Title: Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project - ScienceDirect
Headings: Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project
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Journal of Pediatric Nursing
Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project 1, 2
Highlights
Key words
Background/Significance
Methods
Forming the Multidisciplinary Team
Creation of Evidence-Based Algorithms
Measures
Piloting Practice Changes
Outcomes
Time on Oxygen
Time on Pulse Oximetry
Length of Stay and Patient Charges
Discussion
Conclusion/Implications for Practice
Acknowledgments
References

Content: 2011, Khemani et al., 2012, Mower et al., 1997 ). Despite its popularity and usefulness, pulse oximetry does have several limitations, including motion artifacts, poor perfusion at the site of measurement, irregular rhythms, ambient light or electromagnetic interference, and time lag in detecting hypoxic events. In addition, poor performance can occur with certain skin pigmentation, nail polish, probe positioning, venous pulsations, intravenous dyes, calibration assumptions, and presence of abnormal hemoglobin molecules ( Fouzas et al., 2011 ). Successful use of continuous pulse oximetry is also hindered by staff competency and understanding of the above limitations, frustration with false alarms, and failure to follow manufacturer guidelines regarding proper oximetry use ( Mininni, Marino, Kohler, & Stephan, 2009 ). Researchers have hypothesized that the increased use of pulse oximetry since the 1980s has been associated with increased admissions and length of stay because of unclear guidelines about safe SpO2 levels in children discharged from the hospital, especially in the bronchiolitis population ( Shay et al., 1999, Zentz, 2011 ). Approximately 149,000 children were hospitalized with bronchiolitis in the U.S. in 2002 ( Pelletier, Mansbach, & Camargo, 2006 ).