Audit of oxygen administration to achieve a target oxygen saturation range in acutely unwell medical patients. Harper, J., Kearns, N., Bird, G., McLachlan, R., Eathorne, A., Weatherall, M., & Beasley, R. Postgraduate Medical Journal, February, 2021.
Audit of oxygen administration to achieve a target oxygen saturation range in acutely unwell medical patients [link]Paper  doi  abstract   bibtex   2 downloads  
Purpose of the study To evaluate documentation of a target oxygen saturation (SpO 2 ) range and ability to achieve this range in acutely unwell inpatients. Study design In this single-centre audit, patients with discharge diagnoses of pneumonia, heart failure and exacerbation of asthma or COPD admitted to Wellington Regional Hospital, New Zealand between 1 June 2019 and 31 August 2019 who received oxygen were identified. In those with a documented target SpO 2 range, the proportion of SpO 2 measurements in the observation chart which were within, above and below range were determined as well as the maximum and minimum SpO 2 . Regression analysis was performed to determine whether these outcomes were influenced by the prescribed range, high-dependency care or the number of adjustments to oxygen administration. Results 268 admissions were screened. Of the 100 eligible admissions who received oxygen, a target SpO 2 range was documented in 62. The mean (SD) proportion of SpO 2 measurements within range was 56.2 (30.6)%. A hypercapnic target SpO 2 range was associated with a higher probability of an SpO 2 above range; multivariate OR 5.34 (95% CI 1.65 to 17.3, p=0.006) and a lower probability of an SpO 2 below range; multivariate OR 0.25 (95% CI 0.08 to 0.80) p=0.02. The mean (SD) maximum SpO 2 was similar in those with a target range of 92%–96% versus a hypercapnic range; 96.2 (3.0)% and 95.2 (3.4)%, respectively. Conclusions Oxygen prescription and delivery in this clinical setting was suboptimal. SpO 2 values above the designated range are common, particularly in patients with a hypercapnic target range.
@article{harper_audit_2021-1,
	title = {Audit of oxygen administration to achieve a target oxygen saturation range in acutely unwell medical patients},
	issn = {0032-5473, 1469-0756},
	url = {https://pmj.bmj.com/lookup/doi/10.1136/postgradmedj-2020-139511},
	doi = {10.1136/postgradmedj-2020-139511},
	abstract = {Purpose of the study
              
                To evaluate documentation of a target oxygen saturation (SpO
                2
                ) range and ability to achieve this range in acutely unwell inpatients.
              
            
            
              Study design
              
                In this single-centre audit, patients with discharge diagnoses of pneumonia, heart failure and exacerbation of asthma or COPD admitted to Wellington Regional Hospital, New Zealand between 1 June 2019 and 31 August 2019 who received oxygen were identified. In those with a documented target SpO
                2
                range, the proportion of SpO
                2
                measurements in the observation chart which were within, above and below range were determined as well as the maximum and minimum SpO
                2
                . Regression analysis was performed to determine whether these outcomes were influenced by the prescribed range, high-dependency care or the number of adjustments to oxygen administration.
              
            
            
              Results
              
                268 admissions were screened. Of the 100 eligible admissions who received oxygen, a target SpO
                2
                range was documented in 62. The mean (SD) proportion of SpO
                2
                measurements within range was 56.2 (30.6)\%. A hypercapnic target SpO
                2
                range was associated with a higher probability of an SpO
                2
                above range; multivariate OR 5.34 (95\% CI 1.65 to 17.3, p=0.006) and a lower probability of an SpO
                2
                below range; multivariate OR 0.25 (95\% CI 0.08 to 0.80) p=0.02. The mean (SD) maximum SpO
                2
                was similar in those with a target range of 92\%–96\% versus a hypercapnic range; 96.2 (3.0)\% and 95.2 (3.4)\%, respectively.
              
            
            
              Conclusions
              
                Oxygen prescription and delivery in this clinical setting was suboptimal. SpO
                2
                values above the designated range are common, particularly in patients with a hypercapnic target range.},
	language = {en},
	urldate = {2021-04-28},
	journal = {Postgraduate Medical Journal},
	author = {Harper, James and Kearns, Nethmi and Bird, Grace and McLachlan, Robert and Eathorne, Allie and Weatherall, Mark and Beasley, Richard},
	month = feb,
	year = {2021},
	pages = {postgradmedj--2020--139511},
}

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