Format

Send to

Choose Destination
J Pediatr. 2014 Jan;164(1):67-71.e2. doi: 10.1016/j.jpeds.2013.08.044. Epub 2013 Oct 10.

Quality improvement in screening for critical congenital heart disease.

Author information

1
Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA; Emory University Rollins School of Public Health, Atlanta, GA. Electronic address: osterm@kidsheart.com.
2
Emory University Rollins School of Public Health, Atlanta, GA; Emory University Woodruff School of Nursing, Atlanta, GA; Children's Medical Center, Dallas, TX.
3
Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA.

Abstract

OBJECTIVES:

Screening for critical congenital heart disease with pulse oximetry requires healthcare providers to decipher a previously published algorithm, a feature that raises concerns about quality of interpretation of pulse oximetry results. We hypothesized that this method would be prone to error and a computer-based tool would lead to a more accurate interpretation of the screening results.

STUDY DESIGN:

In this randomized crossover study, healthcare providers with prior experience using pulse oximetry received 2 sets of 10 mock screening scenarios and were asked to interpret the results of each scenario as "pass," "fail," or "retest." Participants were randomized to use either the paper algorithm or computer-based tool for the first set of 10 scenarios and the alternative method for the second set. We used Wilcoxon rank sum tests to compare the accuracy of interpretation using the 2 methods.

RESULTS:

The 102 participants answered 81.6% of the scenarios correctly when manually interpreting the algorithm vs 98.3% correct when using the computer-based tool (P < .001). These differences were most pronounced for the "fail" scenarios (65.4% manual vs 96.7% computer, P < .001) and the "retest" scenarios (80.7% manual vs 98.7% computer, P < .001), but were also significant for the "pass" scenarios (94.1% manual vs 99.0% computer, P < .001).

CONCLUSIONS:

Use of a manual algorithm for the interpretation of results in screening for critical congenital heart disease with pulse oximetry is susceptible to human error. Implementation of a computer-based tool to aid in the interpretation of the results may lead to improved accuracy and quality.

KEYWORDS:

CCHD; Critical congenital heart disease

PMID:
24120017
DOI:
10.1016/j.jpeds.2013.08.044
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center