Overcoming barriers to oxygen saturation targeting.
OBJECTIVE
To reduce hyperoxia in very low birth weight infants who receive supplemental oxygen, the Children's Mercy Hospital neonatal respiratory quality improvement committee introduced the potentially better practice of oxygen saturation targeting and identified strategies to overcome barriers to implementation of this practice.


METHODS
Using rapid-cycle quality improvement projects, this center adapted an oxygen saturation targeting protocol and tracked hourly oxygen saturation as measured by pulse oximetry in very low birth weight infants who received supplemental oxygen.


RESULTS
The percentage of time in the range of 90% to 94% of oxygen saturation as measured by pulse oximetry increased from 20% to an average of 35% after implementation of the protocol. The percentage of time with oxygen saturation as measured by pulse oximetry >98% dropped from 30% to an average of 5% to 10%.


CONCLUSIONS
A well-planned strategy for implementing oxygen saturation targeting can result in a sustained change in clinical practice as well as change in the culture of the NICU regarding the use of oxygen.
Ford
Susannah P
SP
Section of Neonatology, Department of Pediatrics, Children's Mercy Hospitals and Clinics, 2401 Gillham Rd, Kansas City, MO 64108, USA.
Leick-Rude
Mary Kay
MK
Meinert
Kerri A
KA
Anderson
Betsi
B
Sheehan
Michael B
MB
Haney
Barbara M
BM
Leeks
Sherri R
SR
Simon
Stephen D
SD
Jackson
Jodi K
JK
D002985:Clinical Protocols; D006801:Humans; D018496:Hyperoxia / Q000517:prevention & control; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood*; D015931:Intensive Care, Neonatal; D008923:Missouri; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D010102:Oxygen Inhalation Therapy; D011785:Quality Assurance, Health Care; D012016:Reference Values
D010100:Oxygen