毛细支气管炎患者过度持续脉搏血氧监测的报警负担。
The Alarm Burden of Excess Continuous Pulse Oximetry Monitoring Among Patients With Bronchiolitis.
机构信息
Section of Pediatric Hospital Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
出版信息
J Hosp Med. 2021 Dec;16(12):727-729. doi: 10.12788/jhm.3731.
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.
指南不鼓励对接受补充氧气的住院毛细支气管炎婴儿进行连续脉搏血氧监测。过度监测理论上会增加报警负担，但尚未对这种负担进行量化。我们评估了 201 名（0-24 个月）毛细支气管炎患儿的入院情况。我们将停止补充氧气后时间≥60 分钟归类为“持续监测（不符合指南）”、“间歇性测量（符合指南）”或“无法分类”。在 4402 个可分类小时中，77%（11,101）的报警发生在不符合指南的监测期间。在不符合指南的持续监测时间内，患者平均经历 35 次报警（四分位距 [IQR]，10-81），每小时报警率为 6.7 次（IQR，2.1-12.3）。相比之下，在符合指南的间歇性测量期间，每小时的平均报警率为 0.5 次（IQR，0.1-0.8）。减少毛细支气管炎患者不符合指南的监测将减轻护士的报警负担。
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