The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

FINANCIAL AND RESOURCE IMPACT OF NITRIC OXIDE WEANING GUIDELINES



Brian K. Walsh, BS, RRT-NPS, RPFT; Sara Nugent, RRT-NPS University of Virginia Health System, Charlottesville, Virginia.

Background:
The charge for the daily administration of Inhaled Nitric Oxide (INO) was set by INO Therapeutics at $125.00 per hour in January 2002 with a 96 hour cap of $12,000. This high cost of administration has forced clinicians to evaluate their use of INO and strive to discontinue its use as soon as clinically possible. On May 15, 2002 we implemented the use of a Nitric Oxide Weaning Guideline to standardize our practice.

Methods:
In the ten months prior to the implementation of the INO Weaning Guideline, INO was administered to 36 patients (Group A). In the 10 months following the implementation of the INO Weaning Guideline, INO was administered to 24 patients (Group B). The date, time of initiation, and discontinuation of INO were recorded at the time of service by the Respiratory Therapist caring for the patients. The hourly charge for INO services was reported by the Pharmacy.

 Results

Patient Group Number of Patients in Group INO Charges per Patient Length of INO Therapy
A 36 $9,328.13 4.35 days
B 24 $8,984.38 3.30 days


Conclusion The average cost per patient for the administration of INO was reduced by $343.75 following the implementation of the INO Weaning Guidelines. More importantly, the average length of time each patient received INO was reduced 1.05 days resulting in the use of fewer Respiratory Therapy resources.

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