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Utility and impact of inpatient pediatric physiologic monitoring

Objective: To study the practice and effect of monitoring pediatric patients on the hospital length of stay (LOS). Methods: We conducted a cross-sectional observational study of pediatric patients in the general ward from October to December 2016. We recorded the use of cardiac, pulse-oximeter, or both, and physician order at the time of admission. We studied the proportions of monitoring on different patient groups. The median length of stay assessed for various modes of monitoring. We did regression analysis for the effect of cardiopulmonary monitoring, orders, and medical complexity on hospital length of stay. Results: Among 398 patients, patients with cardiac monitor and pulse oximeter with orders were 68 % and 82%, respectively. The pulmonary group of patients had more monitoring than the neurology group of patients. LOS was shorter in patients without monitors; the median difference for the cardiac monitor was 1 day, and pulse oximeter was 0.5 days. Cardiac monitor order increased LOS by 22% (95% CI, 0.5% to 48%) and complex past medical history increased it by 25% (95% CI, 4% to 51%). Conclusion: Our study highlights the variable practice in using monitors, demanding a standardized approach. The judicious use of monitoring reduces prolonged hospital stay.