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
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    • "Bedside nurses can be very helpful ‘monitors’ if knowledgeable, but require a working understanding of all three RECC patterns in order to be able to efficiently adjust their workflow to provide optimal safety, even when using one continuous electronic monitor like pulse oximetry [7,20,51]. Without any continuous monitoring, opioid associated adverse events continue to persist in postoperative populations [20,31-34], so from what we now know about RECC and two of our three coexisting pattern types, it’s difficult to argue a case for leaving patients unmonitored at all. Intermittent nursing checks, especially when opioids are involved, will always leave patients unobserved over 90% of their time on the GCF [6] regardless how enlightened the nurses might be. "
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