TABLE 5.

Participant comments on interventions and policies

What they liked Standardization of response to SpO2 alarms using management algorithms Standardizing trouble shooting of desaturation events with initial five steps Standardizing infant wellness assessment and team communication using ROSE tool Bedside coaching on how to perform tasks, adapt to change, helping them connect their point of care work with an infant’s stability Visually appealing and simple learning materials (ROSE tool and SpO2 alarm management algorithms) Improved documentation and ability to trend infant wellness over time Making staff feel important, connected, and useful Interprofessional, hands on simulation based immersive and interactive learning Making print outs available at bedside Ability to convey infant wellness at shift handovers Facilitates conversation on further work up and clinical management in response to infant wellness changes Activities prompting interprofessional understanding, decision making and problem solving, closely mimicking real-life scenarios. Suggestions to improve the workshop or coaching/in-servicing Avoid staff moving to two different workshop venues after mid-break Suggestions to improve the integration Move from manual infant wellness assessment and documentation to automated electronic process to reduce workload, use of paper, and errors Direct downloading of histogram and event reviews to patient electronic health records Avoid decision-making based solely on histogram and event reviews Physicians taking ownership of using daily summaries of SpO2 histogram and events Clarify whether infant is on supplemental O2 Be skeptic about daily summaries capturing false alarms or equipment issues Validate the tools for better uptake and spread Observations by bedside coach Challenges, what didn’t go well Daily summaries not made available at the bedside during weekends, preventing their use Unit printers did not print automatically daily summaries on Infants on pre- and post-SpO2 monitoring Perception of increasing workload with no apparent benefit for staff No fixed spot to document histogram and event review reports on nurse and RT flow sheets, making it difficult to track trends SpO2 high alarms checking is not part of the standard work during staff shift handover Not knowing how to use ROSE tool when an infant was on intermittently receiving supplemental O2, for example, during procedures Documenting total desaturation events in 24 h, when an infant reached the monitor’s maximum capture ability of 50 events in 6–8 h. Sustainability: Manual printing, distribution, reviewing, plotting, and documenting of daily SpO2 and desaturation event summaries Ongoing staff practices monitoring Orienting learners and new staff Validation of tools with relevant patient or process outcomes