Home › Trials › NCT05132322

Reducing unnecessary pulse oximetry monitoring in children with bronchiolitis

Eliminating Monitor Overuse (EMO) Hybrid Effectiveness-Deimplementation Trial

Not applicable Interventional Children's Hospital of Philadelphia · NCT05132322

This study is testing ways to help hospitals reduce unnecessary pulse oximetry monitoring for children with bronchiolitis who don't need extra oxygen.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment32357 (estimated)
Ages2 Months and up
SexAll
SponsorChildren's Hospital of Philadelphia Academic / other
Locations58 sites (Birmingham, Alabama and 57 other locations)
Trial IDNCT05132322 on ClinicalTrials.gov

What this trial studies

This trial aims to identify effective strategies to reduce the overuse of continuous pulse oximetry monitoring in children hospitalized with bronchiolitis who do not require supplemental oxygen. The study employs a cluster-randomized design and includes interventions such as educational outreach, real-time audit and feedback, and the integration of clinical pathways into electronic health records. By focusing on hospital staff, the trial seeks to gather insights through questionnaires and qualitative interviews to inform best practices in monitoring. The ultimate goal is to improve patient care by minimizing unnecessary interventions.

Who should consider this trial

Good fit: Ideal candidates for this study are hospital staff, including nurses and physicians, who care for bronchiolitis patients and are fluent in English.

Not a fit: Patients who are not hospitalized for bronchiolitis or those receiving supplemental oxygen will not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to more appropriate use of monitoring in pediatric patients, reducing unnecessary interventions and healthcare costs.

How similar studies have performed: Other studies have shown success in implementing deimplementation strategies in healthcare settings, suggesting that this approach may be effective.

Eligibility criteria

Show full inclusion / exclusion criteria 
Population 1a: Hospital staff who complete study questionnaires.

Inclusion Criteria:

* Nurse or physician fluent in English and employed full-time by the hospital, affiliated practice, or affiliated university who cared for bronchiolitis patients on a unit participating in the trial during at least 5 days of the most recent bronchiolitis season
* Hospital administrator fluent in English who oversaw the care of bronchiolitis on a local level (e.g. nurse manager) or a hospital level (e.g. Chief Quality and Safety Officer)

Exclusion Criteria:

• Under the direct supervision of study or site principal investigator(s)

Population 1b: Hospital staff who participate in qualitative interviews

In Aim 2, we will conduct semi-structured interviews with physicians and nurses who provide care to bronchiolitis patients in participating units at the 5 hospitals with the highest and 3 hospitals with the lowest sustainability (8 hospitals total; up to maximum of 8 interviews/hospital). Maximum anticipated enrollment 64.

Inclusion criteria:

* Nurses or Physicians who cared for bronchiolitis patients on a unit participating in the trial during at least 5 days of the most recent bronchiolitis season
* Employed full-time by the hospital, affiliated practice, or affiliated university
* Fluent in English

Exclusion criteria:

• No exclusion criteria

Population 2a: Bronchiolitis patients directly observed while not receiving supplemental oxygen ("in room air," for primary trial outcome)

Inclusion Criteria:

* Infants and children 2 months through 23 months old
* Hospitalized on non-ICU wards participating in the trial
* Cared for by generalist inpatient services (e.g. general pediatrics, hospital medicine)
* Primary diagnosis of bronchiolitis in most recent physician progress note
* Not actively receiving supplemental oxygen ("in room air")
* Last documented receipt of supplemental oxygen \>1 hour prior to direct observational data collection

Exclusion Criteria:

* Documented apnea or cyanosis during the current illness
* Extreme prematurity (\<28 weeks completed gestation)
* Cardiac disease
* Pulmonary hypertension
* Chronic lung disease
* Home oxygen requirement
* Neuromuscular disease
* Immunodeficiency
* Cancer
* Severe Acute Respiratory Syndrome Coronavirus 2 (Covid-19 / SARS-CoV-2)-related illness (known or suspected, including multisystem inflammatory syndrome in children multi-system inflammatory syndrome in children (MIS-C)

Population 2b: Bronchiolitis patients directly observed while receiving supplemental oxygen (for underuse evaluation).

Inclusion Criteria:

* Infants and children 2 months through 23 months old
* Hospitalized on non-ICU wards participating in the trial
* Cared for by generalist inpatient services (e.g. general pediatrics, hospital medicine)
* Primary diagnosis of bronchiolitis in most recent physician progress note
* Actively receiving ≥2 Liters/minute (2L/min) supplemental oxygen or 21% room air flow

Exclusion Criteria:

* Extreme prematurity (\<28 weeks completed gestation)
* Cardiac disease
* Pulmonary hypertension
* Chronic lung disease
* Home oxygen requirement
* Neuromuscular disease
* Immunodeficiency
* Cancer
* Severe Acute Respiratory Syndrome Coronavirus 2 \[Covid-19 / SARS-CoV-2 (known or suspected)\]

Population 3: Parents or guardians of bronchiolitis patients who participate in qualitative interviews.

Inclusion Criteria:

* Their child was hospitalized for bronchiolitis on a unit participating in the trial during the most recent bronchiolitis season
* Their child was found to be in room air during Aim 1 data collection
* Fluent in English

Exclusion criteria:

• They are an employee of the hospital or a hospital volunteer

Where this trial is running

Birmingham, Alabama and 57 other locations

+8 more sites — see ClinicalTrials.gov for the full list.

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
View on ClinicalTrials.gov → Find more trials like this →
Conditions Bronchiolitis Acute Viralpulse oximetrydeimplementationcluster-randomized trialeffectiveness-implementation hybrid trialimplementation science
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.