported taking vital signs 3–4 times a day, and 96.8% of them found the frequency of vital sign monitoring to be sufficient. Moreover, 87.3% of the students found the theoretical training time sufficient, and 90.5% found the laboratory training time sufficient. While 79.4% of the students found the support of the instructors adequate in teaching vital signs skills in the clinic, 41.3% found the support of the nurses inadequate (Table 1 ). Table 1 Comparison of participants’ characteristics and V-scale total and sub-dimension scores Variables (N = 63) Workload Technology Communication Knowledge Key Indicators V-scale Total N (%) Mean ± SD Mean ± SD Mean ± SD Mean ± SD Mean ± SD Mean ± SD Gender Female 52 (82.5) 3.56 ± .89 2.62 ± .71 3.67 ± 1.25 3.44 ± .76 2.90 ± .60 3.38 ± .59 Male 11 (17.5) 3.50 ± .94 2.56 ± .82 3.45 ± 1.36 3.24 ± .92 3.03 ± .60 3.34 ± .48 Test p t = .224 P = .824 t = .254 P = .801 t = .515 P = .608 t = .764 P = .448 t=-.626 P = .534 t = .222 P = .825 Service where the application was performed Orthopedics Service a 14 (22.2) 3.14 ± .86 2.91 ± .38 3.25 ± 1.20 2.92 ± .83 2.83 ± .70 3.04 ± .52 Neurosurgery service b 13 (20.6) 3.48 ± .75 2.65 ± .64 4 ± .81 3.48 ± .76 2.92 ± .59 3.40 ± .44 Chest Diseases Service c 24 (38.1) 3.51 ± .74 2.73 ± .64 3.66 ± 1.31 3.34 ± .53 2.95 ± .57 3.33 ± .44 Cardiovascular Surgery Service d 12 (19.0) 4.20 ± 1.09 2.00 ± .95 3.62 ± 1.63 4 ± .85 2.97 ± .62 3.81 ± .73 Test p F = 3.521 P = .020 a d* F = .783 P = .508 F = 4.860 P = .004 a < d* F = .149 P = .930 F = 4.627 P = .006 a < d* Satisfaction level of being a nurse Yes 49 (77.8) 3.62 ± .91 2.55 ± .73 3.75 ± 1.21 3.43 ± .79 2.91 ± .57 3.42 ± .57 No 14 (22.2) 3.30 ± .83 2.85 ± .64 3.21 ± 1.41 3.30 ± .77 2.95 ± .73 3.18 ± .55 Test p t = 1.192 P = .238 t=-1.401 P = .166 t = 1.416 P = .162 t = .525 P = .601 t=-.184 P = .855 t = 1.406 P = .165 Choosing nursing voluntarily Yes 43 (68.3) 3.61 ± .94 2.56 ± .74 3.60 ± 1.29 3.37 ± .81 2.91 ± .56 3.38 ± .56 No 20 (31.7) 3.43 ± .80 2.72 ± .69 3.70 ± 1.23 3.48 ± .72 2.95 ± .69 3.34 ± .59 Test p t = .707 P = .482 t=-.787 P = .434 t=-.275 P = .784 t=-.520 P = .605 t=-.213 P = .832 t = .273 P = .786 Frequency of Receiving Vital Signs 1–2 times a day a 11 (17.5) 3.68 ± .89 2.70 ± .70 3.36 ± 1.30 3.39 ± .68 2.75 ± .57 3.31 ± .50 3–4 times a day b 48 (76.2) 3.52 ± .89 2.60 ± .74 3.69 ± 1.26 3.48 ± .78 2.91 ± .58 3.39 ± .59 Depending on the patient's condition c 4 (6.3) 3.62 ± 1.23 2.50 ± .73 3.62 ± 1.49 2.50 ± .57 3.50 ± .79 3.35 ± .65 Test p F = .152 P = .860 F = .130 P = .878 F = .303 P = .740 F = 3.104 P = .052 F = 2.320 P = .107 F = .071 P = .932 Finding the frequency of taking vital signs sufficient Yes 61 (96.8) 3.52 ± .89 2.60 ± .72 3.62 ± 1.28 3.39 ± .79 2.91 ± .60 3.36 ± .57 No 2 (3.2) 4.5 ± .70 3 ± .70 4 ± .00 3.83 ± .23 3.33 ± .47 3.71 ± .13 Test p t=-1.525 P = .132 t=-.751 P = .456 t=-.410 P = .683 t=-.776 P = .441 t=-.966 P = .338 t=-.857 P = .395 Finding the duration of theoretical training on vital signs sufficient Yes 55 (87.3) 3.53 ± .90 2.67 ± .70 3.60 ± 1.27 3.39 ± .81 2.90 ± .60 3.34 ± .56 No 8 (12.7) 3.71 ± .87 2.21 ± .80 3.87 ± 1.32 3.50 ± .61 3.04 ± .62 3.58 ± .63 Test p t=-.546 P = .587 t = 1.693 P = .096 t=-.569 P = .572 t=-.354 P = .725 t=-.575 P = .567 t=-1.111 P = .271 Finding the duration of laboratory training on vital signs sufficient Yes 57 (90.5) 3.56 ± .94 2.56 ± .72 3.59 ± 1.31 3.40 ± .78 2.91 ± .62 3.38 ± .59 No 6 (9.5) 3.50 ± .31 3.12 ± .60 4.00 ± .70 3.44 ± .86 3.05 ± .44 3.31 ± .31 Test p t = .158 P = .875 t=-1.827 P = .073 t=-.737 P = .464 t=-.120 P = .905 t=-.548 P = .586 t = .283 P = .778 Finding the support of the instructor sufficient in teaching vital signs skills in the clinic Yes 50 (79.4) 3.61 ± .88 2.53 ± .71 3.72 ± 1.29 3.51 ± .80 2.95 ± .59 3.44 ± .57 No 13 (20.6) 3.34 ± .96 2.96 ± .68 3.30 ± 1.16 3 ± .56 2.82 ± .64 3.10 ± .50 Test p t = .941 P = .350 t=-1.950 P = .056 t = 1.043 P = .301 t = 2.158 P = .035 t = .701 P = .486 t = 1.995 P = .048 Finding the support of nurses sufficient in teaching vital signs skills in the clinic Yes 37 (58.7) 3.76 ± .88 2.84 ± .60 3.71 ± 1.35 3.63 ± .80 2.97 ± .58 3.52 ± .58 No 26 (41.3) 3.25 ± .84 2.45 ± .77 3.51 ± 1.15 3.08 ± .64 2.85 ± .64 3.15 ± .49 Test p t = 2.260 P = .027 t = 2.139 P = .036 t = .603 P = .549 t = 2.837 P = .006 t = .732 P = .467 t = 2.641 P = .010 Mean ± SD r values r values r values r values r values r values Age 20.60 ± 1.11 .199 − .135 .226 .010 .051 .196 Academic achievement 2.84 ± 0.44 .054 − .021 .002 .264* .101 .116 Abbreviation: SD = Standard deviation, t: t-test in independent groups, F = ANOVA (analysis of variance),r = Pearson Correlation analysis. *Tukey post hoc analysis. * Correlation is significant at the 0.05 level (2 tailed) The results showed no significant difference in the subscale scores related to communication and basic indicators between the departments where the clinical practice was performed. However, in the total score, the subscales of workload and knowledge, students in cardiovascular surgery internships demonstrated more positive attitudes compared to students in orthopedic internships (p < 0.05). Conversely, in the technology subscale, students in the orthopedic service demonstrated more positive attitudes (11.64 ± 1.54). Furthermore, students who found adequate support from lecturers exhibited more positive attitudes in the knowledge subscale (10.54 ± 2.41) and total V-scale (55.16 ± 9.17). Furthermore, students who found the support of nurses sufficient reported more positive attitudes towards workload, technology, knowledge, and total V-scale. Furthermore, a significant positive correlation was identified between students' academic achievement and their scores on the knowledge subscale (r = .264, p < .001). The responses of nursing students to each item in the V-scale are presented in Table 2 . The study revealed that the majority of the students exhibited negative attitudes towards three items related to vital signs. These items are as follows: The first item, which states that "SpO 2 is a more reliable indicator than respiratory rate in reflecting the early signs of respiratory dysfunction," was endorsed by 55.5% of the students. The second item, which states that "blood pressure is usually the first parameter to show that the patient's condition is deteriorating," was endorsed by 52.4% of the students. The third item, which states that "respiratory rate is the least important finding in determining the deterioration of the patient's condition," was endorsed by 55.5% of the students. Additionally, more than one-third of the students incorrectly agreed with the statements "Electronic monitoring of vital signs causes irregular monitoring (counting) of respiratory rate" (34.9%) and "Monitoring of SpO 2 by pulse oximetry reduces the need for counting respiration" (41.3%) in the technology subscale. These findings suggest a deficiency in students' understanding of critical parameters and the utilization of technology. Table 2 Participants’ Attitudes Towards the Results of the Vital Signs Scale (V-scale) Scale Subdimensions Scale Items Strongly disagree/ Disagree Undecided Strongly agree/ I agree n % n % n % Workload Monitoring vital signs is time-consuming. * 42 66.7 6 9.5 15 23.8 Monitoring vital signs is a tedious task. * 38 60.3 7 11.1 18 28.6 Complete and accurate monitoring of vital signs is neglected due to time constraints. * 35 55.5 15 23.8 13 20.6 Monitoring my patients' vital signs at different frequencies (every hour, every 2 hours, every 4 hours, etc.) would overwhelm me. * 37 58.7 12 19 14 22.2 Information I can relate the vital signs of my patients to the physiology and pathophysiology of their disease. 15 23.8 12 19 36 57.1 My knowledge of interpreting vital signs to determine that the patient's condition is deteriorating is limited. * 39 61.9 11 17.5 13 20.6 Changes in vital signs are not interpreted correctly by student nurses. * 36 57.1 11 17.5 16 25.4 Contact I feel confident in reporting deteriorating vital signs to the doctor/charge nurse for assessment of the patient. 13 20.7 6 9.5 44 69.9 If there is no timely intervention when vital signs change, I repeatedly inform the doctor/responsible nurse about these changes. 11 17.5 7 11.1 45 71.4 Key Indicators SpO 2 is a more reliable indicator of early signs of respiratory dysfunction than respiratory rate. * 7 11.1 21 33.3 35 55.5 The first parameter that indicates that the patient's condition is deteriorating is usually blood pressure. * 15 23.8 15 23.8 33 52.4 The respiratory rate is the least important finding in determining whether the patient's condition is deteriorating. * 16 25.4 12 19 35 55.5 Technology In patients who are stable during routine monitoring of vital signs, the respiratory rate value is usually estimated and written down. * 32 50.8 16 25.4 15 23.8 Electronic monitoring of vital signs leads to irregular monitoring (counting) of respiratory rate. * 24 38.1 17 27 22 34.9 Monitoring SpO 2 with pulse oximetry reduces the need to count respirations. * 26 41.3 11 17.5 26 41.3 If the SpO 2 is within the normal range, I usually record the respiratory rate as any number in the standard range of 12–20/min. * 36 57.1 13 20.6 14 22.2 *Negatively worded items. A strongly agree or agree response indicates a negative attitude. As illustrated in Table 3 , nursing students demonstrated proficiency in vital sign monitoring during clinical practice. According to the data presented in Table 3 , all students (100%) measured body temperature, while the majority measured blood pressure (92.2%) and oxygen saturation (92.2%). However, it is noteworthy that approximately one-third of the students did not assess pulse (34.4%) and respiration (37.5%). Table 3 Status of Nursing Students' Follow-up of Vital Signs I did (%) I did not (%) Body Temperature Measurement 63 (100) 0 Blood Pressure Measurement 59 (92.2) 4 (6.3) Evaluation of the Pulse from the Radial Artery 41 (64.1) 22 (34.4) Assessment of Respiration 39 (60.9) 24 (37.5) Evaluation of oxygen saturation (SpO 2 ) 59 (92.2) 4 (6.3) As illustrated in Table 4 , nursing students demonstrated a lack of proficiency in the application of vital signs measurement steps in clinical practice. The findings indicate that students exhibited deficiencies in all steps of the process. Significantly, a notable proportion of students exhibited deficiencies in the cleaning of equipment utilized for blood pressure and oxygen saturation measurements, in addition to inadequate adherence to hand hygiene protocols post-procedure. Furthermore, nearly half of the students exhibited deficiencies in the selection of appropriate sites (47.5%) and the positioning of the patient's arm or leg (44.1%). Furthermore, in the context of body temperature measurement, the majority of students did not evaluate the area to be measured (96.8%). Furthermore, in the process of blood pressure measurement, more than half of the students performed the identity verification process incompletely or incorrectly (49.1%). Table 4 Status of Nursing Students' Implementation of Vital Signs Measurement Application Steps in Clinical Practice Implementation Steps Correct * Incorrect/incomplete* Not implemented* Measuring Body Temperature Performing hand hygiene 63 (100) 0 0 Identifying patient 29 (46) 5 (7.9) 29 (46) Evaluating the area where the temperature will be measured 0 2 (3.2) 61 (96.8) Positioning the measuring device in the appropriate area/keeping it at the appropriate distance 63 (100) 0 0 Applying the process 63 (100) 0 0 Ensuring hand hygiene 0 0 63 (100) Saving the transaction 55 (87.3) 0 8 (12.7) Blood Pressure Measurement Performing hand hygiene 59 (100) Identifying patient 29 (49.1) 5 (8.5) 25 (42.4) Selection of an appropriate area 31 (52.5) 20 (33.9) 8 (13.6) Positioning the patient's arm/leg in the appropriate position 33 (55.9) 15 (25.5) 11 (18.6) Palpating the brachial or popliteal artery; positioning the cuff 25 cm above the pulse 42 (71.2) 17 (28.8) Placement of the stethoscope receiver over the brachial or popliteal artery and the earphones in the ears 56 (94.9) 2 (3.4) 1 (1.7) Closing valve of pressure bulb; rapidly inflates cuff to 30 mmHg above systolic pressure 51 (86.4) 3 (5.1) 5 (8.5) Releasing pressure bulb slowly at a rate of 2–3 mmHg/second; noting value on manometer when first sound heard 54 (91.5) 5 (18.5) Deflating cuff gently and noting the point at which dampened/muffled sound disappears 54 (91.5) 5 (18.5) Removing cuff from extremity 59 (100) Proper cleaning of equipment 59 (100) Ensuring hand hygiene 59 (100) Saving the transaction 54 (91.5) 5 (18.5) Evaluation of the Pulse from the Radial Artery Perform hand hygiene 41 (100) Identify patient 29 (70.7) 5 (12.2) 7 (17.1) Selection of an appropriate area 38 (92.7) 3 (7.3) Appropriate positioning of the patient's arm 32 (78) 7 (17.1) 2 (4.9) Placing tips of first two fingers over groove along radial or thumb side of patients’ inner wrist 40 (97.6) 1 (2.4) Compressing against radius to obliterate pulse, then slightly releasing to palpate pulse 41 (100) Counting 30 seconds if the pulse is rhythmic and 60 seconds if abnormal 41 (100) Saving the transaction 41 (100) Evaluation of Respiration Monitoring the rib cage without telling the patient 39 (100) Counting 30 seconds if breathing is rhythmic and 60 seconds if breathing is abnormal 38 (97.4) 1 (2.6) Saving the transaction 39 (100) Evaluation of oxygen saturation (SpO 2 ) Selection of an appropriate area 59 (100) Correctly placing the tool on the skin 59 (100) Implementing the process 59 (100) Proper cleaning of equipment 59 (100) Ensuring hand hygiene 59 (100) Saving saturation 59 (100) As illustrated in Table 5 , a comparison has been made between nursing students' capacity to identify abnormal vital signs and communicate these findings to nurses. The findings indicate that students reported all abnormal findings detected in body temperature and oxygen saturation assessments to nurses (p < .001). However, no such notification was made regarding abnormal findings in respiration and pulse measurements. Furthermore, in the context of blood pressure measurement, only 15.8% of students reported any abnormal findings to nurses (Table 5 ). Table 5 Comparison of Students' Skills in Recognizing Abnormal Vital Signs and Reporting These Findings to Nurses Presence of Abnormal Findings in Vital Signs Reporting Abnormal Findings to Nurses p Value Reported (n %) Not reported (n %) Body Temperature Measurement Yes 5 (100) 0 P < .001 No 0 58 (100) Blood Pressure Measurement Yes 3 (15.8) 16 (84.2) < .030 No 0 40 (100) Evaluation of Pulse from Radial Artery Yes 0 8 (100) No 0 33 (100) Evaluation of Respiration Yes 0 16 (100) No 0 23 (100) Evaluation of oxygen saturation (SpO 2 ) Yes 10 (100) 0 Fisher’s Exact Test < .001 No 0 49 (100) These results show that students experience deficiencies in recognizing and reporting some vital signs. DISCUSSION Vital signs represent a category of patient data that is frequently monitored in medical facilities. The monitoring of these findings plays a pivotal role in the early recognition of clinical deterioration. Notably, vital sign monitoring does not necessitate an invasive procedure, making it a prevalent skill among nursing students in clinical settings. The present study aims to observe and document the attitudes of nursing students toward vital signs measurement, their ability to measure vital signs accurately, and their behaviors in reporting abnormal findings. Nursing students must possess sufficient knowledge and a positive attitude to measure and record vital signs at appropriate time intervals using the correct methods. They must also be able to interpret these data correctly and report abnormal findings to experienced health professionals [ 14 ]. In this study, the attitudes of nursing students toward vital signs measurement were found to be above the intermediate level. Consistent with this, other studies examining nurses' attitudes toward vital signs monitoring have also reported results above the moderate level [ 5 , 20 , 24 ]. Conversely, Alshehry et al. (2020) reported that nursing students' attitudes towards vital signs measurement were suboptimal [ 14 ]. This discrepancy may be attributed to the heterogeneity of students' clinical experiences or the structural differences in their education programs. The present study found that students who perceived adequate support from instructors and nurses during clinical practice exhibited more positive attitudes toward vital signs monitoring. The findings demonstrate that professional and supportive relationships play a critical role in creating a positive clinical learning environment. Such an environment fosters the development of effective performance skills and heightened individual motivation while concurrently supporting a successful professional socialization process [ 25 ]. Zamanzadeh et al. (2024) further substantiated this finding, observing that when students received adequate guidance in clinical practice, their confidence in their skills increased, and they assumed more responsibility while performing their tasks [ 26 ]. These findings emphasize the importance of guidance provided by instructors and nurses for students to improve their clinical skills. In this study, an evaluation of vital signs measurements in clinical practice revealed that the majority of students performed body temperature, blood pressure, and oxygen saturation measurements. However, approximately one-third did not perform pulse and respiratory assessments. This finding suggests that students exhibited deficiencies in monitoring certain vital signs. Furthermore, an examination of students' attitudes toward vital signs revealed that they perceived oxygen saturation as a more reliable indicator of early respiratory dysfunction compared to respiratory rate. Conversely, respiratory rate was considered the least significant factor in determining the deterioration of a patient's condition. Cardona-Morrell et al. (2016) examined the monitoring of vital signs and nurse-patient interaction and found that 21% of nurses measured all vital signs, and only 22% recorded respiratory rates [ 27 ]. In the literature review by Mok et al. (2015), it was reported that nurses often neglected respiratory assessment and that it was the least documented vital sign in patient records [ 13 ]. Another study found that nearly half of the nurses surveyed agreed that changes in respiratory rate were the least important of the indicators [ 20 ]. Despite the common reference to respiratory rate as a "neglected vital sign," the underlying reasons for this phenomenon remain ambiguous [ 13 ]. However, respiratory rate has been identified as a significant predictor of clinical deterioration [ 28 ]. However, pulse oximetry, which is the primary method of measuring oxygen saturation, has been shown to provide misleading information when supplemental oxygen is administered and can mask underlying respiratory issues [ 29 ]. It is plausible that nurses may have prioritized oxygen saturation over respiratory rate due to a lack of understanding regarding the significance of the latter. This misapprehension may contribute to the underestimation of respiratory rate [ 30 ]. A qualitative study posits that nurses may regard oxygen saturation measurement as a surrogate for respiratory rate monitoring [ 31 ]. Another potential explanation for this phenomenon could be the unavailability of respiratory rate monitoring equipment. In light of these findings, the incomplete performance of respiratory assessment by nursing students is a significant source of concern. To address this issue, education and guidance processes must be strengthened. Another salient finding from the study was the erroneous agreement among students with the statement that "blood pressure is usually the first parameter indicating that the patient's condition is deteriorating." Consistent with the outcomes of the present study, a previous investigation involving ward nurses revealed that the majority of nurses erroneously perceived blood pressure changes as the primary indicator of deterioration [ 13 ]. Blood pressure should not be considered the primary indicator of a deteriorating condition. While high blood pressure and variability are associated with early neurological deterioration, other factors, such as cerebral edema and hemorrhagic transformation, also contribute to patient outcomes after stroke [ 32 ]. The findings of this study demonstrated that nursing students experienced significant deficiencies in the application steps of vital signs measurement. The failure to adhere to the principles of equipment maintenance and post-procedure hand hygiene in the implementation of basic measurements such as body temperature, blood pressure, and oxygen saturation poses a serious problem in terms of infection control and patient safety. The extant literature emphasizes that students' inadequacies in hand hygiene and equipment cleaning may increase the risk of infection and lead to deficiencies in meeting professional nursing standards [ 33 ]. In terms of recognizing and reporting abnormal vital signs, it was evaluated as a positive finding that students reported parameters such as body temperature and oxygen saturation to nurses completely. However, the low rate of reporting critical parameters such as respiration, pulse, and blood pressure to nurses indicates that there are deficiencies in clinical decision-making skills. In their study, Mok et al. revealed that clinical knowledge, roles, responsibilities, and reporting affect nurses' ability to detect clinical deterioration and monitor vital signs in general wards. A qualitative-observational study in Australia found that only 6–21% of the five vital signs required by the policy were assessed [ 27 ]. Other studies have shown that important vital signs, such as respiratory rate, are underreported or misrecorded due to perceived time constraints and low prioritization in clinical settings [ 30 , 34 ]. Furthermore, body temperature is measured with infrared temporal thermometers, and oxygen saturation is measured with pulseoximetry devices in the clinics where the study is performed. Blood pressure is measured with a manual sphygmomanometer, while respiration and pulse rate are measured manually by palpation and inspection methods. The reliance on technology in this context may inadvertently diminish interest in manual vital signs measurements and potentially lead to underreporting. This shift towards electronic vital signs monitoring may impede the nurse-patient interaction, potentially leading to the failure to identify early indications of physical deterioration. Limitations This study has several limitations, and its results should be evaluated in the context of these limitations. One of the limitations of the study is that the sample consists of students from only one faculty. Therefore, the findings of the study are limited to this faculty. Another limitation is the low level of participation due to the fact that observation of the study caused anxiety among the students. The study was conducted in a single center and four wards, and observations were made only during certain time periods during the day when students were receiving vital signs. Therefore, the data may not be representative of other wards or other hospitals in the study hospital. The strength of the study is that two observers made observations at the same time. Observational data is subject to the influence of the researcher's perspective and may contain bias [ 35 ]. Additionally, the Hawthorne effect, which occurs when observed individuals adapt their behavior to the observation process, whether consciously or unconsciously, is a potential concern [ 36 ]. Consequently, the findings of observational studies may be influenced by the observational conditions, potentially resulting in a deviation from the subjects' natural behaviors. It is crucial to consider this effect in observational studies and to apply appropriate methods to minimize potential bias. In the present study, these concerns were addressed through the following measures: the subject of observation was kept undisclosed to the students, the observation period was not extended over an extensive time frame, and the skill steps of the observation form were structured to promote objective evaluation. CONCLUSION The objective of this study was to assess nursing students' competencies in vital sign monitoring, recognition, and reporting of abnormal findings. The findings indicated that, while students generally exhibited a positive attitude towards vital signs measurement, they demonstrated deficiencies in measuring and reporting certain fundamental parameters. The evaluation of critical parameters, such as respiratory rate and pulse rate, revealed significant shortcomings. These deficiencies may be attributed to inadequacies in educational and clinical guidance processes. Although students regularly performed measurements such as body temperature and oxygen saturation, it is noteworthy that respiratory rate and pulse rate assessments were neglected. Respiratory rate, being a critical parameter in terms of early detection of clinical deterioration, exemplifies an area of concern that requires more emphasis in the educational process, given the lack of importance given to this finding by the students. The low rate of students reporting abnormal vital signs suggests the need for additional training and support programs to improve clinical decision-making skills. The results of the study once again demonstrated the importance of clinical guidance in nursing education. The findings demonstrate the importance of clinical guidance in nursing education. Guidance provided by clinical instructors and experienced nurses can contribute to the development of students' professional skills and help them become more competent in clinical decision-making. Consequently, enhancing the efficacy of vital sign monitoring and reporting practices within nursing education programs is imperative to ensure optimal patient safety. In conclusion, the results of this study highlight the deficiencies of nursing students in assessing vital signs and reporting abnormal findings and emphasize that nursing education programs should focus more on these areas. A comprehensive review of existing education programs, coupled with a concerted effort to raise awareness about the critical parameters of respiratory rate evaluation and the enhancement of clinical guidance processes, holds the potential to empower students to monitor patients with greater efficacy and awareness. The findings of this study should be further supported by qualitative analysis. Focus group discussions or individual interviews can be conducted to understand why students do not report some findings. Abbreviations STROBE Strengthening the Reporting of Observational Studies in Epidemiology V-scale Vital Signs Scale CVI Content Validity Index SPSS Statistical Package for the Social Sciences SpO 2 Peripheral oxygen saturation Declarations Ethics approval and consent to participate The study was conducted in accordance with the Declaration of Helsinki. All participants provided both verbal and written informed consent. Ethical approval was obtained from the Pamukkale University Non-Interventional Clinical Research Ethics Committee (decision dated 02/04/2024 and numbered E-60116787-020-512969 07). Consent for publication Not applicable Availability of data and materials All data generated or analysed during this study are included in this published article. Competing Interests The authors declare that they have no competing interests Funding No funding was received. Authors' contributions Conceived and designed the research: ÖF, AŞZ. Wrote the paper: AŞZ, ÖF, SA, and AÇ. Analyzed the data: AŞZ. Revised the paper: AŞZ, ÖF, SA, and AÇ. The authors read and approved the final manuscript. Acknowledgements We would like to express our sincerest gratitude to all study participants for their invaluable contribution of time during the data collection phase of the study. Clinical trial number Not applicable. References Samani S, Rattani SA. Recognizing Early Warning Signs (EWS) in patients is critically important. Open J Nurs. 2023;13(1):53. Fagan K, Sabel A, Mehler PS, MacKenzie TD. Vital sign abnormalities, rapid resporse, and adverse outcomes in hospitalized patients. Am J Med Qual. 2012;27:480–6. Ahrens T. The most important vital signs are not being measured. Aust Crit Care. 2008;21(1):3–5. Vincent JL, Einav S, Pearse R, Jaber S, Kranke P, Overdyk FJ. Hoeft Andreas. Improving detection of patient deterioration in the general hospital ward environment. Eur J Anaesthesiol. 2018;35:325–33. 10.1097/EJA.0000000000000798 . Gülnar E, Doğan Yılmaz E, Özveren H. Determination of Nurses’ Attitudes and Applications on Vital Signs. KÜ Tıp Fak Derg. 2020;22(3):377–85. Kokkonen E, Repo J. Taking and observing the vital signs of an adult patient: An educational material for nursing students [Bachelor's thesis]. Satakunta University of Applied Sciences; 2022. Available from: https://www.theseus.fi/handle/10024/755298 Connor N, McArthur D, Camargo Plazas P. Reflections on vital sign measurement in nursing practice. Nurs Philos. 2021;22(1). https://doi.org/10.1111/NUP.12326 . Leuvan CHV, Mitchell I. Missed opportunities? An obser-vational study of vital sign measurements. Crit Care Resusc. 2008;10:111–1154. Kamio T, Kajiwara A, Iizuka Y, Shiotsuka J, Sanui M. Frequency of vital sign measurement among intubated patients in the general ward and nurses’ attitudes toward vital sign measurement. JMDH. 2018;575–81. Kellett J, Sebat F. Make vital signs great again - A call for action. Eur Jntern Med. 2017;45:13–9. Fuhrmann L, Lippert A, Perner A, Ostergaard D. Incident, staff awarenes and mortality of patiens at risk on general wards. Resisciation. 2008;77:325–30. Ludikhuize J, Smorenburg S, de Rooij S, de Jonge E. Identification of deteriorating patients on general wards: measurement of vital parameters and potential effectiveness of the Modified Early Warning Score. J Crit Care. 2012;27:424.e7-424.e13. Mok QW, Wang W, Liaw YS. Vital signs monitoring to detect patient deterioration: An integrative literature review. Int J Nurs Pract. 2015;21(2):91–8. Alshehry AS, Cruz JP, Bashtawi MA, Almutairi KO, Tumala RB. Nursing students’ knowledge, competence and attitudes towards vital signs monitoring during clinical practice. J Clin Nurs. 2021;30(5–6):664–75. Leonard MM, Kyriacos U. Student nurses’ recognition of early signs of abnormal vital sign recordings. Nurse Educ Today. 2015;35(9):e11–8. Pozam M, Zaybak A. Examination of nursing students’ self efficacy regarding their clinical performance. DEUHFED. 2022;15(1):22–9. Sarı HY, Yöntem SÇ, Demir D, Karaoğlan N, Başkurt SŞ, Çimen S. The knowledge and attitudes of pediatric nurses towards vital signs. J Educ Res Nurs. 2013;10(1):38–44. Cooper S, Kinsman L, Buykx P, McConnell-Henry T, Endacott R, Scholes J. Managing the deteriorating patient in a simulated environment: nursing students’ knowledge, skill and situation awareness. J Clin Nurs. 2010;19(15–16):2309–18. Von Elm E, Altman DG, Egger M, Pocock S, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495–9. Mok W, Wang W, Cooper S, Ang ENK, Liaw SE. Attitudes towards vital signs monitoring in the detection of clinical deterioration: scale development and survey of ward nurses. Int J Qual Health Care. 2015;27(3):207–13. Ertuğ N. Evaluating the validity and reliability of the V-scale instrument (Turkish version) used to determine nurses' attitudes towards vital sign monitoring. Int J Nurs Pract. 2018;24(3), e12637. Fidan Ö, Şanlıalp Zeyrek A. Nursing students’ knowledge and attitudes towards vital signs monitoring in clinical practices: Descriptive-cross-sectional study. Turkiye Klinikleri J Nurs Sci. 2025;17(1). Göçmen Baykara Z, Çalışkan N, Öztürk D, Karadağ A. Temel Hemşirelik Becerileri. Ankara Nobel Tıp Kitabevleri. Ankara; 2024. Özsaban A, Turan N, Beki Ç, Aşti T. The relationship between nurses' attitudes towards vital signs monitoring and their emotional intelligence levels. GTD. 2022;32(6):652–7. Farzi S, Shahriari M, Farzi S. Exploring the challenges of clinical education in nursing and strategies to improve it: A qualitative study. J Educ Health Promot. 2018;7. Zamanzadeh V, Valizadeh L, Ghahramanian A, Namadi-Vosoughi M, Bagheriyeh F, Pourmollamirza A. Nursing students’ experiences from clinical education using the TPSN model. BMC Nurs. 2024;23(1):155. Cardona-Morrell M, Prgomet M, Lake R, Nicholson M, Harrison R, Long J, Westbrook J,… Hillman K. Vital signs monitoring and nurse–patient interaction: A qualitative observational study of hospital practice. Int. J. Nurs. Stud. 2016;56:9–16. Churpek MM, Adhikari R, Edelson DP. The value of vital sign trends for detecting clinical deterioration on the wards. Resuscitation. 2016;102:1–5. Epub 2016/02/24. pmid:26898412. Ramsay MAE. Monitoring respiratory rate. Springer, New York, 2014;207–216. NY. https://doi.org/10.1007/978-1-4614-8557-5_24 Elliott M, Baird J. Pulse oximetry and the enduring neglect of respiratory rate assessment: a commentary on patient surveillance. BJN. 2019;28(19):1256–9. Hogan J. Why don’t nurses monitor the respiratory rates of patients. BJN. 2006;15:489–92. Kjeldsen SE, Berge E. Blood pressure and early neurological deterioration in acute ischemic stroke. J Hypertens. 2015;33(10):2020–1. Bouchoucha SL, Phillips NM, Lucas J, Kilpatrick M, Hutchinson A. An investigation into nursing students' application of infection prevention and control precautions. Nurse Educ Today. 2021;104:104987. Kayser SA, Williamson R, Siefert G, Roberts D, Murray A. Respiratory rate monitoring and early detection of deterioration practices. BJN. 2023;32(13):620–7. Kawulich BB. Participant observation as a data collection method. Forum: Qual Soc Res. 2005;26(2):43. McCambridge J, Witton J, Elbourne DR. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol. 2014;67(3):267–77. 08/13/accepted, PubMed PMID: PMC3969247. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6502579","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":482958093,"identity":"122aa2c0-2adb-45ae-9535-04abfc59e300","order_by":0,"name":"Arife Şanlıalp Zeyrek","email":"","orcid":"","institution":"Pamukkale University","correspondingAuthor":false,"prefix":"","firstName":"Arife","middleName":"Şanlıalp","lastName":"Zeyrek","suffix":""},{"id":482958094,"identity":"16b161d0-4b5a-46a1-afc1-e9aae67e0760","order_by":1,"name":"Özlem Fidan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwklEQVRIiWNgGAWjYFACxgaGhAM2EDYPCVrS4FokiLTpwGEStPDzH2778ODM+Tz+GQmMD962MdSZNxDQIjkjsXlGwo3bxRI3EpgN57YxSMgcIKDF4AZjM0PCh9uJDTcS2KR5gVoIuszg/EGQlnOJ828ksP8mTsuBRKCWGwcSNwBtYSZKC8gvDAlnkosNzzxslpxzTkJyBiEt/PzHHzP+OGaXJ3c8+eCHN2U2/MRGDEMCOE6Jj0mIllEwCkbBKBgFOAAAGExAW9QPb2oAAAAASUVORK5CYII=","orcid":"","institution":"Pamukkale University","correspondingAuthor":true,"prefix":"","firstName":"Özlem","middleName":"","lastName":"Fidan","suffix":""},{"id":482958095,"identity":"368a8f73-747e-4c29-8972-f01e64548123","order_by":2,"name":"Safiyenur Akın","email":"","orcid":"","institution":"Pamukkale University","correspondingAuthor":false,"prefix":"","firstName":"Safiyenur","middleName":"","lastName":"Akın","suffix":""},{"id":482958096,"identity":"9c9ce855-14ea-4fca-89e4-8bc06c733555","order_by":3,"name":"Aydan Çapar","email":"","orcid":"","institution":"Pamukkale University","correspondingAuthor":false,"prefix":"","firstName":"Aydan","middleName":"","lastName":"Çapar","suffix":""}],"badges":[],"createdAt":"2025-04-22 09:23:36","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6502579/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6502579/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86533631,"identity":"b5237f02-13f2-4404-9be7-98ad7f5c0bcb","added_by":"auto","created_at":"2025-07-11 17:53:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1794447,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6502579/v1/c8993fab-e39a-4bde-885c-1d666d6986c4.pdf"},{"id":86532666,"identity":"ca025618-4992-4cc0-9fc5-0bbc8fa1f7c6","added_by":"auto","created_at":"2025-07-11 17:29:41","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":30350,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementaryfile.docx","url":"https://assets-eu.researchsquare.com/files/rs-6502579/v1/d19f19e4b32154e9753854e2.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Nursing Students' Skills of Monitoring, Measuring, Reporting and Attitudes towards Vital Signs in the Clinical Practice Process: An Observational Evaluation","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eVital signs are critical for assessing the health status of individuals and early detection of clinical deterioration [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. It is well-established that abnormalities in vital signs in patients typically manifest several hours before the onset of physiological deterioration. Specifically, changes in respiratory rate are widely regarded as the most significant indicator of physiological deterioration [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Consequently, the regular monitoring of vital signs is essential to reflect the current state of the patient's health and to identify potential clinical deterioration in advance [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Accurate measurement, recording, and interpretation of vital signs facilitate early interventions, inform the determination of appropriate treatment and patient care, and prevent complications [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e–\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe monitoring of vital signs constitutes a key part of nursing care and is the responsibility of the nurse [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. A nurse must possess a comprehensive understanding of both normal and abnormal variations in vital signs, in addition to the ability to discern when to implement requisite precautions [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. However, numerous studies have indicated that vital signs are not regularly measured, recorded, or interpreted correctly in clinical settings [\u003cspan additionalcitationids=\"CR9 CR10 CR11\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e–\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Mok et al. (2015) reported that although nurses appear to monitor vital signs regularly, their critical role in detecting patients' deteriorating conditions is often overlooked [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. This finding underscores the necessity of cultivating nurses' competencies to meticulously monitor, assess, and intervene in vital signs, a process that ought to be integrated into their professional training curricula [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe measurement of vital signs is among the most frequently assigned tasks to nursing students in clinical practice, as these procedures are generally non-invasive [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. However, it has been found that nursing students' knowledge and skills in assessing vital signs are generally inadequate, and they also have difficulties in recognizing abnormal conditions early [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. This may be attributed to a lack of appreciation for the significance of vital signs, which can hinder students' ability to report to nurses in a timely manner. This, in turn, may result in missed opportunities for early intervention, potentially leading to clinical deterioration. Moreover, due to their limited experiential knowledge, nursing students may fail to notice critical signs of clinical deterioration, which may further jeopardize patient safety [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Deficiencies in students' ability to measure, record, and interpret vital signs in clinical practice may compromise the quality of patient care and patient safety [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Consequently, nursing students must enhance their knowledge and attitudes regarding accurate measurement, documentation, interpretation of abnormal findings, and timely reporting to experienced healthcare professionals [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eResearch indicates that nurses and students exhibit a favorable disposition toward vital signs monitoring [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. However, it has also been observed that there are inadequacies in their ability to detect and manage patients whose condition deteriorates in the clinical setting and that they have difficulty transferring the theoretical knowledge they have learned to clinical practice [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. This discrepancy underscores the necessity for effective strategies that will enable nursing students to seamlessly integrate their theoretical knowledge and skills in clinical settings, fostering a positive attitude toward vital signs monitoring. A review of the extant literature reveals a paucity of observational studies that rigorously examine whether nursing students can effectively apply their theoretical knowledge about vital signs skills in the clinical setting. Recognizing the pivotal role of precise vital signs monitoring in patient care, this study was undertaken to assess nursing students' competencies in vital signs monitoring and their attitudes towards vital signs in clinical practice.\u003c/p\u003e\n\u003ch3\u003eAim\u003c/h3\u003e\n\u003cp\u003eThe study was conducted to investigate nursing students' attitudes toward vital signs measurement, their skills in measuring vital signs, and their behaviors in reporting abnormal findings.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResearch questions\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhat is the level of nursing students' attitudes towards the measurement of vital signs?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eIs there a relationship between nursing students' attitudes toward the measurement of vital signs and sociodemographic data?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhat is the level of nursing students' follow-up of vital signs?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhat is the level of nursing students' ability to perform the steps of measuring vital signs in clinical practice?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhat is the level of students' ability to recognize abnormal vital signs and report these findings to nurses?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e"},{"header":"METHODS","content":"\u003ch2\u003eDesign, setting, and participants\u003c/h2\u003e\u003cp\u003eThis is a descriptive and direct observational study. The population of the study consisted of 120 second-year nursing students studying at a university in western Turkey in the spring semester of 2023–2024. The inclusion criteria were taking the Fundamentals of Nursing course, taking the Internal Medicine or Surgical Disease Nursing course, doing clinical practice in the wards, and volunteering to participate in the study. Exclusion criteria included not having taken the Fundamentals of Nursing course, not taking the internal medicine course or the surgical diseases nursing course, having performed clinical practices in operating rooms, emergency, intensive care, and outpatient clinics, and not volunteering to participate in the study. Individuals who did not complete the scales in their entirety were excluded from the study. The objective of the study was to reach the entire population, and thus, no sample was selected. The study was completed with 63 students who met the inclusion criteria. The study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for reporting observational studies [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e\u003ch3\u003eData collection tools\u003c/h3\u003e\u003cp\u003eData were collected using the Participant Information Form, Vital Signs Scale (V-scale), and Vital Signs Measurement Skill Assessment Observation Form.\u003c/p\u003e\u003ch3\u003eParticipant information form\u003c/h3\u003e\u003cp\u003eA form was developed to assess the socio-demographic characteristics of the participants. This form was prepared by conducting a thorough review of the relevant literature [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The form included questions such as age, gender, academic achievement status, the service where the students did their internship, whether they chose nursing voluntarily, their satisfaction with being a nurse, the frequency and adequacy of taking vital signs, the adequacy of theoretical and laboratory training on vital signs, and the adequacy of support received from the instructor and nurses in training vital signs skills in the clinic.\u003c/p\u003e\u003ch3\u003eVital Signs Scale (V-scale)\u003c/h3\u003e\u003cp\u003eThe V-scale was developed by Mok et al. (2015), and the Turkish validity and reliability were performed by Ertuğ (2018) [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The scale was developed to measure nurses' attitudes towards vital signs measurement. The scale consists of 16 items and five subdimensions: Workload, Technology, Communication, Information, and Basic Indicators.\u003c/p\u003e\u003cp\u003eWorkload is defined as the effort and time expended on vital signs. Technology refers to the impact of respiratory rate counting in electronic vital signs monitoring. The term \"communication\" is used to denote the process of recording vital signs that are deteriorating. Knowledge, in this context, signifies the capacity to interpret vital signs accurately. Key indicators refer to vital signs that are of particular importance in indicating a deterioration in the patient's condition. The scale utilizes a 5-point Likert-type assessment, ranging from \"strongly disagree\" to \"strongly agree.\" The total score ranges from 16 to 80. Scores at the lower end of the scale are indicative of nurses' negative attitudes toward vital signs, while higher scores represent positive attitudes. The original Cronbach alpha value of the scale was determined to be 0.71 [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In a subsequent study, Ertuğ (2018) identified a Cronbach's alpha value of 0.76 [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. It is noteworthy that the instrument was initially designed for nurses; consequently, Fidan and Şanlıalp Zeyrek (2025) adapted some questions of the scale to nursing students in their study [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The result of this adaptation process yielded a Cronbach's alpha value of 0.76, which is consistent with the initial findings.\u003c/p\u003e\u003ch2\u003eVital Signs Measurement Skill Assessment Observation Form\u003c/h2\u003e\u003cp\u003eThe observation form was designed to evaluate students' ability to measure vital signs during clinical practice. The study included observation of the following skills: taking body temperature, taking blood pressure, assessing radial artery pulse, assessing respiration, and assessing oxygen saturation. The form further assessed the students' capacity to monitor vital signs and to report any abnormalities to the nursing staff according to the measurement results. The form was developed based on the practical application steps of fundamental nursing skills outlined in the book \"Basic Nursing Skills\" by Göçmen Baykara et al. (2021) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The content validity of the form was evaluated by five experts in the relevant field (five faculty members of the Department of Nursing Principles). Accordingly, the experts examined whether the scope of the form adequately covered the targeted skills and the level of clarity, comprehensibility, and appropriateness of each item. The necessary revisions were made. The Content Validity Index (CVI) value, calculated as a result of the experts' evaluations of each implementation step, was found to be 0.90. This finding demonstrated the usability of the observation form as a reliable and valid tool (see supplementary file).\u003c/p\u003e\u003ch3\u003eData collection\u003c/h3\u003e\u003cp\u003eIn the hospital where the study was conducted, vital signs measurements are typically performed at 9:00, 12:00, 13:00, and 15:00 in the majority of clinics. However, the frequency of measurement may be subject to variation in specific clinical circumstances, including general condition disorders, blood transfusion, and the postoperative period. On clinical practice days, vital signs measurement is conducted by nursing students, with follow-up checks by the clinical nurse or supervising instructor.\u003c/p\u003e\u003cp\u003eThe observation was conducted by two faculty members who had received training in data collection through direct observation and who specialized in the field of nursing principles. The observers determined the vital signs measurement times of the clinics and planned the time for the students to be observed and the measurement times. In order to avoid the Hawthorne effect, students were informed that only a general observation would be made, and it was not specified that the skill steps related to vital signs measurement would be evaluated. The students were instructed to measure body temperature using a non-contact infrared thermometer, blood pressure with an aneroid manometer, pulse rate by manual wrist or neck counting, and oxygen saturation with pulse oximetry devices. It is noteworthy that all devices utilized in this study are routinely subjected to daily calibration and accuracy checks by the institution.\u003c/p\u003e\u003cp\u003e Prior to the observation process, both verbal and written informed consent was obtained from all participants. To assess interobserver agreement, each student was assessed simultaneously by two different observers. The observations focused on the students' adherence to vital signs procedures, the completion of the required steps in the correct order for each measurement (correct, incorrect/incomplete, not performed), the maintenance of the measurement records, and the reporting of any abnormal findings to the nurses as a result of the measurements. Each student's observation period lasted approximately 10–15 minutes.\u003c/p\u003e\u003cp\u003eFollowing the observation, the students were asked to complete the Participant Information Form and the V-Scale. The completion of these forms and scales took approximately 10 minutes.\u003c/p\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eAll statistical analyses were performed using SPSS 27.0 (IBM SPSS Statistics 27 software (Armonk, NY: IBM Corp.)). Continuous variables were defined by the mean ± standard deviation, minimum- maximum values, and categorical variables were defined by number and percent. The relationships between continuous variables were analyzed using Pearson correlation analysis. The significance test of the difference between two means and one-way analysis of variance was used to examine the differences between groups. The differences between categorical variables were analyzed using Chi-square analysis. The Kappa coefficient was used to evaluate interobserver agreement.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the data on the comparison of the sociodemographic characteristics of nursing students and the total and subscale scores of the V-scale. The majority of the participants were female, with a mean age of 20.60\u0026thinsp;\u0026plusmn;\u0026thinsp;1.11 years and a mean academic score of 2.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.44. The departments where students performed clinical practice were thoracic diseases (38.1%), orthopedics (22.2%), neurosurgery (20.6%), and cardiovascular surgery (19%). A significant proportion of the participants expressed satisfaction with their decision to pursue studies in the nursing department, with 77.8% reporting satisfaction and 68.3% indicating a deliberate choice of the nursing profession. During clinical practice, 76.2% of the students reported taking vital signs 3\u0026ndash;4 times a day, and 96.8% of them found the frequency of vital sign monitoring to be sufficient. Moreover, 87.3% of the students found the theoretical training time sufficient, and 90.5% found the laboratory training time sufficient. While 79.4% of the students found the support of the instructors adequate in teaching vital signs skills in the clinic, 41.3% found the support of the nurses inadequate (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of participants\u0026rsquo; characteristics and V-scale total and sub-dimension scores\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables (N\u0026thinsp;=\u0026thinsp;63)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWorkload\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTechnology\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunication\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKnowledge\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eKey Indicators\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003eV-scale\u003c/em\u003e Total\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e52 (82.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.56\u0026thinsp;\u0026plusmn;\u0026thinsp;.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.62\u0026thinsp;\u0026plusmn;\u0026thinsp;.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.67\u0026thinsp;\u0026plusmn;\u0026thinsp;1.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.44\u0026thinsp;\u0026plusmn;\u0026thinsp;.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.90\u0026thinsp;\u0026plusmn;\u0026thinsp;.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.38\u0026thinsp;\u0026plusmn;\u0026thinsp;.59\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11 (17.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.50\u0026thinsp;\u0026plusmn;\u0026thinsp;.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.56\u0026thinsp;\u0026plusmn;\u0026thinsp;.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.45\u0026thinsp;\u0026plusmn;\u0026thinsp;1.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.24\u0026thinsp;\u0026plusmn;\u0026thinsp;.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.03\u0026thinsp;\u0026plusmn;\u0026thinsp;.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;.48\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTest p\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.224\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.824\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.254\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.801\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.515\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.608\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.764\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.448\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003et=-.626\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.534\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.222\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.825\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eService where the application was performed\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOrthopedics Service\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14 (22.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.14\u0026thinsp;\u0026plusmn;\u0026thinsp;.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.25\u0026thinsp;\u0026plusmn;\u0026thinsp;1.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.92\u0026thinsp;\u0026plusmn;\u0026thinsp;.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.83\u0026thinsp;\u0026plusmn;\u0026thinsp;.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.04\u0026thinsp;\u0026plusmn;\u0026thinsp;.52\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeurosurgery service\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13 (20.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.48\u0026thinsp;\u0026plusmn;\u0026thinsp;.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.65\u0026thinsp;\u0026plusmn;\u0026thinsp;.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.48\u0026thinsp;\u0026plusmn;\u0026thinsp;.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.92\u0026thinsp;\u0026plusmn;\u0026thinsp;.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.40\u0026thinsp;\u0026plusmn;\u0026thinsp;.44\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChest Diseases Service\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24 (38.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.51\u0026thinsp;\u0026plusmn;\u0026thinsp;.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.73\u0026thinsp;\u0026plusmn;\u0026thinsp;.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.66\u0026thinsp;\u0026plusmn;\u0026thinsp;1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.95\u0026thinsp;\u0026plusmn;\u0026thinsp;.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.33\u0026thinsp;\u0026plusmn;\u0026thinsp;.44\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCardiovascular Surgery Service\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12 (19.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.20\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.00\u0026thinsp;\u0026plusmn;\u0026thinsp;.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.62\u0026thinsp;\u0026plusmn;\u0026thinsp;1.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.97\u0026thinsp;\u0026plusmn;\u0026thinsp;.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.81\u0026thinsp;\u0026plusmn;\u0026thinsp;.73\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTest p\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;3.521\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.020\u003c/p\u003e\u003cp\u003ea\u0026thinsp;\u0026lt;\u0026thinsp;d*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;4.554\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.006\u003c/p\u003e\u003cp\u003ea\u0026thinsp;\u0026gt;\u0026thinsp;d*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;.783\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.508\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;4.860\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.004\u003c/p\u003e\u003cp\u003ea\u0026thinsp;\u0026lt;\u0026thinsp;d*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;.149\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.930\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;4.627\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.006\u003c/p\u003e\u003cp\u003ea\u0026thinsp;\u0026lt;\u0026thinsp;d*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSatisfaction level of being a nurse\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e49 (77.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.62\u0026thinsp;\u0026plusmn;\u0026thinsp;.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.55\u0026thinsp;\u0026plusmn;\u0026thinsp;.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.75\u0026thinsp;\u0026plusmn;\u0026thinsp;1.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.43\u0026thinsp;\u0026plusmn;\u0026thinsp;.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.42\u0026thinsp;\u0026plusmn;\u0026thinsp;.57\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14 (22.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.30\u0026thinsp;\u0026plusmn;\u0026thinsp;.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.85\u0026thinsp;\u0026plusmn;\u0026thinsp;.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.21\u0026thinsp;\u0026plusmn;\u0026thinsp;1.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.30\u0026thinsp;\u0026plusmn;\u0026thinsp;.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.95\u0026thinsp;\u0026plusmn;\u0026thinsp;.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.18\u0026thinsp;\u0026plusmn;\u0026thinsp;.55\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTest p\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.192\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.238\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et=-1.401\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.166\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.416\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.162\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.525\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.601\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003et=-.184\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.855\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.406\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.165\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eChoosing nursing voluntarily\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43 (68.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.61\u0026thinsp;\u0026plusmn;\u0026thinsp;.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.56\u0026thinsp;\u0026plusmn;\u0026thinsp;.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.60\u0026thinsp;\u0026plusmn;\u0026thinsp;1.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.37\u0026thinsp;\u0026plusmn;\u0026thinsp;.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.38\u0026thinsp;\u0026plusmn;\u0026thinsp;.56\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20 (31.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.43\u0026thinsp;\u0026plusmn;\u0026thinsp;.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.72\u0026thinsp;\u0026plusmn;\u0026thinsp;.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.70\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.48\u0026thinsp;\u0026plusmn;\u0026thinsp;.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.95\u0026thinsp;\u0026plusmn;\u0026thinsp;.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;.59\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTest p\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.707\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.482\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et=-.787\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003et=-.275\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.784\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et=-.520\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.605\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003et=-.213\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.832\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.273\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.786\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFrequency of Receiving Vital Signs\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;2 times a day\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11 (17.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.68\u0026thinsp;\u0026plusmn;\u0026thinsp;.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.70\u0026thinsp;\u0026plusmn;\u0026thinsp;.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.36\u0026thinsp;\u0026plusmn;\u0026thinsp;1.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.39\u0026thinsp;\u0026plusmn;\u0026thinsp;.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.75\u0026thinsp;\u0026plusmn;\u0026thinsp;.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.31\u0026thinsp;\u0026plusmn;\u0026thinsp;.50\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u0026ndash;4 times a day\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48 (76.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.52\u0026thinsp;\u0026plusmn;\u0026thinsp;.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.60\u0026thinsp;\u0026plusmn;\u0026thinsp;.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.69\u0026thinsp;\u0026plusmn;\u0026thinsp;1.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.48\u0026thinsp;\u0026plusmn;\u0026thinsp;.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.39\u0026thinsp;\u0026plusmn;\u0026thinsp;.59\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDepending on the patient's condition\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4 (6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.62\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.50\u0026thinsp;\u0026plusmn;\u0026thinsp;.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.62\u0026thinsp;\u0026plusmn;\u0026thinsp;1.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.50\u0026thinsp;\u0026plusmn;\u0026thinsp;.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.50\u0026thinsp;\u0026plusmn;\u0026thinsp;.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;.65\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTest p\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;.152\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.860\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;.130\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.878\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;.303\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.740\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;3.104\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.052\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;2.320\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.107\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;.071\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.932\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinding the frequency of taking vital signs sufficient\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e61 (96.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.52\u0026thinsp;\u0026plusmn;\u0026thinsp;.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.60\u0026thinsp;\u0026plusmn;\u0026thinsp;.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.62\u0026thinsp;\u0026plusmn;\u0026thinsp;1.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.39\u0026thinsp;\u0026plusmn;\u0026thinsp;.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.36\u0026thinsp;\u0026plusmn;\u0026thinsp;.57\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (3.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.5\u0026thinsp;\u0026plusmn;\u0026thinsp;.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3\u0026thinsp;\u0026plusmn;\u0026thinsp;.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.83\u0026thinsp;\u0026plusmn;\u0026thinsp;.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.33\u0026thinsp;\u0026plusmn;\u0026thinsp;.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.71\u0026thinsp;\u0026plusmn;\u0026thinsp;.13\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTest p\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003et=-1.525\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.132\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et=-.751\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.456\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003et=-.410\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.683\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et=-.776\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.441\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003et=-.966\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.338\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et=-.857\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.395\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinding the duration of theoretical training on vital signs sufficient\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55 (87.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.53\u0026thinsp;\u0026plusmn;\u0026thinsp;.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.67\u0026thinsp;\u0026plusmn;\u0026thinsp;.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.60\u0026thinsp;\u0026plusmn;\u0026thinsp;1.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.39\u0026thinsp;\u0026plusmn;\u0026thinsp;.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.90\u0026thinsp;\u0026plusmn;\u0026thinsp;.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;.56\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 (12.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.71\u0026thinsp;\u0026plusmn;\u0026thinsp;.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.21\u0026thinsp;\u0026plusmn;\u0026thinsp;.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.87\u0026thinsp;\u0026plusmn;\u0026thinsp;1.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.50\u0026thinsp;\u0026plusmn;\u0026thinsp;.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.04\u0026thinsp;\u0026plusmn;\u0026thinsp;.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.58\u0026thinsp;\u0026plusmn;\u0026thinsp;.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTest p\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003et=-.546\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.587\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.693\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.096\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003et=-.569\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.572\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et=-.354\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.725\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003et=-.575\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.567\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et=-1.111\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.271\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinding the duration of laboratory training on vital signs sufficient\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e57 (90.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.56\u0026thinsp;\u0026plusmn;\u0026thinsp;.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.56\u0026thinsp;\u0026plusmn;\u0026thinsp;.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.59\u0026thinsp;\u0026plusmn;\u0026thinsp;1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.40\u0026thinsp;\u0026plusmn;\u0026thinsp;.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.38\u0026thinsp;\u0026plusmn;\u0026thinsp;.59\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6 (9.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.50\u0026thinsp;\u0026plusmn;\u0026thinsp;.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.12\u0026thinsp;\u0026plusmn;\u0026thinsp;.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.00\u0026thinsp;\u0026plusmn;\u0026thinsp;.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.44\u0026thinsp;\u0026plusmn;\u0026thinsp;.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.05\u0026thinsp;\u0026plusmn;\u0026thinsp;.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.31\u0026thinsp;\u0026plusmn;\u0026thinsp;.31\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTest p\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.158\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.875\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et=-1.827\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.073\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003et=-.737\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.464\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et=-.120\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.905\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003et=-.548\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.586\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.283\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.778\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinding the support of the instructor sufficient in teaching vital signs skills in the clinic\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50 (79.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.61\u0026thinsp;\u0026plusmn;\u0026thinsp;.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.53\u0026thinsp;\u0026plusmn;\u0026thinsp;.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.72\u0026thinsp;\u0026plusmn;\u0026thinsp;1.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.51\u0026thinsp;\u0026plusmn;\u0026thinsp;.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.95\u0026thinsp;\u0026plusmn;\u0026thinsp;.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.44\u0026thinsp;\u0026plusmn;\u0026thinsp;.57\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13 (20.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.96\u0026thinsp;\u0026plusmn;\u0026thinsp;.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3\u0026thinsp;\u0026plusmn;\u0026thinsp;.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.82\u0026thinsp;\u0026plusmn;\u0026thinsp;.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.10\u0026thinsp;\u0026plusmn;\u0026thinsp;.50\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTest p\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.941\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.350\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et=-1.950\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.056\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.043\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.301\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;2.158\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.035\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.701\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.486\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.995\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.048\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinding the support of nurses sufficient in teaching vital signs skills in the clinic\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e37 (58.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.76\u0026thinsp;\u0026plusmn;\u0026thinsp;.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.84\u0026thinsp;\u0026plusmn;\u0026thinsp;.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.71\u0026thinsp;\u0026plusmn;\u0026thinsp;1.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.63\u0026thinsp;\u0026plusmn;\u0026thinsp;.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.97\u0026thinsp;\u0026plusmn;\u0026thinsp;.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.52\u0026thinsp;\u0026plusmn;\u0026thinsp;.58\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26 (41.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.25\u0026thinsp;\u0026plusmn;\u0026thinsp;.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.45\u0026thinsp;\u0026plusmn;\u0026thinsp;.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.51\u0026thinsp;\u0026plusmn;\u0026thinsp;1.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.08\u0026thinsp;\u0026plusmn;\u0026thinsp;.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.85\u0026thinsp;\u0026plusmn;\u0026thinsp;.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.15\u0026thinsp;\u0026plusmn;\u0026thinsp;.49\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTest p\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;2.260\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.027\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;2.139\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.036\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.603\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.549\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;2.837\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.006\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;.732\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.467\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;2.641\u003c/p\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.010\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003er values\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003er values\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003er values\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003er values\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003er values\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003er values\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20.60\u0026thinsp;\u0026plusmn;\u0026thinsp;1.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.135\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.226\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.051\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e.196\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAcademic achievement\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.054\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.021\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.264*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.101\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e.116\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eAbbreviation: SD\u0026thinsp;=\u0026thinsp;Standard deviation, t: t-test in independent groups, F\u0026thinsp;=\u0026thinsp;ANOVA (analysis of variance),r\u0026thinsp;=\u0026thinsp;Pearson Correlation analysis. *Tukey post hoc analysis. * Correlation is significant at the 0.05 level (2 tailed)\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe results showed no significant difference in the subscale scores related to communication and basic indicators between the departments where the clinical practice was performed. However, in the total score, the subscales of workload and knowledge, students in cardiovascular surgery internships demonstrated more positive attitudes compared to students in orthopedic internships (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Conversely, in the technology subscale, students in the orthopedic service demonstrated more positive attitudes (11.64\u0026thinsp;\u0026plusmn;\u0026thinsp;1.54). Furthermore, students who found adequate support from lecturers exhibited more positive attitudes in the knowledge subscale (10.54\u0026thinsp;\u0026plusmn;\u0026thinsp;2.41) and total V-scale (55.16\u0026thinsp;\u0026plusmn;\u0026thinsp;9.17). Furthermore, students who found the support of nurses sufficient reported more positive attitudes towards workload, technology, knowledge, and total V-scale. Furthermore, a significant positive correlation was identified between students' academic achievement and their scores on the knowledge subscale (r\u0026thinsp;=\u0026thinsp;.264, p\u0026thinsp;\u0026lt;\u0026thinsp;.001).\u003c/p\u003e\u003cp\u003eThe responses of nursing students to each item in the V-scale are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The study revealed that the majority of the students exhibited negative attitudes towards three items related to vital signs. These items are as follows: The first item, which states that \"SpO\u003csub\u003e2\u003c/sub\u003e is a more reliable indicator than respiratory rate in reflecting the early signs of respiratory dysfunction,\" was endorsed by 55.5% of the students. The second item, which states that \"blood pressure is usually the first parameter to show that the patient's condition is deteriorating,\" was endorsed by 52.4% of the students. The third item, which states that \"respiratory rate is the least important finding in determining the deterioration of the patient's condition,\" was endorsed by 55.5% of the students. Additionally, more than one-third of the students incorrectly agreed with the statements \"Electronic monitoring of vital signs causes irregular monitoring (counting) of respiratory rate\" (34.9%) and \"Monitoring of SpO\u003csub\u003e2\u003c/sub\u003e by pulse oximetry reduces the need for counting respiration\" (41.3%) in the technology subscale. These findings suggest a deficiency in students' understanding of critical parameters and the utilization of technology.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eParticipants\u0026rsquo; Attitudes Towards the Results of the Vital Signs Scale (V-scale)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eScale Subdimensions\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eScale Items\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eStrongly disagree/\u003c/p\u003e\u003cp\u003eDisagree\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eUndecided\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003eStrongly agree/\u003c/p\u003e\u003cp\u003eI agree\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eWorkload\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMonitoring vital signs is time-consuming. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e66.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e23.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMonitoring vital signs is a tedious task. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e28.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eComplete and accurate monitoring of vital signs is neglected due to time constraints. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e55.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e23.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e20.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMonitoring my patients' vital signs at different frequencies (every hour, every 2 hours, every 4 hours, etc.) would overwhelm me. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e58.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e22.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eInformation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI can relate the vital signs of my patients to the physiology and pathophysiology of their disease.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e57.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMy knowledge of interpreting vital signs to determine that the patient's condition is deteriorating is limited. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e20.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChanges in vital signs are not interpreted correctly by student nurses. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e57.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e25.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eContact\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI feel confident in reporting deteriorating vital signs to the doctor/charge nurse for assessment of the patient.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e69.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIf there is no timely intervention when vital signs change, I repeatedly inform the doctor/responsible nurse about these changes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e71.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eKey Indicators\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpO\u003csub\u003e2\u003c/sub\u003e is a more reliable indicator of early signs of respiratory dysfunction than respiratory rate. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e33.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e55.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe first parameter that indicates that the patient's condition is deteriorating is usually blood pressure. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e23.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e52.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe respiratory rate is the least important finding in determining whether the patient's condition is deteriorating. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e55.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eTechnology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIn patients who are stable during routine monitoring of vital signs, the respiratory rate value is usually estimated and written down. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e25.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e23.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eElectronic monitoring of vital signs leads to irregular monitoring (counting) of respiratory rate. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e38.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e34.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMonitoring SpO\u003csub\u003e2\u003c/sub\u003e with pulse oximetry reduces the need to count respirations. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e41.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e41.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIf the SpO\u003csub\u003e2\u003c/sub\u003e is within the normal range, I usually record the respiratory rate as any number in the standard range of 12\u0026ndash;20/min. *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e57.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e22.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003e*Negatively worded items. A strongly agree or agree response indicates a negative attitude.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAs illustrated in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, nursing students demonstrated proficiency in vital sign monitoring during clinical practice. According to the data presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, all students (100%) measured body temperature, while the majority measured blood pressure (92.2%) and oxygen saturation (92.2%). However, it is noteworthy that approximately one-third of the students did not assess pulse (34.4%) and respiration (37.5%).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eStatus of Nursing Students' Follow-up of Vital Signs\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI did (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eI did not (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBody Temperature Measurement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e63 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBlood Pressure Measurement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (92.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (6.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEvaluation of the Pulse from the Radial Artery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41 (64.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22 (34.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAssessment of Respiration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39 (60.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24 (37.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEvaluation of oxygen saturation (SpO\u003csub\u003e2\u003c/sub\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (92.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (6.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAs illustrated in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, nursing students demonstrated a lack of proficiency in the application of vital signs measurement steps in clinical practice. The findings indicate that students exhibited deficiencies in all steps of the process. Significantly, a notable proportion of students exhibited deficiencies in the cleaning of equipment utilized for blood pressure and oxygen saturation measurements, in addition to inadequate adherence to hand hygiene protocols post-procedure. Furthermore, nearly half of the students exhibited deficiencies in the selection of appropriate sites (47.5%) and the positioning of the patient's arm or leg (44.1%). Furthermore, in the context of body temperature measurement, the majority of students did not evaluate the area to be measured (96.8%). Furthermore, in the process of blood pressure measurement, more than half of the students performed the identity verification process incompletely or incorrectly (49.1%).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eStatus of Nursing Students' Implementation of Vital Signs Measurement Application Steps in Clinical Practice\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eImplementation Steps\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCorrect *\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIncorrect/incomplete*\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNot implemented*\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMeasuring Body Temperature\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePerforming hand hygiene\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e63 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIdentifying patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29 (46)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (7.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29 (46)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEvaluating the area where the temperature will be measured\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (3.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61 (96.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePositioning the measuring device in the appropriate area/keeping it at the appropriate distance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e63 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eApplying the process\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e63 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEnsuring hand hygiene\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e63 (100)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSaving the transaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55 (87.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8 (12.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBlood Pressure Measurement\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePerforming hand hygiene\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIdentifying patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29 (49.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (8.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25 (42.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelection of an appropriate area\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31 (52.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20 (33.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8 (13.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePositioning the patient's arm/leg in the appropriate position\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e33 (55.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15 (25.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11 (18.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePalpating the brachial or popliteal artery; positioning the cuff 25 cm above the pulse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42 (71.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17 (28.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlacement of the stethoscope receiver over the brachial or popliteal artery and the earphones in the ears\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56 (94.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (3.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (1.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eClosing valve of pressure bulb; rapidly inflates cuff to 30 mmHg above systolic pressure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51 (86.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (5.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5 (8.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReleasing pressure bulb slowly at a rate of 2\u0026ndash;3 mmHg/second; noting value on manometer when first sound heard\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e54 (91.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (18.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDeflating cuff gently and noting the point at which dampened/muffled sound disappears\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e54 (91.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (18.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRemoving cuff from extremity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProper cleaning of equipment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59 (100)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEnsuring hand hygiene\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59 (100)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSaving the transaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e54 (91.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5 (18.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEvaluation of the Pulse from the Radial Artery\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePerform hand hygiene\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIdentify patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29 (70.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (12.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7 (17.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelection of an appropriate area\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38 (92.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (7.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAppropriate positioning of the patient's arm\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32 (78)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 (17.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (4.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlacing tips of first two fingers over groove along radial or thumb side of patients\u0026rsquo; inner wrist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40 (97.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (2.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCompressing against radius to obliterate pulse, then slightly releasing to palpate pulse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCounting 30 seconds if the pulse is rhythmic and 60 seconds if abnormal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSaving the transaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEvaluation of Respiration\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMonitoring the rib cage without telling the patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCounting 30 seconds if breathing is rhythmic and 60 seconds if breathing is abnormal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38 (97.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (2.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSaving the transaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEvaluation of oxygen saturation (SpO\u003c/b\u003e\u003csub\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sub\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelection of an appropriate area\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCorrectly placing the tool on the skin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eImplementing the process\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProper cleaning of equipment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59 (100)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEnsuring hand hygiene\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59 (100)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSaving saturation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAs illustrated in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, a comparison has been made between nursing students' capacity to identify abnormal vital signs and communicate these findings to nurses. The findings indicate that students reported all abnormal findings detected in body temperature and oxygen saturation assessments to nurses (p\u0026thinsp;\u0026lt;\u0026thinsp;.001). However, no such notification was made regarding abnormal findings in respiration and pulse measurements. Furthermore, in the context of blood pressure measurement, only 15.8% of students reported any abnormal findings to nurses (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Students' Skills in Recognizing Abnormal Vital Signs and Reporting These Findings to Nurses\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ePresence of Abnormal Findings in Vital Signs\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eReporting Abnormal Findings to Nurses\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eReported (n %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNot reported (n %)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBody Temperature Measurement\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e58 (100)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBlood Pressure Measurement\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 (15.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 (84.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.030\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e40 (100)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEvaluation of Pulse from Radial Artery\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33 (100)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEvaluation of Respiration\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23 (100)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEvaluation of oxygen saturation (SpO\u003c/b\u003e\u003csub\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sub\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eFisher\u0026rsquo;s Exact Test\u0026thinsp;\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49 (100)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThese results show that students experience deficiencies in recognizing and reporting some vital signs.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eVital signs represent a category of patient data that is frequently monitored in medical facilities. The monitoring of these findings plays a pivotal role in the early recognition of clinical deterioration. Notably, vital sign monitoring does not necessitate an invasive procedure, making it a prevalent skill among nursing students in clinical settings. The present study aims to observe and document the attitudes of nursing students toward vital signs measurement, their ability to measure vital signs accurately, and their behaviors in reporting abnormal findings.\u003c/p\u003e\u003cp\u003eNursing students must possess sufficient knowledge and a positive attitude to measure and record vital signs at appropriate time intervals using the correct methods. They must also be able to interpret these data correctly and report abnormal findings to experienced health professionals [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In this study, the attitudes of nursing students toward vital signs measurement were found to be above the intermediate level. Consistent with this, other studies examining nurses' attitudes toward vital signs monitoring have also reported results above the moderate level [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Conversely, Alshehry et al. (2020) reported that nursing students' attitudes towards vital signs measurement were suboptimal [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. This discrepancy may be attributed to the heterogeneity of students' clinical experiences or the structural differences in their education programs.\u003c/p\u003e\u003cp\u003eThe present study found that students who perceived adequate support from instructors and nurses during clinical practice exhibited more positive attitudes toward vital signs monitoring. The findings demonstrate that professional and supportive relationships play a critical role in creating a positive clinical learning environment. Such an environment fosters the development of effective performance skills and heightened individual motivation while concurrently supporting a successful professional socialization process [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Zamanzadeh et al. (2024) further substantiated this finding, observing that when students received adequate guidance in clinical practice, their confidence in their skills increased, and they assumed more responsibility while performing their tasks [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. These findings emphasize the importance of guidance provided by instructors and nurses for students to improve their clinical skills.\u003c/p\u003e\u003cp\u003eIn this study, an evaluation of vital signs measurements in clinical practice revealed that the majority of students performed body temperature, blood pressure, and oxygen saturation measurements. However, approximately one-third did not perform pulse and respiratory assessments. This finding suggests that students exhibited deficiencies in monitoring certain vital signs. Furthermore, an examination of students' attitudes toward vital signs revealed that they perceived oxygen saturation as a more reliable indicator of early respiratory dysfunction compared to respiratory rate. Conversely, respiratory rate was considered the least significant factor in determining the deterioration of a patient's condition. Cardona-Morrell et al. (2016) examined the monitoring of vital signs and nurse-patient interaction and found that 21% of nurses measured all vital signs, and only 22% recorded respiratory rates [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In the literature review by Mok et al. (2015), it was reported that nurses often neglected respiratory assessment and that it was the least documented vital sign in patient records [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Another study found that nearly half of the nurses surveyed agreed that changes in respiratory rate were the least important of the indicators [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Despite the common reference to respiratory rate as a \"neglected vital sign,\" the underlying reasons for this phenomenon remain ambiguous [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. However, respiratory rate has been identified as a significant predictor of clinical deterioration [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. However, pulse oximetry, which is the primary method of measuring oxygen saturation, has been shown to provide misleading information when supplemental oxygen is administered and can mask underlying respiratory issues [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. It is plausible that nurses may have prioritized oxygen saturation over respiratory rate due to a lack of understanding regarding the significance of the latter. This misapprehension may contribute to the underestimation of respiratory rate [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. A qualitative study posits that nurses may regard oxygen saturation measurement as a surrogate for respiratory rate monitoring [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Another potential explanation for this phenomenon could be the unavailability of respiratory rate monitoring equipment. In light of these findings, the incomplete performance of respiratory assessment by nursing students is a significant source of concern. To address this issue, education and guidance processes must be strengthened. Another salient finding from the study was the erroneous agreement among students with the statement that \"blood pressure is usually the first parameter indicating that the patient's condition is deteriorating.\" Consistent with the outcomes of the present study, a previous investigation involving ward nurses revealed that the majority of nurses erroneously perceived blood pressure changes as the primary indicator of deterioration [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Blood pressure should not be considered the primary indicator of a deteriorating condition. While high blood pressure and variability are associated with early neurological deterioration, other factors, such as cerebral edema and hemorrhagic transformation, also contribute to patient outcomes after stroke [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe findings of this study demonstrated that nursing students experienced significant deficiencies in the application steps of vital signs measurement. The failure to adhere to the principles of equipment maintenance and post-procedure hand hygiene in the implementation of basic measurements such as body temperature, blood pressure, and oxygen saturation poses a serious problem in terms of infection control and patient safety. The extant literature emphasizes that students' inadequacies in hand hygiene and equipment cleaning may increase the risk of infection and lead to deficiencies in meeting professional nursing standards [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn terms of recognizing and reporting abnormal vital signs, it was evaluated as a positive finding that students reported parameters such as body temperature and oxygen saturation to nurses completely. However, the low rate of reporting critical parameters such as respiration, pulse, and blood pressure to nurses indicates that there are deficiencies in clinical decision-making skills. In their study, Mok et al. revealed that clinical knowledge, roles, responsibilities, and reporting affect nurses' ability to detect clinical deterioration and monitor vital signs in general wards. A qualitative-observational study in Australia found that only 6\u0026ndash;21% of the five vital signs required by the policy were assessed [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Other studies have shown that important vital signs, such as respiratory rate, are underreported or misrecorded due to perceived time constraints and low prioritization in clinical settings [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Furthermore, body temperature is measured with infrared temporal thermometers, and oxygen saturation is measured with pulseoximetry devices in the clinics where the study is performed. Blood pressure is measured with a manual sphygmomanometer, while respiration and pulse rate are measured manually by palpation and inspection methods. The reliance on technology in this context may inadvertently diminish interest in manual vital signs measurements and potentially lead to underreporting. This shift towards electronic vital signs monitoring may impede the nurse-patient interaction, potentially leading to the failure to identify early indications of physical deterioration.\u003c/p\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eThis study has several limitations, and its results should be evaluated in the context of these limitations. One of the limitations of the study is that the sample consists of students from only one faculty. Therefore, the findings of the study are limited to this faculty. Another limitation is the low level of participation due to the fact that observation of the study caused anxiety among the students. The study was conducted in a single center and four wards, and observations were made only during certain time periods during the day when students were receiving vital signs. Therefore, the data may not be representative of other wards or other hospitals in the study hospital. The strength of the study is that two observers made observations at the same time.\u003c/p\u003e\u003cp\u003eObservational data is subject to the influence of the researcher's perspective and may contain bias [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Additionally, the Hawthorne effect, which occurs when observed individuals adapt their behavior to the observation process, whether consciously or unconsciously, is a potential concern [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Consequently, the findings of observational studies may be influenced by the observational conditions, potentially resulting in a deviation from the subjects' natural behaviors. It is crucial to consider this effect in observational studies and to apply appropriate methods to minimize potential bias. In the present study, these concerns were addressed through the following measures: the subject of observation was kept undisclosed to the students, the observation period was not extended over an extensive time frame, and the skill steps of the observation form were structured to promote objective evaluation.\u003c/p\u003e\u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe objective of this study was to assess nursing students' competencies in vital sign monitoring, recognition, and reporting of abnormal findings. The findings indicated that, while students generally exhibited a positive attitude towards vital signs measurement, they demonstrated deficiencies in measuring and reporting certain fundamental parameters. The evaluation of critical parameters, such as respiratory rate and pulse rate, revealed significant shortcomings. These deficiencies may be attributed to inadequacies in educational and clinical guidance processes.\u003c/p\u003e\u003cp\u003eAlthough students regularly performed measurements such as body temperature and oxygen saturation, it is noteworthy that respiratory rate and pulse rate assessments were neglected. Respiratory rate, being a critical parameter in terms of early detection of clinical deterioration, exemplifies an area of concern that requires more emphasis in the educational process, given the lack of importance given to this finding by the students. The low rate of students reporting abnormal vital signs suggests the need for additional training and support programs to improve clinical decision-making skills.\u003c/p\u003e\u003cp\u003eThe results of the study once again demonstrated the importance of clinical guidance in nursing education. The findings demonstrate the importance of clinical guidance in nursing education. Guidance provided by clinical instructors and experienced nurses can contribute to the development of students' professional skills and help them become more competent in clinical decision-making. Consequently, enhancing the efficacy of vital sign monitoring and reporting practices within nursing education programs is imperative to ensure optimal patient safety.\u003c/p\u003e\u003cp\u003eIn conclusion, the results of this study highlight the deficiencies of nursing students in assessing vital signs and reporting abnormal findings and emphasize that nursing education programs should focus more on these areas. A comprehensive review of existing education programs, coupled with a concerted effort to raise awareness about the critical parameters of respiratory rate evaluation and the enhancement of clinical guidance processes, holds the potential to empower students to monitor patients with greater efficacy and awareness. The findings of this study should be further supported by qualitative analysis. Focus group discussions or individual interviews can be conducted to understand why students do not report some findings.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eSTROBE\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStrengthening the Reporting of Observational Studies in Epidemiology\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eV-scale\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eVital Signs Scale\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eCVI\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eContent Validity Index\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eSPSS\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eSpO\u003c/b\u003e\u003csub\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sub\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePeripheral oxygen saturation\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki. All participants provided both verbal and written informed consent. Ethical approval was obtained from the Pamukkale University Non-Interventional Clinical Research Ethics Committee (decision dated 02/04/2024 and numbered E-60116787-020-512969 07).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analysed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting Interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026apos; contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceived and designed the research: \u0026Ouml;F, AŞZ. Wrote the paper: AŞZ, \u0026Ouml;F, SA, and A\u0026Ccedil;. Analyzed the data: AŞZ. Revised the paper: AŞZ, \u0026Ouml;F, SA, and A\u0026Ccedil;. The authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to express our sincerest gratitude to all study participants for their invaluable contribution of time during the data collection phase of the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eClinical trial number\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSamani S, Rattani SA. Recognizing Early Warning Signs (EWS) in patients is critically important. Open J Nurs. 2023;13(1):53.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFagan K, Sabel A, Mehler PS, MacKenzie TD. 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Nursing students\u0026rsquo; knowledge, competence and attitudes towards vital signs monitoring during clinical practice. J Clin Nurs. 2021;30(5\u0026ndash;6):664\u0026ndash;75.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLeonard MM, Kyriacos U. Student nurses\u0026rsquo; recognition of early signs of abnormal vital sign recordings. Nurse Educ Today. 2015;35(9):e11\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePozam M, Zaybak A. Examination of nursing students\u0026rsquo; self efficacy regarding their clinical performance. DEUHFED. 2022;15(1):22\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSarı HY, Y\u0026ouml;ntem S\u0026Ccedil;, Demir D, Karaoğlan N, Başkurt SŞ, \u0026Ccedil;imen S. The knowledge and attitudes of pediatric nurses towards vital signs. J Educ Res Nurs. 2013;10(1):38\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCooper S, Kinsman L, Buykx P, McConnell-Henry T, Endacott R, Scholes J. Managing the deteriorating patient in a simulated environment: nursing students\u0026rsquo; knowledge, skill and situation awareness. J Clin Nurs. 2010;19(15\u0026ndash;16):2309\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVon Elm E, Altman DG, Egger M, Pocock S, G\u0026oslash;tzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMok W, Wang W, Cooper S, Ang ENK, Liaw SE. Attitudes towards vital signs monitoring in the detection of clinical deterioration: scale development and survey of ward nurses. 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Forum: Qual Soc Res. 2005;26(2):43.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMcCambridge J, Witton J, Elbourne DR. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol. 2014;67(3):267\u0026ndash;77. 08/13/accepted, PubMed PMID: PMC3969247.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Vital signs, Nursing students, Skill, Clinical, Attitudes","lastPublishedDoi":"10.21203/rs.3.rs-6502579/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6502579/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eMonitoring of vital signs is one of the most frequently practiced skills of nursing students in clinical practice. These findings are of critical importance in terms of evaluating the health status of individuals and early detection of clinical deterioration. This study aimed to examine nursing students' attitudes toward vital sign measurement, vital sign measurement skills, and abnormal finding reporting behaviors during clinical practice.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis descriptive and observational study was conducted with a sample of 63 second-year nursing students studying at the Faculty of Health Sciences of a university located in western Turkey. Data were collected using the following instruments: the Participant Information Form, the Vital Signs Scale, and the Vital Signs Measurement Assessment Observation Form. The study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for reporting observational studies.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe attitudes of the nursing students participating in the study towards measuring vital signs were found to be above the middle level. The analysis revealed that the majority of the students measured body temperature (100%), blood pressure (92.2%), and oxygen saturation (92.2%). However, pulse (34.4%) and respiration (37.5%) counts were not performed by approximately one-third of the students. It is noteworthy that students reported all abnormal findings in body temperature and oxygen saturation measurements to the nurses. However, no notification was made for abnormal findings detected in respiratory and pulse assessments. Furthermore, only 15.8% of students reported any abnormal findings concerning blood pressure measurements to the nursing staff.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThe present study revealed that nursing students' attitudes toward measuring vital signs were, in general, positive. However, the study also identified deficiencies in pulse and respiratory assessments. Furthermore, the study found that the reporting rates of abnormal findings varied according to the type of measurement. There were also deficiencies in reporting, especially in critical parameters such as pulse, respiration, and blood pressure. These findings underscore the necessity for the refinement of educational programs to enhance nursing students' competencies in vital sign assessment and the reporting of abnormal conditions.\u003c/p\u003e","manuscriptTitle":"Nursing Students' Skills of Monitoring, Measuring, Reporting and Attitudes towards Vital Signs in the Clinical Practice Process: An Observational Evaluation","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-11 17:29:36","doi":"10.21203/rs.3.rs-6502579/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-07-22T18:28:11+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-17T20:27:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"21614992455016641380216327725422074838","date":"2025-07-17T10:54:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263189104001040561263097434042281643803","date":"2025-07-17T10:10:12+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-09T10:53:02+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-16T07:41:38+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-16T07:32:48+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-14T12:06:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-05-14T12:05:22+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2be16a7c-d7d2-47de-aea2-df27fdaa0abc","owner":[],"postedDate":"July 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-07-11T17:29:36+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-11 17:29:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6502579","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6502579","identity":"rs-6502579","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}