Sustainable deimplementation of continuous pulse oximetry monitoring in children hospitalized with bronchiolitis: study protocol for the Eliminating Monitor Overuse (EMO) type III effectiveness-deimplementation cluster-randomized trial

Christopher P. Bonafide, Rui Xiao, Amanda C. Schondelmeyer, Amy R. Pettit, Patrick W. Brady, Christopher P. Landrigan, Courtney Benjamin Wolk, Zuleyha Cidav, Halley Ruppel, Naveen Muthu, Nathaniel J. Williams, Enrique Schisterman, Canita R. Brent, Kimberly Albanowski & Rinad S. Beidas
Abstract Background Methods of sustaining the deimplementation of overused medical practices (i.e., practices not supported by evidence) are understudied. In pediatric hospital medicine, continuous pulse oximetry monitoring of children with the common viral respiratory illness bronchiolitis is recommended only under specific circumstances. Three national guidelines discourage its use for children who are not receiving supplemental oxygen, but guideline-discordant practice (i.e., overuse) remains prevalent. A 6-hospital pilot of educational outreach with audit and feedback resulted in...
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