The objectives of this study were: 1) to perform documented event‐monitoring (DEM) for apnea (A, ⩾20 s) and bradycardia (B, <80 beats per min for ⩾5 s) in premature infants prior to discharge, and 2) to examine the accuracy of nursing documentation (ND) of A and B. Forty‐four stable preterm infants, with mean weights and gestational ages at birth (± SD) of 1,543 (± 365) g, and 30 (± 2) weeks, respectively, were studied using DEM for 9 (± 2) days prior to discharge. Differences in DEM and ND were analyzed by the z‐test for proportions.
There were 561 true events recorded by DEM: 56 were As and 505 were Bs. ND revealed 296 events, 190 As and 106 Bs. Of the 56 true As on DEM, only 21 (38%) were correctly reported by ND (P < 0.001, 95% confidence interval (CI) 0.44–0.81). Of the 505 true Bs on DEM, 153 (30%) were correctly reported by ND (P < 0.001, CI 0.63–0.76). When ND was compared with DEM, 174 (59%) of NDs were true events. Of the 106 As on ND, only 21 (20%) were true As on DEM (P < 0.001, CI 0.58–1). Of the 190 Bs on ND, 153 (80%) were true Bs on DEM (P < 0.001, CI 0.13–0.26). ND did not detect 6 of the 33 infants who had significant events on DEM, while 4 of the 11 who had events reported on ND did not have any on DEM. Thus, 10 infants were misclassified by ND (P < 0.01, CI 0.1–0.36). These results indicate that, compared to DEM, ND not only identified significantly fewer true As and Bs, but also misclassified a significant number of infants. We conclude that DEM performed prior to discharge for preterm infants at risk for apnea and bradycardia provides more objective and accurate information than ND. Pediatr Pulmonol. 1999; 27:113–116. © 1999 Wiley‐Liss, Inc.
