Hi Marsha,
Thank you for your response, and I appreciate your clarification. I pray each day that health care in general will become more inclusive with sharing information across organizations, no one has time to reinvent the wheel and with so many people creating great work it is a shame that we cannot share more. I feel blessed that my organization allows us to share most of our work :)
Thank you and have a great weekend!
Tash
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Tash Rounds, MSN Ed, RN, AMB-BC, NPD-BC
Clinical Nurse Educator -Ambulatory
Skagit Regional Health
Mount Vernon, WA
Office: 360-814-6743
NRounds@skagitregionalhealth.org------------------------------
Original Message:
Sent: 09-01-2022 08:13
From: Marsha Pike
Subject: Pediatric Visit Vital Signs
Good morning,
We do have policies and procedures to guide our practice but I am not at liberty to share them. I would say that our practice would be to minimize procedures for children to when clinically appropriate and if supported by evidence. An example would be blood pressures - these are not easy to collect on every child and therefore can take time and upset some children. The AAP (2017) outlines that blood pressures are due annually in children ages 3 years and older, thus that is how our practice is outlined (with some exceptions based on age, clinical scenario etc.). Accurate and current heights inform blood pressure percentiles, and so we have guidelines for how often heights should be measured. There are certainly pros to cons to each - getting a full set each time or creating guidelines as we have done.
Thanks so much,
Marsha
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Marsha Pike DNP CNS
Clinical Nurse Specialist
Mayo Clinic
Rochester MN
507-266-0440
Original Message:
Sent: 08-31-2022 10:26
From: Natasha Rounds
Subject: Pediatric Visit Vital Signs
Hi Marsha,
Thanks for sharing. Do you have your standardized vitals in a policy/protocol/or guidelines for your staff to follow? If so, would you be willing to share? We are looking at standardizing across our clinics; however, there is always some hesitancy in some of our specialty clinics to complete a full set on each patient. I don't feel it takes much longer to complete a full set and try to maintain a higher standard of care for all our patients.
Thank you,
Tash
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Tash Rounds, MSN Ed, RN, AMB-BC, NPD-BC
Clinical Nurse Educator -Ambulatory
Skagit Regional Health
Mount Vernon, WA
Office: 360-814-6743
NRounds@skagitregionalhealth.org
Original Message:
Sent: 08-31-2022 07:57
From: Marsha Pike
Subject: Pediatric Visit Vital Signs
Hello,
We have Family Medicine and Pediatric clinics in the same space. For both practices, we have standardized which vital signs and measurements are taken based on age and visit type.
- Weight
- Collected at every visit (well, acute, follow-up)
- Height/Length
- Every well child visit
- At least every 3 months in those ages 3 months or greater at acute or follow-up visits
- Head circumference
- Every well visit for those less than 3 years of age
- At least every 3 months at acute or follow-up visits if due (age less than 3 years)
- Blood pressure
- Annually at age 3 – at acute, well, or follow-up visits if due
- Temp
- Infants less than 3 months, collected rectally in acutely ill visits only
- All other ages only if clinically indicated
- Pulse
- If clinically indicated or directed by the provider
- If needed to validate automated BP reading
- Certain specialty clinics: ADHD, Eating Disorders
- Pulse oximetry and Respiratory Rate
- Only if clinically indicated or directed by the provider
I hope this is helpful,
Marsha L. Pike, D.N.P., APRN, ACCNS-P |she/her/hers| Pediatric Clinical Nurse Specialist |Ambulatory Pediatrics (SEMN Primary Care/RST Subspecialty Pediatrics)| Department of Nursing | Instructor in Nursing | Mayo Clinic College of Medicine |Office: 507-266-4437 | Administrative Assistant: 507-293-1949| Fax: 507-255-8873| pike.marsha@mayo.edu | Mayo Clinic | 200 First Street SW | Rochester, MN 55905 | mayoclinic.org | facebook.com/MayoClinicKids
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Original Message:
Sent: 8/30/2022 4:23:00 PM
From: Amanda Pearce
Subject: RE: Pediatric Visit Vital Signs
We have both family medicine and pediatric providers at my work. We do all vitals at all visits. Unless the provider tells MA/RN to not do some of them. Standard of care is all vitals though.
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Amanda Pearce, RN-BSN
Clinic RN
Swedish Medical Group
Renton WA
Original Message:
Sent: 08-29-2022 12:32
From: Danielle Smith
Subject: Pediatric Visit Vital Signs
Good morning Colleagues,
I am looking for how clinics who see children for well and sick visits determine what vital signs are measured at visits. Do the providers make the decision? Clinical staff? Does it depend on what type of visit the patient is coming for?
Thanks for sharing your thoughts and resources!
Danielle
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Danielle Smith MSN, RN, CNL
Clinical Practice Leader, Primary Care
dsmith2@childrenswi.org
Children's Wisconsin
Milwaukee, WI
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