Hypoxemia Clinical Trial
Official title:
Oxygen Saturation Monitoring in the Neonatal Intensive Care Unit (NICU): An Observational Study of Response to Alarms
Infants will be observed in the neonatal intensive care unit for 4 hours. The observer will note the timing of oxygen saturation alarms, staff response, and interrupted staff activities.
False alarms may be particularly prevalent in the neonatal intensive care unit (NICU) where
uncontrolled motion of infants can intensify the problem. The performance of pulse oximeters
is of particular importance in the NICU because of the danger that both hyperoxemia and
hypoxemia pose to newborns; hyperoxemia can lead to chronic lung disease or retinopathy of
prematurity, and hypoxemia depresses spontaneous ventilation. High false alarm rates
contribute to the problem of noise in the NICU. They also have the potential to endanger
patients if clinicians become inured to the continual alarms and ignore some that may be
clinically relevant. There have been few studies on the utility of pulse oximeter alarms in
the NICU, particularly with the new-generation technology. This study will build on the
small body of existing literature on alarm rates in new-generation pulse oximeters in
neonates and provide details about the relationship of the alarms to clinical interventions.
This is an observational study of 50 infants at three hospitals in the United States. The
observer will be an experienced nurse with comprehensive training to ensure consistency. The
infants and clinical staff will be observed for four hours continuously. Observers will note
the timing of alarms, response, interrupted clinical staff activities, and any clinical
interventions, and timing of interventions. Clinical staff will also be questioned on
whether the alarm was consistent with a desaturation event. Infant characteristics may
affect the frequency of alarms. Data collected will include age, gender, weight, ethnicity,
diagnosis, and medications.
This study will evaluate the proportion of nuisance alarms relative to the proportion of
clinically relevant alarms. It will also evaluate the differences in alarm frequencies
across infant characteristics and characterize nurse activities interrupted by the alarms.
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Observational Model: Case-Only, Time Perspective: Prospective
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