对因细支气管炎住院儿童停止持续脉搏血氧饱和度监测时照顾者的体验：一项定性研究。
Caregiver experiences with deimplementation of continuous pulse oximetry monitoring for children hospitalized with bronchiolitis: A qualitative study.
作者信息
Wolk Courtney Benjamin, O'Brien Caroline S, Bonafide Christopher, Beidas Rinad S, Schisterman Enrique F, Albanowski Kimberly, Brent Canita, Schondelmeyer Amanda C
机构信息
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Penn Implementation Science Center (PISCE), University of Pennsylvania, Philadelphia, Pennsylvania, USA.
出版信息
J Hosp Med. 2025 Jul 3. doi: 10.1002/jhm.70123.
BACKGROUND
Continuous pulse oximetry monitoring in stable children with bronchiolitis not requiring supplemental oxygen has been identified as a low-value practice. However, little is known about how parents and other caregivers experience efforts to deimplement this practice.
OBJECTIVES
This study investigated caregivers' experiences during their child's recent hospitalization for bronchiolitis on units involved in a deimplementation trial.
METHODS
We conducted semi-structured qualitative interviews with 15 caregivers of children hospitalized with bronchiolitis at 11 hospitals participating in deimplementation strategies to reduce unnecessary continuous pulse oximetry monitoring as part of the Eliminating Monitoring Overuse (EMO) trial. Interviews were recorded, transcribed, and coded using an integrative analytic approach.
RESULTS
Caregivers were a mean (SD) 31.1 (5.7) years old, predominantly female (93.3%), white (73.3%), and Non-Hispanic (86.7%). Previous hospitalization experiences and prior knowledge and training influenced caregiver perceptions of the value of monitoring. Participants did not discuss noticing changes in monitoring practices in interviews.
CONCLUSIONS
Findings suggest that tailored education about monitoring may lessen caregiver concerns.
背景
对于无需补充氧气的稳定型小儿支气管炎患者，持续脉搏血氧饱和度监测已被认定为一种低价值的医疗行为。然而，对于父母及其他护理人员在减少这种医疗行为的过程中的体验，我们却知之甚少。
目的
本研究调查了参与一项减少医疗行为实施试验的科室中，护理人员在其孩子近期因支气管炎住院期间的体验。
方法
我们对11家参与减少不必要的持续脉搏血氧饱和度监测实施策略的医院中，15名因支气管炎住院患儿的护理人员进行了半结构化定性访谈，该策略是“消除监测过度使用（EMO）试验”的一部分。访谈进行了录音、转录，并采用综合分析方法进行编码。
结果
护理人员的平均（标准差）年龄为31.1（5.7）岁，主要为女性（93.3%），白人（73.3%），非西班牙裔（86.7%）。既往住院经历以及先前的知识和培训影响了护理人员对监测价值的认知。参与者在访谈中未提及注意到监测行为的变化。
结论
研究结果表明，针对监测进行量身定制的教育可能会减轻护理人员的担忧。
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