Association between clinician team structure and continuous pulse oximetry overuse among infants hospitalized with bronchiolitis: An Eliminating Monitor Overuse Trial substudy.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 42571927.
- Also identified by DOI 10.1002/jhm.70420.
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Abstract
Continuous pulse oximetry (cSpO<sub>2</sub>) monitoring for hospitalized children with bronchiolitis not requiring supplemental oxygen is an established form of medical overuse. We examined whether clinician team structure influences cSpO<sub>2</sub> 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 cSpO<sub>2</sub> 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 cSpO<sub>2</sub> overuse may be attenuated when residents deliver frontline patient care rather than attendings alone.