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J Pediatr Intensive Care
DOI: 10.1055/s-0042-1749679
Original Article

Utility and Impact Analysis of Inpatient Pediatric Physiologic Monitoring

Anand Gourishankar 
1   Division of Pediatric Hospital Medicine, Department of Pediatrics, Children's National Hospital, Washington, DC, United States
,
Monaliza Evangelista
2   Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Texas Health, McGovern Medical School at Houston, Texas, United States
,
Misti Ellsworth
3   Division of Pediatric Infectious Disease, Department of Pediatrics, University of Texas Health, McGovern Medical School at Houston, Texas, United States
,
Jean Hsu
1   Division of Pediatric Hospital Medicine, Department of Pediatrics, Children's National Hospital, Washington, DC, United States
› Author Affiliations Funding None.
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Abstract

This study aimed to study the practice and effect of monitoring hospitalized pediatric patients in terms the length of stay (LOS). We have performed a prospective, observational study of pediatric patients in the general ward from October to December 2016. We have recorded the use of cardiac monitor, pulse oximeter, or both, and as per physician order at patient admission. We have studied the proportions of monitoring in different patient groups. We have applied a linear regression model to investigate the relationship between LOS and cardiopulmonary monitoring, orders, and medical complexity. Among 399 patients, patients with cardiac and pulse oximeter monitoring with orders were 68 and 82%, respectively. The pulmonary group had more monitoring than the neurology group of patients. LOS was shorter in patients without monitoring; the median difference for the cardiac monitoring was one day (interquartile range [IQR] = 1), and the pulse oximeter was 0.5 days (IQR = 1). Cardiac monitoring order increased LOS by 22% (95% confidence interval [CI]: 0.5, 48%) and complex past medical history increased it by 25% (95% CI: 4, 51%). Our study highlights the variable practice in using monitors, emphasizing a standardized approach. The judicious use of monitoring may reduce prolonged hospitalization. Selective use of physiologic monitoring of ill-appearing or at risk of hypoxemia or cardiac dysrhythmia will reduce overuse.

Keywords

physiologic monitoring - length of stay - cardiac monitoring - pulse oximetry


Publication History

Received: 12 December 2021

Accepted: 20 April 2022

Article published online:
27 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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