Multidisciplinary education for oxygen prescription. A continuous quality improvement study.
Arch Intern Med
; 156(16): 1797-801, 1996 Sep 09.
Article
em En
| MEDLINE
| ID: mdl-8790073
ABSTRACT
OBJECTIVES:
To examine the oxygen-prescribing habits and monitoring patterns on a medical teaching ward and to review the literature in this area.DESIGN:
A continuous quality improvement study.SETTING:
A 29-bed medical clinical teaching unit in a 453-bed university-affiliated tertiary care hospital. PATIENTS We studied 50 consecutive patients who required 79 oxygen treatments.METHODS:
We recorded the indication, prescriber, documentation of prior hypoxemia, method and mode of delivery, oxygenation assessment after initiation, and duration of therapy.RESULTS:
Patients received oxygen for a mean (+/- SD) of 4.7 +/- 4.5 days. Oxygen therapy was ordered on a continuous basis 60.3% of the time. It was ordered by house staff in 54 cases (68%); nurses initiated oxygen therapy in 14 cases (18%) but discontinued it more often than any other health care workers. The most common indications for starting oxygen therapy were dyspnea and tachypnea. In 15 patients (30%), none of the American College of Chest Physicians and National Heart, Lung, and Blood Institute criteria for starting oxygen therapy were fulfilled. For 16 patients (32%), arterial blood gas values were measured within 1 hour of oxygen administration; for 29 patients, oximetry was performed. For 9 patients (18%), no testing of adequate oxygenation was performed within 24 hours. Oxygenation status was assessed daily for 23 patients (46%).CONCLUSIONS:
Oxygen prescribing and monitoring practices were suboptimal on our busy medical teaching ward. Practice guidelines based on best available evidence are needed to increase the efficiency of oxygen use. A physiologic, multidisciplinary educational focus on the benefits and hazards of supplemental oxygen is necessary, and randomized trials of such educational interventions should be conducted.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Oxigênio
/
Equipe de Assistência ao Paciente
/
Pessoal de Saúde
/
Gestão da Qualidade Total
Tipo de estudo:
Clinical_trials
/
Guideline
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Arch Intern Med
Ano de publicação:
1996
Tipo de documento:
Article