The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

EDUCATIONAL INTERVENTION FOR AN EFFICIENT USE OF PULSE OXIMETRY AT ST. MARY’S HOSPITAL LACOR, GULU, UGANDA

Simone Gambazza1, Elisabetta Zampogna2; 1Servizio Riabilitazione Funzionale, Azienda Ospedaliero- Universitaria Meyer, Firenze, Italy; 2Divisione di Pneumologia, Fondazione Salvatore Maugeri I.R.C.C.S., Tradate, Italy

Background Medical and diagnostic information offered by technological devices that usually help the western medicine, are scanty or non-existent in developing countries; and if suitable instruments are available in the more depressed rural areas it is impossible to benefit from such devices without considering watering and electricity supply. The accuracy of instruments set on white-skin population and the lack of trained health workers may also lead to a misinterpretation of the read values and waste of economic resources. This project was developed to describe existing procedures of administering oxygen and monitoring SpO2 in a rural sub-Saharian hospital and to design and implement an educational intervention aiming to promote an efficient use of pulse oximetry among nursing staff. Method The project was carried out at St. Mary’s Hospital Lacor in Gulu, Uganda from August 2007 to January 2008. Data from 323 dark-skin subjects from different wards were collected to determine their hypoxaemic risk (SpO2<94%). Using the Nellcor NPB-40 pulse-oximeter, the saturation was registered, considering reliable every value taken after 60 seconds. A questionnaire was then administered to nursing staff to assess their knowledge about pulse-oximetry technique through four questions: definition of SpO2 2) meaning of the read value, 3) knowledge of human physiology and 4) of oxygen. A series of meetings was organized to give nursing staff all the relevant information about pulse oximetry techniques. Results Patients in Medicine ward (30%) and Nutrition unit (20%) were the most exposed to hypoxaemic risk (p<.05) and only 16,6% of those with SpO2≤90% had been receiving the appropriate oxygen therapy. Only 28 out of 93 nurses gave the right answer to the first three questions and a substantial lack of rudiments concerning nature and use of oxygen as medical therapy was highlighted by the answers to the last question. The content of the educational meetings was developed accordingly to the results of the questionnaire; the importance of administering oxygen was particularly stressed suggesting to consider oxygen as any other medical therapy. Conclusions Oxygen concentrators and pulse-oximeters represent an important but rare combination in rural African hospitals. Increasing safety of patients through a more conscious use of pulse-oximetry and a consequent better fruition of oxygen has represented a small but significant result for this project lasted five months. Sponsored Research - None

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