Table 1 Electronic survey sent to the Italian neonatologists
From: Management of oxygen saturation monitoring in preterm newborns in the NICU: the Italian picture
Infrastructure variables | |
|---|---|
1. Your NICU is based in a: | 2. Your NICU is: |
▪ II level hospital | ▪ South of Italy |
▪ III level hospital | ▪ North of Italy Center of Italy |
3. Is yours a University hospital? | 4. Indicate the annual number of births in your hospital |
▪ Yes | |
▪ No | |
5. Indicate the annual number of newborns with gestational age < 32 weeks assisted in your NIC | |
6. Indicate the annual number of newborns with gestational age < 28 weeks assisted in your NICU | |
7. How many NICU beds does your NICU have | 8. Which are the doctors/beds ratio in your NICU? |
9. Which is the nurses/beds ratio in your NICU? | 10. Is there a local oxygen management protocol in your NICU? ▪ Yes ▪ No ☐ |
11. Indicate the minimum and maximum values of the range of SatO2 used in its NICU for newborns with gestational age less than 32 weeks requiring oxygen supply | |
12. In which conditions may the above ranges vary? | |
▪ Never | |
▪ Variation in ventilator support mode (e.g. from not invasive to invasive) | |
▪ Presence of associated comorbidity (anemia, congenital cardiopathy, retinopathy of prematurity, need for surgery, sepsis) | |
▪ Other (explain here your answer) | |
13. In case of SpO2 range variation, which of the two alarms is modified? | |
▪ Lower value alarm | |
▪ Upper value alarm | |
▪ Both | |
14. Who is in charge of setting the minimum and maximum alarms? | |
▪ Chief | |
▪ Neonatologist | |
▪ Nurse | |
15. Who is in charge to change the alarm value? (You can choose more than one answer) | 16. Who is in charge to disable the maximum alarm? (You can choose more than one answer) |
▪ Chief | ▪ Chief |
▪ Neonatologist | ▪ Neonatologist |
▪ Nurse | Nurse |
17. In which conditions are the alarms disabled? (You can choose more than one answer) | |
▪ Never | |
▪ During invasive procedures (such as CVC insertion, chest drainage, reintubation) | |
▪ During nursing care (washing, weight evaluation, change of the diaper) | |
▪ patient respiratory instability | |
▪ Other (explain here your answer) | |
18. If the alarms are disabled, which of the two alarms is disabled? | |
19. Lower alarm | |
20. Upper alarm | |
21. Both | |
22. Who responds to the alarm signal? | 23. Is there written documentation of the interventions in |
▪ Doctor on duty | 24. response to the alarm signal? |
▪ Nurse | ▪ Yes |
▪ Indifferently the doctor or the nurse | ▪ No |
Training related variables | |
1. Is there a staff training program on the use of the pulse oximeter and on the rationale for careful monitoring of O2 saturation? | |
▪ Yes | |
▪ No | |
2. Is there a formal staff training on how to respond to alarms? | |
▪ Yes | |
▪ No | |
Technology variables | |
1. Indicate the type of the pulse oximeter in use in your NICU | |
2. Is an O2 saturation daily plot available for admitted newborns? | |
▪ Yes | |
▪ No | |
3. If you answered yes to the previous question, is it possible to archive daily data? | |
▪ Yes | |
▪ No | |
Staff variables | |
1. Do you think that a high alarm frequency during the work shift leads to latency in response time to the alarm or a decreased attention to that? | |
▪ Yes | |
▪ No | |
2. If you answered yes, for what kind of alarm do you think that happens? | |
3. Lower alarm | |
4. Upper alarm | |
5. Both | |
6. In case of severe conditions, with frequent activation of the alarm, is there a progressive latency in the response time to the upper value alarm? | |
▪ Yes | |
▪ No | |
7. Is the acoustic intensity of the alarms reduced during the night shift? | 8. During the night shift, can the upper value alarm be changed / disabled? |
▪ Yes | ▪ Yes, it can be changed |
▪ No | ▪ Yes, it can be disabled |
▪ No | |
9. 1Are alarms disabled during assistance maneuvers (e.g. washing, suction, weight evaluation, nursing care)? ▪ Yes | |
▪ No | |
10. If you answered yes, how long are they disabled on average? | 11. During the execution of the assistance maneuvers, does the healthcare professional use supplemental oxygen? |
▪ Less than 5 min | ▪ Yes |
▪ From 5 to 10 min | ▪ No |
▪ More than 10 min | ▪ |
12. Before carrying out invasive maneuvers (e.g. reintubation, positioning of the thoracic drainage, CVC insertion, etc.) is a further supplementation of oxygen used, compared to that already administered? ▪ Yes ▪ No | |
Patient-related variables | |
1. How many newborns less than 32 weeks of gestational age with respiratory support are currently hospitalized in your NICU? | |
2. How many of the newborns mentioned in the previous question are assisted with non-invasive ventilation? | 3. How many of the newborns mentioned in the previous question are assisted with invasive ventilation? |
4. Indicate the minimum and maximum values of the SatO2 range used for currently hospitalized newborns with GA < 32 weeks | |
5. Do the clinical conditions of the newborn (anemia, hypotension, apnea, infections, need for mechanical ventilation) influence the saturation range set? | 6. In your NICU, do you have NIRS as an additional tissue oxygenation monitoring system? ▪ |
▪ Yes | ▪ Yes |
▪ No | ▪ No |
7. In your NICU, do you have the VEGF dosage as an additional tissue oxygenation monitoring tool? | 8. Is there the possibility to measure oxidative stress by dosing specific biomarkers? |
▪ Yes | ▪ Yes |
▪ No | ▪ No |