Technology in Nursing Name School of Nursing and Health Sciences, Capella University NURS-FPX4045 Instructor

Technology in Nursing Pulse oximetry is one of the most common methods of measuring the percentage of oxygen saturation in blood (Narayen et al., 2016). Pulse oximeters play a crucial role in critical care settings by detecting low levels of oxygen saturation. Pulse oximeters are also adopted by anesthesiologists in recovery, emergency, and pediatric wards; operation theatres; and neonatal units (Hendaus, Jomha, & Alhammadi, 2015). This annotated bibliography provides insight into how pulse oximeters are used, their limitations and accuracy, and patient outcomes. Annotated Bibliography Hendaus, M. A., Jomha, F. A., & Alhammadi, A. H. (2015). Pulse oximetry in bronchiolitis: Is it needed? Therapeutics and Clinical Risk Management, 11, 1573–1578. https://dx.doi.org/10.2147%2FTCRM.S93176 This article discusses the use of pulse oximetry in pediatric wards. The authors state that hospitals in the United States admit a significant number of children every year with bronchiolitis and other respiratory problems. These problems are usually monitored with the help of a pulse oximeter, an instrument used to measure the saturation of oxygen in the blood. Oxygen saturation levels are used by health care providers to evaluate a patient’s respiratory status and are one of the deciding factors for a patient’s discharge. Pulse oximetry is frequently used in pediatrics (in pediatric intensive care units and pediatric wards) and in emergency departments. Pulse oximeters are used to monitor oxygen saturation during resuscitations, while estimating perfusion, while detecting pulsus paradoxus, and while screening infants for congenital heart disease. Though the source does not fully explain why the limitations occur, it identifies several cases in which pulse oximeters are likely to be inaccurate. Pulse oximeters have certain Commented [A1]: Comprehensive information regarding the types of pulse oximetry devices, selection criteria, decision makers, and associated costs is not available in the selected papers. The two types of pulse oximeters and their advantages over the others is provided; however, information on the various types of pulse oximeters is not available and the associated costs are not provided. This paper does mention that this technique is cost-effective which can fulfill the required criteria. Copyright ©2019 Capella University. Copy and distribution of this document are prohibited. ANNOTATED BIBLIOGRAPHY ON TECHNOLOGY IN NURSING 3 limitations due to inadequate signals. Inadequate signals occur in cases of anemia, bright external light, dark skin, nail polish, low perfusion, and intravenous dye. Pulse oximeters show low readings in cases of venous pulsations such as severe right heart failure, tricuspid regurgitation, and blood pressure cuffs or tourniquets above the site of the pulse oximeter. Pulse oximeters might not detect hypoxemia in patients with elevated arterial oxygen tension levels because of the sigmoidal shape of the oxyhemoglobin dissociation curve. Also, pulse oximeters provide unreliable readings in cases of methemoglobinemia. The source highlights several limitations, which will help readers exercise caution when using pulse oximeters. However, despite these limitations, the use of pulse oximeters in pediatrics is recommended because they are handy and allow for noninvasive measuring of arterial oxygen saturation. Jubran, A. (2015). Pulse oximetry. Critical Care, 19(1), 272. https://dx.doi.org/10.1186%2Fs13054-015-0984-8 This article provides insight into the principles, accuracy, functioning, and outcome of pulse oximeters. It discusses the potential advantages of multiwavelength pulse oximeters over conventional pulse oximeters. Multiwavelength pulse oximeters are capable of estimating the blood levels of carboxyhemoglobin and methemoglobin, whereas conventional pulse oximeters assume that dyshemoglobins such as carboxyhemoglobin and methemoglobin are absent because they can only distinguish between hemoglobin and oxyhemoglobin. Hence, physicians prefer to use multiwavelength pulse oximeters for more accurate results. In hospital settings, the transfer rate from a postsurgical care floor to the intensive care unit (ICU) is an important factor that influences the use of pulse oximeters. The resource reviews a study by Ochroch et al. in which patients were Commented [A3]: Deals with criterion 3: Organizational factors that influence the selection of a technology in health care setting. Commented [A2]: Meets criterion 3 as it deals with organizational factors that influence the selection of a technology in health care setting. Copyright ©2019 Capella University. Copy and distribution of this document are prohibited. ANNOTATED BIBLIOGRAPHY ON TECHNOLOGY IN NURSING 4 monitored by pulse oximeters either continuously (oximeter group) or intermittently based on clinical needs as judged by a physician or a nurse (control group). The rate of ICU t