Oxygen therapy in hospitalized patients: the impact of local guidelines.
OBJECTIVE
To study the influence of local guidelines on the behaviour of nursing and medical staff to optimize the oxygen use in patients admitted to hospital.


METHODS
Study was performed in a district teaching hospital. Guidelines produced suggested indications, monitoring, use of arterial blood gases (ABGs) and advice on when to stop oxygen therapy. The guidelines were implemented both verbally and in writing to all the nursing and medical staff before and after an audit studying the oxygen use by patients on medical and surgical wards.


RESULTS
Ninety patients were included in pre-intervention audit and 59 in post-intervention study. Oxygen prescription did not change with guidelines 30% (27/90) vs. 32% (19/59). Nurses administered oxygen better 95% (18/19) vs. 70% (19/27) (P = 0.043) and monitored more frequently using oximetry 91% (54/59) vs. 69% (62/90) (P = 0.001) after the guidelines. Patients with airway disease had their ABGs checked more frequently 87% (14/16) vs. 65% (15/23) on admission and after they started oxygen inhalation 68% (11/16) vs. 34% (8/23).


CONCLUSIONS
The guidelines disseminated verbally and in writing had no influence on oxygen prescription but improved the practice of close monitoring of patients with airway disease. Nurses improved their performance of both administration of oxygen according to the prescribed dose and monitoring with oximetry.
Kbar
Fazal A
FA
Llandough Hospital, Penarth, Cardiff, Welsh, UK. akbar_yzai@yahoo.co.uk
Campbell
Ian Allen
IA
D000368:Aged; D005260:Female; D019983:Guideline Adherence; D006746:Hospital Bed Capacity, 500 and over; D006785:Hospitals, University / Q000592:standards; D006801:Humans; D007297:Inpatients; D008297:Male; D008505:Medical Staff, Hospital / Q000592:standards; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000592:standards; D010102:Oxygen Inhalation Therapy / Q000592:standards*; D017410:Practice Guidelines as Topic