Associação entre a estrutura da equipe clínica e o uso excessivo de oximetria de pulso contínuo em lactentes hospitalizados com bronquiolite: Subestudo Um Monitor Eliminando o Overuse Trial

Resumo original em inglês

O que aconteceu

Continuous pulse oximetry (cSpO2) monitoring for hospitalized children with bronchiolitis not requiring supplemental oxygen is an established form of medical overuse. We examined whether clinician team structure influences cSpO2 overuse. In this secondary analysis of the Eliminating Monitor Overuse (EMO) Trial (NCT05132322), we compared overuse by frontline clinician type (resident physician vs. attending physician or advanced practice provider [APP]) during the active cSpO2 deimplementation and sustainment phases using multivariable mixed-effects logistic regression. Among 4167 inpatient observations in 36 hospitals, 61% had their frontline care provided by residents, 27% by attendings, and 10% by APPs. In adjusted analyses, the odds of overuse were 47% higher among patients with frontline care delivered by attendings compared with residents (adjusted odds ratio: 1.47 [95% confidence interval [CI]: 1.12-1.93], p = .01), with no difference observed for APPs compared with residents. These findings suggest that cSpO2 overuse may be attenuated when residents deliver frontline patient care rather than attendings alone.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.