Pulse Oximetry With Automated Verbal Prompts

Study Overview
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Brief Summary
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This study will evaluate the effectiveness of an automated voice prompting system on post operative hypoxia within the Postoperative Anesthesia Care Unit (PACU). This will be done to detect an improvement of the patient experience and provider care through a decrease in the number of peripheral capillary oxygen saturation (SpO2) monitor alarms via the patients own ability to follow the instruction and improve their SpO2 levels.

Detailed Description
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The investigators will examine and observe the patient's stay in the PACU and utilize the pulse oximetry software and data to analyze the ability to evaluate the difference in patient oxygenation levels and supplemental oxygen use with automated verbal prompted monitoring versus a standard care control group. As well as determine if automated verbal prompted monitoring leads to less monitor alarms and subsequent improvement of subjective alarm fatigue and patient satisfaction with their care versus standard care. The pulse oximeter will have a finger probe that will be attached to the patient's middle finger to read the patient's SpO2 levels. Each time the participant's pulse oximetry value declines to 93% or less, an automated verbal prompt, created via the software, will generate as a soft prompt. This will be followed up by a hard prompt if no improvement is seen in their oxygenation level after a period of time. A positive feedback elicitation will be given if the participant's saturation levels increase above 93%. This automated verbal prompt guidance will take place during the entirety of the investigational group's PACU stay.

Official Title
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Prevention of Post Operative Hypoxia in the Post Anesthesia Care Unit Using Pulse Oximetry With Automated Verbal Prompts

Conditions
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Hypoxemia

Intervention / Treatment
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* Other: pulse oximetry software
* Behavioral: Brief post-PACU stay survey.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: planned general anesthetic ability to provide informed consent Exclusion Criteria: use of regional anesthesia altered mental status hearing impairment requiring assistive devices inability to hear normal conversational voice during the consent process inability preoperatively to squeeze probe finger against thumb for any reason baseline SpO2 less than or equal to 93% (on room air or baseline home oxygen requirement) history of methemoglobinemia suspected or confirmed carbon monoxide (CO) poisoning planned admission to an intensive care unit

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control Non-Automated Group<br>Participants assigned to this group will receive the standard of care procedures for the monitoring and treatment of hypoxemia. Complete brief post-PACU stay survey. | Behavioral: Brief post-PACU stay survey.<br>* Complete a brief post-PACU stay survey focused around their satisfaction and experience during their time in the PACU.<br>|
| Experimental: Automated Prompt Group<br>Participants assigned to this group will utilize the automated verbal prompts to enable their ability to improve their current condition by following generated commands. Complete a questionnaire focused around their experience with the pulse oximetry software and its effects on the patient's satisfaction and experience. | Other: pulse oximetry software<br>* This pulse oximetry software will utilize automated verbal prompts that direct the patients to breathe when their pulse oximetry reading falls at or below 93%.<br>Behavioral: Brief post-PACU stay survey.<br>* Complete a brief post-PACU stay survey focused around their satisfaction and experience during their time in the PACU.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the frequency of a participant's SpO2 level falling below 87% | SpO2 will be monitored using the standard pulse oximeter system | Change from baseline up to 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change between the study groups number of pulse oximetry alarms | SpO2 will be monitored using the standard physiologic monitoring system | Change from baseline up to 24 hours | 
| Change between the study groups level of alarm fatigue | Number of participants reporting a decreased level of alarm noise | Change from baseline up to 24 hours | 
| Change between the study groups level of postoperative care satisfaction | Number of participants reporting alarm noise affected their level of postoperative care satisfaction | Change from baseline up to 24 hours |