{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:48:11Z","timestamp":1773676091597,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","award":["ERP\u20102020\u201012546"],"award-info":[{"award-number":["ERP\u20102020\u201012546"]}],"id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine if smart alarm\u2010guided treatment of respiratory depression using the Integrated Pulmonary Index is an effective way to implement capnography during nurse\u2010administered sedation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Parallel cluster\u2010randomized trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Nurses will be randomized to use capnography with or without the Integrated Pulmonary Index enabled. Capnography alarm performance will be compared between nurses using capnography alone or with the Integrated Pulmonary Index enabled. The target sample size is 400 adult patients scheduled for elective procedures with nurse\u2010administered sedation. The primary outcome is the number of seconds in an alert condition state without an intervention being applied. Secondary outcomes are alarm burden, number of appropriate alarms, number of inappropriate alarms, total duration of alert conditions, choice of alarm settings and adverse sedation events. This study has been funded since April 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Implementing capnography into practice for respiratory monitoring during nurse\u2010administered sedation is considered a high priority. The Integrated Pulmonary Index shows promise as a strategy to optimize the implementation of capnography for respiratory monitoring during nurse\u2010administered sedation. If it is found in this study that using the Integrated Pulmonary Index improves the nursing management of physiologically abnormal states during nurse\u2010administered sedation, it would provide the high\u2010level evidence needed to support broader use of this \u2018smart alarm\u2019 strategy for respiratory monitoring in practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>With advances in medical technology continuing to expand the indications for minimally invasive surgical techniques, the use of nurse\u2010administered sedation during medical procedures is likely to expand in the future. The findings may be applied to other populations receiving nurse\u2010administered sedation during medical procedures. Results from this study will help translate the usage of smart alarm\u2010guided treatment of respiratory depression during procedural sedation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>NCT05068700.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.15243","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T04:53:15Z","timestamp":1651207995000},"page":"2245-2254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Integrated Pulmonary Index during nurse\u2010administered procedural sedation: Study protocol for a cluster\u2010randomized trial"],"prefix":"10.1111","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-8636","authenticated-orcid":false,"given":"Aaron","family":"Conway","sequence":"first","affiliation":[{"name":"Peter Munk Cardiac Centre University Health Network  Toronto Ontario Canada"},{"name":"Lawrence S. Bloomberg Faculty of Nursing University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Chang","sequence":"additional","affiliation":[{"name":"Peter Munk Cardiac Centre University Health Network  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2609-8611","authenticated-orcid":false,"given":"Mohammad","family":"Goudarzi Rad","sequence":"additional","affiliation":[{"name":"Lawrence S. Bloomberg Faculty of Nursing University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Mafeld","sequence":"additional","affiliation":[{"name":"Interventional Radiology Joint Department of Medical Imaging University Health Network and University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Parotto","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital, UHN  Toronto Ontario Canada"},{"name":"Department of Anesthesiology and Pain Medicine and Interdepartmental Division of Critical Care Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,4,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-018-1205-0"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.710"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010019\u201046751\u20102"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13378"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2013.05.003"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2016.05.004"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13387"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/mlr.0b013e3182408812"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630\u2010018\u20101230\u2010z"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl\u20102015\u2010307656"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h391"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz237"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6325"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k1614"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542\u2010199303000\u201000007"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1258"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-015828"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005110-200507000-00004"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2017.08.004"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aco.0000236146.46346.fe"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877\u2010016\u20109851\u20107"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100042\u2010100719"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2010.08.012"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002803"}],"container-title":["Journal 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