Nurses' compliance with alarm limits for pulse oximetry: qualitative study

Objective: Monthly audits for the multicenter Canadian Oxygen Trial have shown that our neonatal team has consistently maintained study participants within the intended pulse oximetry alarm limits between 68 and 79% of the time during the first 3 days of life while infants were receiving supplemental oxygen. This good performance prompted us to explore our nurses' perceptions of what makes them compliant with alarm limits for pulse oximetry in preterm infants. Study Design: The local neonatal research nurse interviewed all 41 staff nurses in the neonatal intensive care unit at the University Children's Hospital in Tuebingen, Germany, for this qualitative study. Result: Nurses identified education (22/41), prompt response to alarms (22/41), a favorable patient-to-staff ratio (18/41), root cause analysis at the bedside (15/41), and the high priority given to control of oxygen therapy in the department (14/41) as the five most important determinants of their good compliance. Conclusion: These findings may be useful for other neonatal teams who struggle to improve their compliance with alarm limits for pulse oximetry. Journal of Perinatology (2010) 30, 531-534; doi:10.1038/jp.2009.189; published online 10 December 2009