title: The impact of a postoperative oxygen therapy protocol on use of pulse oximetry and oxygen therapy.
abstract: BACKGROUND
  Recent evidence suggests that both pulse oximetry monitoring and oxygen (O2) therapy may be used inappropriately at times, implying the need for improved use of pulse oximetry by health-care providers.
  
  
  METHODS
  We studied the clinical and financial impact of a postoperative O2-therapy protocol in 2 groups of patients. Group 1 (n = 20) was comprised of patients whose physicians made all O2 therapy management decisions. Group 2 (n = 20) was comprised of patients whose O2 therapy management was performed by respiratory therapists according to an algorithm with a stop criterion of SpO2 > or = 92%. The duration of postoperative O2 therapy, the frequency of unnecessary O2 therapy, and group totals of SpO2 measurements were compared between groups using the Mann-Whitney Rank Sum Test.
  
  
  RESULTS
  O2 therapy was used on average (SD) 3.45 (1.28) days/patient in Group 1 and 2.1 (0.64) days/patient in Group 2 (p < 0.003). Sixteen Group-1 patients continued to receive O2 at least 24 hours after achieving a room-air SpO2 > or = 92%. Group 1 had 57 SpO2 measurements and Group 2 had 24 (p < 0.003). No adverse clinical events ascribed to hypoxemia were noted in either group.
  
  
  CONCLUSIONS
  Our experience suggest that implementing a uniform, clinically appropriate 'stop criterion' for low-flow O2 therapy in nonthoracic postoperative patients can shorten the duration of O2 therapy and reduce the number of SpO2 measurements without incurring additional complications.
authors.affiliation: Cleveland Clinic Foundation, OH, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Komara
authors.forename: J K
authors.initials: JK
authors.lastname: Stoller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D003657:Decision Making; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010092:Oximetry / Q000592:standards*; D010102:Oxygen Inhalation Therapy / Q000592:standards*; D011182:Postoperative Care / Q000592:standards*; D011997:Recovery Room / Q000592:standards; D013997:Time Factors