Oximeters used for continuous monitoring experience periods with no signal. This SpO2 drop-out is widely acknowledged and its causes generally understood. This is a prospectively designed analysis of an existing database with the aim of characterizing drop-outs as experienced in the neonatal ICU. The data reflects 116 days of monitoring in seven tertiary care neonatal ICUs in 6 countries. From the evaluation of 1,396 drop-outs we found that typically the time was minimal with missing SpO2 data, and the episodes were short (median 2.79 minutes per day IQR 0.17–76, median 22 seconds IQR: 15–37, respectively). During about half of the days there were no prolonged dropouts (1 minute or longer), even so half of the total time spent with no SpO2 data were in prolonged episodes (median length 110 seconds IQR 85–150). The predominate factor associated with excessive drop-out time was the number of prolonged episodes rather than their duration. We concluded that the impact of drop-outs during manual control of inspired oxygen primarily impact alarm fatigue, but that during automatic FiO2 control they could have an important impact. The relative effectiveness of the fall-back strategies of these automatic control systems ought to be evaluated.
- MeSH
- Intensive Care, Neonatal * methods MeSH
- Humans MeSH
- Infant, Newborn MeSH
- Oxygen Inhalation Therapy methods MeSH
- Oximetry methods MeSH
- Check Tag
- Humans MeSH
- Infant, Newborn MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
To use home mechanical ventilation, it is necessary to choose the right target group that can benefit from moving to home care. Moving a patient to home care with home mechanical ventilation involves a number of risks. The aim of this study was to use Health Failure Mode and Effects Analysis (HFMEA) to analyse health risks at a time when a patient is just preparing to move to home care, and a nursing plan is being drawn up. HFMEA was used to analyse health risks. The expert team divided the process of nursing care into 7 parts with other own subprocess, which are 18 in total. Altogether, 41 risks were identified, of which 14 failures were analysed after HFMEA application, potential causes were defined, and their follow-up proposed. According to the results of the method used and the analysis of individual risks, it is necessary to focus on detailed setting of the nursing plan with thorough education of informal caregivers who play an important role in it. The education should be regularly repeated and the check of care itself should be supported by created checklists to confirm the individual steps.
