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| Title |
INPATIENT PEDIATRIC MONITORING: A SURVEY |
| Author |
C. Festa, C. Lee, D. Feng, D. Bigos |
| Affiliation |
Division of Pediatric Critical Care Temple
University Children’s Medical Center, Philadelphia, PA 19140 |
| Introduction |
Currently no standards exist for inpatient
pediatric monitoring. We attempted to determine the presence of policy and procedure, and
the criteria used to determine the need for noninvasive monitoring in our geographic
region. |
| Method |
We surveyed nurse managers (NM) in 39 acute care
institutions who admit general pediatric patients. The survey included hospital
demographics, the presence of a monitoring policy, and criteria used as indicators for
monitoring. If no policy existed, NM were asked which criteria were used to determine the
need for monitoring in several different disease states. |
| Result |
27/39 NM responded. The academic status was
distributed as follows: 3 children’s hospitals, 2 university hospitals, 6 university
affiliates, and 16 community hospitals. The number of beds ranged from 2 to 123. The
hospitals were divided into academic (ACD) and nonacademic (NACD) categories based on
their university affiliation and teaching status. 13/27 had monitoring protocols (PP),
whereas 14/27 had no monitoring policy (NP). Chi-square analysis of the PP group and the
NP group was performed with respect to the following monitoring criteria: bronchodilator
frequency, Fi02 requirement, patient age, and hemodynamic
status. A statistically significant difference (p<0.05) was present only for the use of
Fi02 requirement as a monitoring criteria with 11/13
(84.6%) of the PP and 6/14 (42.9%) of the NP group citing it as an indication. No
significant difference was found in ACD and NACD hospitals within the PP and NP groups
with respect to their use of Fi02 requirement as an
indication for monitoring. NP institutions most commonly cited respiratory conditions
(asthma, pneumonia, and bronchiolitis) as those most frequently monitored. |
| Conclusion |
There is a large discrepancy in the existence of
monitoring policies, and the defined criteria for monitoring needs within pediatric
facilities in our region. This suggests the need for the development of pediatric
monitoring standards. |
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