The Science Journal of the American Association for Respiratory Care

1995 OPEN FORUM Abstracts

Oxygen Therapy Practice Patterns For Non-Icu Patients Indicates The Need For Tools To Standardize Oxygen Therapy Administration

Sandy M Metcalf RRT, Xiaoping Zhang, MD, Jane Wallace, RN, MS, Wang Hsueh-fen Young, MS, Loren Greenway, RRT, and Alan H Morris, MD. Pulmonary Division/Respiratory Care, LDS Hospital, 8th Avenue and C Street, Salt Lake City, UT 84143

Although guidelines for oxygen therapy administration are available (Resp Care 91;36:1410, Chest 86;90:647), they have not been reported to be routinely applied or shown to improve oxygen therapy practice patterns in non-ICU patients. We retrospectively reviewed data from a large, integrated hospital information system (HELP) at the LDS Hospital in order to determine oxygen therapy practice pattems in our hospital. We identified 339 patients who were given oxygen therapy at any time during their stay on one medical and one surgical ward from 1/1/94 to 3/31/94. We retrieved 6,362 routine, clinical SpO2 measurements and associated oxygen therapy status. A simple, quantitative definition for excessive, reasonable and insufficient use of O_2 is shown in Table 1. Of the 790 measurements in the category of insufficient use of oxygen, 250 (32%) were not associated with oxygen administration, and 540 (68%) were associated with oxygen administration. We concluded the following: (1) oxygen therapy for non-ICU patients was not effectively administrated in our hospital, (2) we suspect those observations are a reflection of a widespread problem in the medical community (Chest 92;102:1672, AJM 92;92:591). Tools to standardize and improve the quality of oxygen therapy administration at the point of care are needed. Computerized protocols designed to provide specific, executable instructions at the point of care offer a solution to the problem and need to be evaluated in terms of their ability to reduce excessive use of oxygen and the incidence and duration of hypoxemia.

Table 1. Oxygen Therapy Classification

Category Definition LOS in hrs Measure-

(% of total) ments (%)

Excessive use of O2SpO2>=94% w/O2 10,349(31)2,128 (33)

Reasonable use of O2 or SpO2 90-93% w/O2 &

no use of O2SpO2>=90 w/o O220,775 (62) 3,444 (54)

Insufficient use of O2SpO2 < =89% 2,404 (7) 790 (12)

Total 33,5286,362

LOS = ward length of stay; w/ = with; w/o = without; O2 = oxygen therapy

OF-95-036

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