De-implementing low-value continuous pulse oximetry practice in infants hospitalized with bronchiolitis: A...

Area of Science:

• Pediatric Hospital Medicine
• Implementation Science
• Respiratory Care

Background:

• Clinical evidence supports intermittent pulse oximetry for stabilized infants with bronchiolitis.
• Continuous pulse oximetry is frequently used despite evidence favoring intermittent monitoring.

Purpose of the Study:

• To identify barriers and facilitators for de-implementing continuous pulse oximetry.
• To promote the implementation of intermittent pulse oximetry in hospitalized infants with bronchiolitis.

Main Methods:

• A multicentre qualitative study involving healthcare providers and caregivers of infants with bronchiolitis.
• Thematic analysis of interviews and focus groups, mapped to the Consolidated Framework for Implementation Research (CFIR).

Main Results:

• Healthcare provider roles and practice variations influenced monitoring decisions.
• Nurses recognized benefits of intermittent monitoring, including reduced alarm fatigue and workload.
• Clearer indications for continuous versus intermittent monitoring were identified by clinicians.

Conclusions:

• Clarifying professional roles and local practice standards is crucial for successful implementation.
• Supporting family understanding of pulse oximetry is essential for practice change.
• Findings can guide quality improvement initiatives to optimize monitoring practices in bronchiolitis care.