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Abstract

Objective: This study aimed to study the practice and effect of monitoring pediatric patients in the length of stay (LOS). Methods: We performed a prospective, observational study of pediatric patients in the general ward from October to December 2016. We have recorded the use of cardiac, pulse-oximeter, or both, and as per physician order at time of patient admission. We have studied the proportions of monitoring at different patient groups. We have applied linear regression model to investigate the relationship between LOS and cardiopulmonary monitoring, orders, and medical complexity. Results: Among 399 patients, patients with cardiac and pulse oximeter monitoring with orders were 68 % and 82%, respectively. The pulmonary group had more monitoring than the neurology group of patients. LOS was shorter in patients without monitoring; the median difference for the cardiac monitoring was one day (IQR 1), and the pulse oximeter was 0.5 days (IQR 1). Cardiac monitoring order increased LOS by 22% (95% CI, 0.5% to 48%) and complex past medical history increased it by 25% (95% CI, 4% to 51%). Conclusion: Our study highlights the variable practice in using monitors, emphasizing a standardized approach. The judicious use of monitoring may reduce prolonged hospitalization. Selective use of physiologic monitoring of ill appearing or at-risk of hypoxemia or cardiac dysrhythmia will reduce overuse.

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