Chest
Clinical InvestigationsPattern of Non-ICU Inpatient Supplemental Oxygen Utilization in a University Hospital
Section snippets
Materials And Methods
Study patients potentially included all hospitalized adult medical and surgical patients receiving supplemental O2 for greater than 24 h outside the ICU. Patients who were receiving O2 for a medical emergency (ie, myocardial infarction, anemia, carboxyhemoglobinemia) or those who had an unstable underlying medical condition were excluded. In addition, patients with inadequate digit perfusion, jaundice or highly pigmented skin in whom accurate oximetry could not be obtained were similarly
Population Studied
Of the 1,084 O2 assessments and titrations randomly performed, 614 were performed on 172 medical patients and 470 on 102 surgical patients (Table 1). No attempt was made to categorize the admitting diagnoses. The decision to institute the use of supplemental O2 and the concentration of inspired O2 was made by the treating physicians. In all patients, the concentration of inspired O2 measured on the oxygen delivery device at the time of the O2 titration study corresponded to the amount ordered
Discussion
The results of this study demonstrate that the use of supplemental O2 in hospitalized patients outside the ICU is arbitrary, poorly monitored and does not uniformly comply with regulations regarding its prescription. One alarming finding in this study is that a significant number of patients prescribed O2 (20 percent) remain hypoxemic due to insufficiently prescribed concentrations of inspired O2 and follow-up monitoring. Although our study was not designed to evaluate nursing, respiratory
References (11)
- et al.
Effectiveness of medical necessity guidelines in reducing cost of oxygen therapy
Chest
(1986) - et al.
Reliability of pulse oximetry in titrating supplemental oxygen therapy in ventilator dependent patients
Chest
(1990) - et al.
Pulse oximetry for tapering supplemental oxygen in hospitalized patients: evaluation of a protocol
Chest
(1987) Medical necessity program-respiratory care
(1982)- et al.
Oxygen therapy in medical patients hospitalized outside of the intensive care unit
Am Rev Respir Dis
(1980)
Cited by (42)
Is the Liberal Use of Oxygen Associated With Worse Outcomes Among Critically Ill Patients?
2019, Annals of Emergency MedicineNasal high-flow oxygen therapy in ICU: A before-and-after study
2016, Australian Critical CareCitation Excerpt :Despite supplemental oxygen being widely prescribed therapeutic drug in medicine,13 there remains little published evidence to guide intensive clinicians on selecting the most appropriate oxygen delivery device in non-intubated patients.1 Indeed, much variability in the management of oxygen therapy and delivery devices in critical and non-critical care settings has been identified previously.1,2,14–17 A recent point prevalence study of 506 patients from 40 Australian and New Zealand ICU's reported that 35.2% of patients were non-intubated and receiving supplemental oxygen therapy.3
Oxygen therapy multicentric study-A nationwide audit to oxygen therapy procedures in Internal Medicine wards
2012, Revista Portuguesa de PneumologiaLow-flow oxygen therapy in intensive care: An observational study
2011, Australian Critical CareCitation Excerpt :A failure to safely manage low-flow oxygen therapy places the patient at risk of hypoxaemia, worsening respiratory dysfunction and death.9,10 Previous studies conducted in non-critical care settings have shown the nursing management of oxygen therapy across a range of contexts to be suboptimal.11–20 There is scant published evidence that explains how intensive care nurses’ manage low-flow oxygen therapy; and, hence little is known about how low-flow oxygen therapy is delivered on a daily basis.
The effect of education on hypothetical and actual oxygen administration decisions
2007, Nurse Education Today
Manuscript received March 3; revision accepted April 16.