SHM Converge Scientific Abstract ePoster Gallery-Reducing Inappropriate Oxygen Use in Hospitalized Medicine Patients

Pdf Summary

This project aimed to reduce inappropriate oxygen use in hospitalized medicine patients at Froedtert Hospital. The team noted that oxygen therapy benefits mainly hypoxic patients and that liberal oxygen use can worsen outcomes. Because the hospital had no clear oxygen guideline, the project set a goal to reduce inappropriate oxygen supplementation by 50% within one year.<br /><br />Beginning in January 2020, weekly chart reviews were conducted for inpatients on the medicine service receiving nasal cannula oxygen. Certain patients were excluded, including those with cystic fibrosis, pulmonary hypertension, home oxygen use, hospice care, post-operative oxygen needs, or use of other oxygen devices. A multidisciplinary team created an evidence-based guideline with a target SpO2 range of 92–96% and instructions for appropriate oxygen ordering, charting, and weaning.<br /><br />Key interventions included formal guideline dissemination to staff in August 2020, modification of the electronic medical record oxygen order in December 2020 to require a target range and maximum of 96%, and distribution of reminder placards to nursing staff in June 2021.<br /><br />Results showed meaningful improvement. Inappropriate oxygen initiation decreased from 39.2% to 26.8%, and excessive oxygen supplementation on the floor dropped from 55.6% to 35.1%. The most effective change appeared to be the standardized oxygen order. Many inappropriate starts originated in the emergency department and continued after transfer to the floor. Although nursing reminders helped somewhat, charting often still lacked a documented reason for oxygen use or a correlated order.<br /><br />Overall, the project successfully reduced inappropriate oxygen use, but further work is needed to improve documentation and expand efforts beyond the medicine units, including collaboration with the emergency department.

Asset Subtitle

Erica Daniels

Meta Tag

Author List Erica Daniels, Geoffrey Lamb

Category Research

Concept Supplemental Oxygen

Concept Oxygen Saturation

Concept Oxygen Toxicity

Concept Target Oxygen Saturation Range

Concept Inappropriate Oxygen Initiation

Distinguished Non-Finalist

Presenter Organization Medical College of Wisconsin

Presenting Author Erica Daniels

Track Quality Improvement

Keywords

oxygen therapy

inappropriate oxygen use

hospitalized patients

medicine service

SpO2 target range

evidence-based guideline

electronic medical record order

oxygen weaning

emergency department

quality improvement

Supplemental Oxygen

Oxygen Saturation

Oxygen Toxicity

Target Oxygen Saturation Range

Inappropriate Oxygen Initiation