With sicker patients, less nursing staff and too many tasks to complete in a shift, bedside staff frequently don’t have the time to take a set of vital signs, let alone actually count a patient’s respiratory rate. Instead, bedside staff eyeball the rate based on their experience, charting a standard respiratory rate of 16 or 20. Then, that respiratory rate, along with other vital signs, are then entered in an algorithm (Modified Early Warning Score (EWS)) that is designed to identify patient deterioration. But with inaccurate respiratory rates and vital signs being taken less frequently than ordered due to time constraints, high MEWS levels that could have identified patient deterioration are miscalculated or even missed.