Parental Insights into Improving Home Pulse Oximetry Monitoring in Infants.

TitleParental Insights into Improving Home Pulse Oximetry Monitoring in Infants.
Publication TypeJournal Article
Year of Publication2022
AuthorsFerro DF, Bonafide CP, Fregene N, Ruppel H, Nelson MN, Eriksen W, DeMauro SB
JournalPediatr Qual Saf
Volume7
Issue2
Paginatione538
Date Published2022 Mar-Apr
ISSN2472-0054
Abstract

Home pulse oximeters prescribed for infants with cardiorespiratory conditions generate many false alarms, which create caregiver stress and sleep disturbance and can lead to unsafe practices. Additionally, relationships among oximeters, alarms, and everyday living demands are not well understood. Therefore, we aimed to gather parent perspectives on home pulse oximetry monitoring during the problem analysis phase of a quality improvement (QI) initiative.

Methods: We purposively sampled and interviewed parents of infants prescribed home pulse oximeters and receiving local home care company services. We based questions on systems engineering frameworks previously used in healthcare. Data were coded iteratively and analyzed deductively (theoretical frameworks) and inductively (emerging themes).

Results: Generally, themes aligned with theoretical frameworks. Parents expressed dissatisfaction with the number of false alarms home pulse oximeters generate, which parents primarily attributed to poor probe adhesiveness and the inability of oximeters to account for infant movement. Interviews highlighted the burden associated with poor device tones and portability. Device-related issues had negative repercussions for the entire family related to sleep quality, mobility, and social interactions. Universally, parents developed workarounds, including cessation of monitoring.

Conclusions: Parents of infants monitored at home using pulse oximetry face many challenges, resulting in compromises in safety. Continuing to instruct parents to comply with prescribed monitoring recommendations may be unrealistic. Instead, we suggest re-engineering the home monitoring system with the needs and goals of children and their families at the center. Our description of adapting qualitative research and systems engineering methods may benefit others developing QI work.

DOI10.1097/pq9.0000000000000538
Alternate JournalPediatr Qual Saf
PubMed ID35369408
PubMed Central IDPMC8970095