Sustainment of continuous pulse oximetry deimplementation: Analysis of Eliminating Monitor Overuse study data from six hospitals.
Sustainment of continuous pulse oximetry deimplementation: Analysis of Eliminating Monitor Overuse study data from six hospitals.
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DOI：
10.1002/jhm.13154
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发表时间：
2023-08
影响因子：
2.6
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中科院分区：
文献类型：
--
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使用连续脉搏血氧饱和度（cSpO2）监测未接受辅助供氧的毛细支气管炎儿童是一种医疗过度使用。在这项消除监护仪过度使用（EMO）研究的纵向分析中，我们旨在评估6家医院在强化cSpO2停用工作之前、期间和之后cSpO2过度使用的变化。监测数据是在三个阶段收集的：“P1”基线、“P2”主动取消执行（所有地点都参与教育、审计和反馈战略）和“P3”维持（战略撤销后测量的新基线）。分析了2053个观察结果。我们发现，每家医院在主动取消实施（P2）期间均出现减少，P1和P2之间的总体调整后cSpO2过度使用从53%，95% CI：（49，57）降至22%，95% CI：（19，25）。然而，在撤销取消实施策略后，所有6个研究中心的过度使用反弹，P3中总体调整后cSpO2过度使用增加至37%，95% CI：（33，41）。
Using continuous pulse oximetry (cSpO2) to monitor children with bronchiolitis who are not receiving supplemental oxygen is a form of medical overuse. In this longitudinal analysis from the Eliminating Monitor Overuse (EMO) study, we aimed to assess changes in cSpO2 overuse before, during, and after intensive cSpO2-deimplementation efforts in six hospitals. Monitoring data were collected during three phases: “P1” baseline, “P2” active deimplementation (all sites engaged in education and audit & feedback strategies), and “P3” sustainment (a new baseline measured after strategies were withdrawn). 2053 observations were analyzed. We found that each hospital experienced reductions during active deimplementation (P2), with overall adjusted cSpO2 overuse decreasing from 53%, 95% CI: (49, 57) to 22%, 95% CI: (19, 25) between P1 and P2. However, following withdrawal of deimplementation strategies, overuse rebounded in all six sites, with overall adjusted cSpO2 overuse increasing to 37%, 95% CI: (33, 41) in P3.
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