Continuous pulse oximetry monitoring in children hospitalized with bronchiolitis: A qualitative analysis of clinicians' justifications
Continuous pulse oximetry (cSpO<sub>2</sub>) monitoring use outside established guidelines is common in children hospitalized with bronchiolitis. We analyzed clinicians' real-time rationale for continuous monitoring in stable children with bronchiolitis not requiring supplemental oxygen. Data for this study were collected as part a multicenter deimplementation trial for cSpO<sub>2</sub> in children hospitalized with bronchiolitis. We analyzed 371 clinician responses across 36 hospitals; 258 (70%) responses did not include a clinical reason for monitoring ("nonclinical"; e.g., respondent forgot to discontinue monitoring, did not know why the patient was monitored, or was following an order). The remaining 113 (30%) responses contained a clinical reason for monitoring ("clinical"; e.g., recently requiring oxygen, physical exam concerns, or concerns relating to patient condition or history). Strategies to reduce unnecessary monitoring should include changes in workflow to facilitate shared understanding of monitoring goals and timely discontinuation of monitoring.
Authors
- Rinad S. Beidas (ORCID: https://orcid.org/0000-0001-6056-6071)
- Kimberly Albanowski (ORCID: https://orcid.org/0009-0009-6435-5314)
- Kathleen D. Snow (ORCID: https://orcid.org/0000-0002-5918-3054)
- Amanda C. Schondelmeyer (ORCID: https://orcid.org/0000-0003-3223-6109)
- Christopher P. Bonafide (ORCID: https://orcid.org/0000-0003-2823-5883)
- Andrew S. Kern‐Goldberger (ORCID: https://orcid.org/0000-0003-0610-4292)
- Prabi Rajbhandari (ORCID: https://orcid.org/0000-0002-9920-6345)
- Patricia A. Stoeck
- Samantha A. House (ORCID: https://orcid.org/0000-0002-7459-4054)
- Raymond Parlar‐Chun (ORCID: https://orcid.org/0000-0001-7445-277X)
- Patrick W. Brady (ORCID: https://orcid.org/0000-0002-7078-3077)
- Kate Lucey (ORCID: https://orcid.org/0009-0005-5757-291X)
- Halley Ruppel (ORCID: https://orcid.org/0000-0001-8326-5175)
Institutions
- Northwestern University (US)
- Cincinnati Children's Hospital Medical Center (US)
- Boston Children's Hospital (US)
- Lurie Children's Hospital (US)
- Cleveland Clinic (US)
- Children's Hospital of Philadelphia (US)
- Harvard University (US)
- Baylor College of Medicine (US)
- Cleveland Clinic Lerner College of Medicine (US)
- Akron Children's Hospital (US)
- Texas Children's Hospital (US)
- Dartmouth Health (US)
- Case Western Reserve University (US)
- University of Cincinnati (US)
- University of Pennsylvania (US)
- University of Cincinnati Medical Center (US)
- Northeast Ohio Medical University (US)
Publication Details
- Journal
- Journal of Hospital Medicine
- Published
- 2024-08-09
- DOI
- https://doi.org/10.1002/jhm.13442
- Citations
- 4
- Primary Topic
- Healthcare Technology and Patient Monitoring
- Type
- article
- Field-Weighted Citation Impact
- 2.29
Funders
- National Academies of Sciences, Engineering, and Medicine
- University of Oxford
- National Institutes of Health
- National Heart, Lung, and Blood Institute