ABSTRACT
OBJECTIVE: To study the influence of local guidelines on the behaviour of nursing and medical staff to optimize the oxygen use in patients admitted to hospital. METHODS: Study was performed in a district teaching hospital. Guidelines produced suggested indications, monitoring, use of arterial blood gases (ABGs) and advice on when to stop oxygen therapy. The guidelines were implemented both verbally and in writing to all the nursing and medical staff before and after an audit studying the oxygen use by patients on medical and surgical wards. RESULTS: Ninety patients were included in pre-intervention audit and 59 in post-intervention study. Oxygen prescription did not change with guidelines 30% (27/90) vs. 32% (19/59). Nurses administered oxygen better 95% (18/19) vs. 70% (19/27) (P = 0.043) and monitored more frequently using oximetry 91% (54/59) vs. 69% (62/90) (P = 0.001) after the guidelines. Patients with airway disease had their ABGs checked more frequently 87% (14/16) vs. 65% (15/23) on admission and after they started oxygen inhalation 68% (11/16) vs. 34% (8/23). CONCLUSION: The guidelines disseminated verbally and in writing had no influence on oxygen prescription but improved the practice of close monitoring of patients with airway disease. Nurses improved their performance of both administration of oxygen according to the prescribed dose and monitoring with oximetry.
Subject(s)
Guideline Adherence , Inpatients , Oxygen Inhalation Therapy/standards , Practice Guidelines as Topic , Aged , Female , Hospital Bed Capacity, 500 and over , Hospitals, University/standards , Humans , Male , Medical Staff, Hospital/standards , Middle Aged , Nursing Staff, Hospital/standardsABSTRACT
Oxygen therapy is a central part of our clinical practice and is widely used in many pulmonary and non-pulmonary conditions worldwide but it is sometimes used unnecessarily and can be harmful. Optimum use is not only important for patient care but is also sound fiscally because of the expense of oxygen and the cost of devices utilised. This article is aimed both at reviewing available research and guidelines for the use of oxygen and providing knowledge of different administering and monitoring devices and equipment. Various hospital based audits have shown oxygen as being poorly prescribed and inappropriately administered and it is important for everyone involved in patient care to understand the basics of oxygen therapy before optimum practice can be implemented and followed.
