Impact of Pulse Oximetry Surveillance on Rescue Events and Intensive Care Unit Transfers

Department of Anesthesiology, Dartmouth Hitchcock Medical Center, Dartmouth Medical School, One Medical Center Drive, Hanover, New Hampshire 03756, USA.
Anesthesiology (Impact Factor: 5.88). 02/2010; 112(2):282-7. DOI: 10.1097/ALN.0b013e3181ca7a9b
Source: PubMed


Some preventable deaths in hospitalized patients are due to unrecognized deterioration. There are no publications of studies that have instituted routine patient monitoring postoperatively and analyzed impact on patient outcomes.
The authors implemented a patient surveillance system based on pulse oximetry with nursing notification of violation of alarm limits via wireless pager. Data were collected for 11 months before and 10 months after implementation of the system. Concurrently, matching outcome data were collected on two other postoperative units. The primary outcomes were rescue events and transfers to the intensive care unit compared before and after monitoring change.
Rescue events decreased from 3.4 (1.89-4.85) to 1.2 (0.53-1.88) per 1,000 patient discharges and intensive care unit transfers from 5.6 (3.7-7.4) to 2.9 (1.4-4.3) per 1,000 patient days, whereas the comparison units had no change.
Patient surveillance monitoring results in a reduced need for rescues and intensive care unit transfers.

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Available from: Andreas H Taenzer, Oct 05, 2015
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    • "PSS required all its patients to be electronically monitored with continuous pulse oximetry, and all threshold breaches to be transmitted electronically through pager devices to the caregivers in charge. The program was tightly aligned with their Hitchcock Early Response Team (HERT), a Rapid Response program that brings critical care expertise to the bedside once RECC are detected [7,51]. "
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    • "However, an evaluation of such systems has been limited. Recent studies have found that continuous surveillance with a nurse notification component reduced transfers to critical care (CC) (Taenzer et al., 2010) or improved early identification of postoperative patients requiring CC admission (Ochroch et al., 2006). However, these studies did not evaluate factors or system shortfalls that potentially impede nursing response, leaving significant gaps in our understanding of safe monitoring practices. "
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