Summary

The purpose of this study is to identify the optimal deimplementation strategies for an overused practice: continuous pulse oximetry monitoring of children hospitalized with bronchiolitis who are not receiving supplemental oxygen.

Age: 2 Months and older

Gender: All

Start Date: 12/01/2021

Primary Completion Date (Estimated): 03/31/2024

Study Completion Date (Estimated): 08/01/2026

Accepts Healthy Volunteers: No

Trial Purpose and Description

Eligibility Criteria

Age: 2 Months and older

Gender: All

Accepts Healthy Volunteers: No

Population a: Bronchiolitis patients directly observed while not receiving supplemental oxygen ("in room air," for primary trial outcome)

Inclusion criteria:

* Infants and children 2 months through 23 months old

* Hospitalized on non-ICU wards participating in the trial

* Cared for by generalist inpatient services (e.g. general pediatrics, hospital medicine)

* Primary diagnosis of bronchiolitis in most recent physician progress note

* Not actively receiving supplemental oxygen ("in room air")

* Last documented receipt of supplemental oxygen \>1 hour prior to direct observational data collection

Exclusion criteria:

* Documented apnea or cyanosis during the current illness

* Extreme prematurity (\<28 weeks completed gestation)

* Cardiac disease

* Pulmonary hypertension

* Chronic lung disease

* Home oxygen requirement

* Neuromuscular disease

* Immunodeficiency

* Cancer

* Severe Acute Respiratory Syndrome Coronavirus 2 (Covid-19 / SARS-CoV-2)-related illness (known or suspected, including multisystem inflammatory syndrome in children multi-system inflammatory syndrome in children (MIS-C)

Population b: Bronchiolitis patients directly observed while receiving supplemental oxygen (for underuse evaluation).

Inclusion criteria:

* Infants and children 2 months through 23 months old

* Hospitalized on non-ICU wards participating in the trial

* Cared for by generalist inpatient services (e.g. general pediatrics, hospital medicine)

* Primary diagnosis of bronchiolitis in most recent physician progress note

* Actively receiving ≥2 Liters/minute (2L/min) supplemental oxygen or 21% room air flow

Exclusion criteria:

* Extreme prematurity (\<28 weeks completed gestation)

* Cardiac disease

* Pulmonary hypertension

* Chronic lung disease

* Home oxygen requirement

* Neuromuscular disease

* Immunodeficiency

* Cancer

* Severe Acute Respiratory Syndrome Coronavirus 2 \[Covid-19 / SARS-CoV-2 (known or suspected)\]