Dutch neonatal intensive care nurses' perceptions of pulse oximeter saturation target limits for preterm infants.

Dutch neonatal intensive care nurses' perceptions of pulse oximeter saturation target limits for preterm infants.

Huizing, Maurice J;Villamor-Martínez, Eduardo;Meus, Stefanie;de Jonge, Fred M;Villamor, Eduardo;
Journal of pediatric nursing 2019
313
huizing2019dutchjournal

Abstract

To conduct a national survey to assess practice, knowledge, barriers, and perceptions regarding oxygen saturation (SpO) target limits among Dutch neonatal intensive care unit (NICU) nurses.Cross-sectional, web-based survey among 667 nurses from 9 level 3 Dutch NICUs. Part of the questions were based on a clinical scenario (28-weeks preterm infant, treated with CPAP, FiO 0.4).328 (53.6%) nurses responded to the survey. Of these, 281 (85.7%) reported to know the local policy of SpO target limits, and 261 (79.6%) and 244 (74.4%) rightly identified the lower and upper limit, respectively. Six NICUs recently increased their lower SpO limit and for 62.0% of their nurses this led to a significant alarm increase. For the majority of the respondents, the baby from the clinical scenario would spend <10% of the time outside the lower or upper SpO limits. Automated oxygen control systems were considered a good idea by 59.2% of the respondents, but 53.9% considered allowing parents to participate in FiO titration a bad or very bad idea CONCLUSIONS: The majority of the respondents identified their unit's policy-specified SpO target limits and reported that the increase in SpO target limits may have led to more alarms. Titration of FiO is a part of care that respondents were reluctant to share with parents.A potential increase in the number of SpO alarms may lead to alarm fatigue. Although family-centered care philosophy is widely accepted across Dutch NICUs, there are still barriers to overcome.

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