The Alarm Burden of Excess Continuous Pulse Oximetry Monitoring Among Patients With Bronchiolitis.

TitleThe Alarm Burden of Excess Continuous Pulse Oximetry Monitoring Among Patients With Bronchiolitis.
Publication TypeJournal Article
Year of Publication2021
AuthorsRasooly IR, Makeneni S, Khan AN, Luo B, Muthu N, Bonafide CP
JournalJ Hosp Med
Date Published2021 Nov 17
ISSN1553-5606
Abstract

Guidelines discourage continuous pulse oximetry monitoring of hospitalized infants with bronchiolitis who are not receiving supplemental oxygen. Excess monitoring is theorized to contribute to increased alarm burden, but this burden has not been quantified. We evaluated admissions of 201 children (aged 0-24 months) with bronchiolitis. We categorized time ≥60 minutes following discontinuation of supplemental oxygen as "continuously monitored (guideline-discordant)," "intermittently measured (guideline-concordant)," or "unable to classify." Across 4402 classifiable hours, 77% (11,101) of alarms occurred during periods of guideline-discordant monitoring. Patients experienced a median of 35 alarms (interquartile range [IQR], 10-81) during guideline-discordant, continuously monitored time, representing a rate of 6.7 alarms per hour (IQR, 2.1-12.3). In comparison, the median hourly alarm rate during periods of guideline-concordant intermittent measurement was 0.5 alarms per hour (IQR, 0.1-0.8). Reducing guideline-discordant monitoring in bronchiolitis patients would reduce nurse alarm burden.

DOI10.12788/jhm.3731
Alternate JournalJ Hosp Med
PubMed ID34798003