Caregiver experiences with deimplementation of continuous pulse oximetry monitoring for children hospitalized with bronchiolitis: A qualitative study

J Hosp Med. 2025 Jul 3. doi: 10.1002/jhm.70123. Online ahead of print.

Abstract

Background: Continuous pulse oximetry monitoring in stable children with bronchiolitis not requiring supplemental oxygen has been identified as a low-value practice. However, little is known about how parents and other caregivers experience efforts to deimplement this practice.

Objectives: This study investigated caregivers' experiences during their child's recent hospitalization for bronchiolitis on units involved in a deimplementation trial.

Methods: We conducted semi-structured qualitative interviews with 15 caregivers of children hospitalized with bronchiolitis at 11 hospitals participating in deimplementation strategies to reduce unnecessary continuous pulse oximetry monitoring as part of the Eliminating Monitoring Overuse (EMO) trial. Interviews were recorded, transcribed, and coded using an integrative analytic approach.

Results: Caregivers were a mean (SD) 31.1 (5.7) years old, predominantly female (93.3%), white (73.3%), and Non-Hispanic (86.7%). Previous hospitalization experiences and prior knowledge and training influenced caregiver perceptions of the value of monitoring. Participants did not discuss noticing changes in monitoring practices in interviews.

Conclusions: Findings suggest that tailored education about monitoring may lessen caregiver concerns.