Validity of Continuous Pulse Oximetry Orders for Identification of Actual Monitoring Status in Bronchiolitis.

TitleValidity of Continuous Pulse Oximetry Orders for Identification of Actual Monitoring Status in Bronchiolitis.
Publication TypeJournal Article
Year of Publication2020
AuthorsBrady PW, Schondelmeyer AC, Landrigan CP, Xiao R, Brent C, Bonafide CP
JournalJ Hosp Med
Volume15
Issue11
Pagination665-668
Date Published2020 11
ISSN1553-5606
KeywordsBronchiolitis, Cross-Sectional Studies, Humans, Infant, Monitoring, Physiologic, Oximetry
Abstract

The accuracy of pulse oximetry monitor orders for identifying infants with bronchiolitis who are being continuously monitored is unknown. In this 56-hospital repeated cross-sectional study, investigators used direct bedside observation to determine continuous pulse oximetry monitor use and then assessed if an active continuous monitoring order was present in the electronic health record. Investigators completed 3,612 observations of infants aged 8 weeks to 23 months hospitalized with bronchiolitis and on room air. Most monitored infants did not have an active monitoring order (sensitivity 49% [95% CI, 41-57]). The positive predictive value of a monitoring order was 77% (95% CI, 72-82), and the negative predictive value was 69% (95% CI, 61-77). Teams intending to measure continuous pulse oximetry use should understand the limitations of using electronic health record orders as a stand-alone measure.

DOI10.12788/jhm.3443
Alternate JournalJ Hosp Med
PubMed ID33147128
PubMed Central IDPMC7657657
Grant ListK08 HS023827 / HS / AHRQ HHS / United States
K08 HS026763 / HS / AHRQ HHS / United States
K23 HL116427 / HL / NHLBI NIH HHS / United States
U01 HL143475 / HL / NHLBI NIH HHS / United States