EHR-Integrated Monitor Data to Measure Pulse Oximetry Use in Bronchiolitis
| Autor: | Padmavathy Parthasarathy, Halley Ruppel, Andrew S. Kern-Goldberger, Courtney M. Solomon, Naveen Muthu, Daria F. Ferro, Sansanee Craig, Nathaniel Sergay, Brooke Luo, Kate Lucey, Christopher P. Bonafide, Irit R. Rasooly |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Supplemental oxygen Pediatrics Article Interquartile range medicine Electronic Health Records Humans Oximetry Child Monitoring Physiologic Oxygen saturation (medicine) Oxygen supplementation medicine.diagnostic_test business.industry Infant General Medicine SpO2 monitoring medicine.disease Predictive value Oxygen Pulse oximetry Cross-Sectional Studies Bronchiolitis Pediatrics Perinatology and Child Health Emergency medicine business |
| Zdroj: | Hosp Pediatr |
| ISSN: | 2154-1671 2154-1663 |
| Popis: | BACKGROUND AND OBJECTIVESContinuous pulse oximetry (oxygen saturation [Spo2]) monitoring in hospitalized children with bronchiolitis not requiring supplemental oxygen is discouraged by national guidelines, but determining monitoring status accurately requires in-person observation. Our objective was to determine if electronic health record (EHR) data can accurately estimate the extent of actual Spo2 monitoring use in bronchiolitis.METHODSThis repeated cross-sectional study included infants aged 8 weeks through 23 months hospitalized with bronchiolitis. In the validation phase at 3 children’s hospitals, we calculated the test characteristics of the Spo2 monitor data streamed into the EHR each minute when monitoring was active compared with in-person observation of Spo2 monitoring use. In the application phase at 1 children’s hospital, we identified periods when supplemental oxygen was administered using EHR flowsheet documentation and calculated the duration of Spo2 monitoring that occurred in the absence of supplemental oxygen.RESULTSAmong 668 infants at 3 hospitals (validation phase), EHR-integrated Spo2 data from the same minute as in-person observation had a sensitivity of 90%, specificity of 98%, positive predictive value of 88%, and negative predictive value of 98% for actual Spo2 monitoring use. Using EHR-integrated data in a sample of 317 infants at 1 hospital (application phase), infants were monitored in the absence of oxygen supplementation for a median 4.1 hours (interquartile range 1.4–9.4 hours). Those who received supplemental oxygen experienced a median 5.6 hours (interquartile range 3.0–10.6 hours) of monitoring after oxygen was stopped.CONCLUSIONSEHR-integrated monitor data are a valid measure of actual Spo2 monitoring use that may help hospitals more efficiently identify opportunities to deimplement guideline-inconsistent use. |
| Databáze: | OpenAIRE |
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