{"title":"减少住院内科患者不适当的氧气使用。","authors":"Erica Daniels, Geoffrey C Lamb, Anna Beckius","doi":"10.1080/21548331.2023.2241341","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Evidence suggests inappropriate oxygenation may be harmful to patients. To improve oxygen use in our hospital, we initiated a quality improvement project with a goal to reduce the percentage of inappropriate utilization of oxygen by 50% within a year.</p><p><strong>Methods: </strong>Nasal cannula (NC) oxygen use data for medicine inpatients was abstracted weekly for chart review. A multidisciplinary team developed a guideline for use. Initiation of NC O2 with a baseline SPO2 > 92% was deemed inappropriate and 3+ consecutive SPO2 > 96% was defined as over-supplementation. Formal interventions included an oxygen use guideline, updated EMR order, unit-specific feedback, and magnetic placards. Progress was tracked by control charts.</p><p><strong>Results: </strong>Baseline data revealed 40% of patients were inappropriately placed on oxygen and 55% of patients had one instance of excessive supplementation. Only half of all improper uses of oxygen had charted medical reasoning, and 30% had a corresponding order. Instances of proper oxygen use had orders 48% of the time. Run charts revealed inappropriate initiation was significantly reduced to 27.1% (<i>p</i> < 0.0001) and excessive oxygenation decreased significantly to 34.4% (<i>p</i> < 0.0001) following interventions with no effect on other variables.</p><p><strong>Conclusions: </strong>Our interventions significantly decreased improper oxygen initiation and excessive supplementation.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reducing inappropriate oxygen use in hospitalized medicine patients.\",\"authors\":\"Erica Daniels, Geoffrey C Lamb, Anna Beckius\",\"doi\":\"10.1080/21548331.2023.2241341\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Evidence suggests inappropriate oxygenation may be harmful to patients. To improve oxygen use in our hospital, we initiated a quality improvement project with a goal to reduce the percentage of inappropriate utilization of oxygen by 50% within a year.</p><p><strong>Methods: </strong>Nasal cannula (NC) oxygen use data for medicine inpatients was abstracted weekly for chart review. A multidisciplinary team developed a guideline for use. Initiation of NC O2 with a baseline SPO2 > 92% was deemed inappropriate and 3+ consecutive SPO2 > 96% was defined as over-supplementation. Formal interventions included an oxygen use guideline, updated EMR order, unit-specific feedback, and magnetic placards. Progress was tracked by control charts.</p><p><strong>Results: </strong>Baseline data revealed 40% of patients were inappropriately placed on oxygen and 55% of patients had one instance of excessive supplementation. Only half of all improper uses of oxygen had charted medical reasoning, and 30% had a corresponding order. Instances of proper oxygen use had orders 48% of the time. Run charts revealed inappropriate initiation was significantly reduced to 27.1% (<i>p</i> < 0.0001) and excessive oxygenation decreased significantly to 34.4% (<i>p</i> < 0.0001) following interventions with no effect on other variables.</p><p><strong>Conclusions: </strong>Our interventions significantly decreased improper oxygen initiation and excessive supplementation.</p>\",\"PeriodicalId\":35045,\"journal\":{\"name\":\"Hospital practice (1995)\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hospital practice (1995)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/21548331.2023.2241341\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hospital practice (1995)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/21548331.2023.2241341","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/2 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Reducing inappropriate oxygen use in hospitalized medicine patients.
Introduction: Evidence suggests inappropriate oxygenation may be harmful to patients. To improve oxygen use in our hospital, we initiated a quality improvement project with a goal to reduce the percentage of inappropriate utilization of oxygen by 50% within a year.
Methods: Nasal cannula (NC) oxygen use data for medicine inpatients was abstracted weekly for chart review. A multidisciplinary team developed a guideline for use. Initiation of NC O2 with a baseline SPO2 > 92% was deemed inappropriate and 3+ consecutive SPO2 > 96% was defined as over-supplementation. Formal interventions included an oxygen use guideline, updated EMR order, unit-specific feedback, and magnetic placards. Progress was tracked by control charts.
Results: Baseline data revealed 40% of patients were inappropriately placed on oxygen and 55% of patients had one instance of excessive supplementation. Only half of all improper uses of oxygen had charted medical reasoning, and 30% had a corresponding order. Instances of proper oxygen use had orders 48% of the time. Run charts revealed inappropriate initiation was significantly reduced to 27.1% (p < 0.0001) and excessive oxygenation decreased significantly to 34.4% (p < 0.0001) following interventions with no effect on other variables.