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Nursing attitudes towards continuous capnographic monitoring of floor patients
  1. Catherine L Clark1,
  2. Liza M Weavind1,
  3. Sara E Nelson1,
  4. Jennifer L Wilkie1,
  5. Joel T Conway1,
  6. Robert E Freundlich1,2
  1. 1Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  2. 2Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  1. Correspondence to Dr Robert E Freundlich; robert.e.freundlich{at}vanderbilt.edu

Abstract

Introduction Nurses’ perceptions of the utility of capnography monitoring are inconsistent in previous studies. We sought to outline the limitations of a uniform education effort in bringing about consistent views of capnography among nurses.

Methods A survey was administered to 22 nurses in three subacute care floors participating in a pragmatic clinical trial employing capnography monitoring in a large, urban tertiary care hospital. A 5-point Likert scale was used to assess the value and acceptance nurses ascribed to the practice. Means and SD were calculated for each response.

Results Survey results indicated inconsistency in the valuation of capnography, coupled with varying degrees of acceptance of its use. The mean for the level of perceived impact of capnography use on patient safety was 3.86, yet the perceived risk of removing capnography was represented by a mean of 2.57. The levels of urgency attached to apnoea alarms (mean 3.57, SD 1.57) were lower than those for alarms for oxygen saturation violations (mean 3.67, SD 1.32). The necessity for pulse oximetry monitoring was perceived as much higher than that for capnography monitoring (mean 1.76, SD 1.34), where ‘1’ represented pulse oximetry as more necessary and ‘5’ represented capnography as more necessary.

Conclusions Nursing acceptance of capnography monitoring is a difficult endpoint to achieve. There is a need for better accounting for the external and internal influences on nurse perceptions and values to have greater success with the implementation of similar monitoring.

  • adverse events, epidemiology and detection
  • attitudes
  • cognitive biases
  • continuing education, continuing professional development
  • hospital medicine

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Footnotes

  • Contributors Substantial contribution to the conception/design of the work: CLC, LMW, JLW and REF. Acquisition, analysis and interpretation of data: all authors. Drafting the work: CLC. Revising the work for intellectual content: all authors. Final approval: all authors. Agreement to be accountable for all aspects of the work: all authors.

  • Funding The authors received grant support from Medtronic to study the impact of continuous capnography monitoring of floor patients. REF receives ongoing grant support from an NIH KL2 grant via the Vanderbilt CTSA (1KL2 TR002245).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval IRB approval was obtained for the conduct of this study, which was deemed to be exempt under the quality improvement exemption (Vanderbilt University Medical Center IRB #170666).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Unpublished data are available upon request.