Oxygen Therapy Utilization in a Community Hospital: Use of a Protocol to Improve Oxygen Administrati

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Oxygen Therapy Utilization in a Community
Hospital Use of a Protocol to Improve Oxygen
Administration and Preserve Resources

• Michael R. Konschak MPH RRT, Adam Binder, and
  Ralph E. Binder MD MPH
• Source Respiratory Care Vol. 44, No 5 506-511,
  May 1999. (16 ref)

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Oxygen Therapy Utilization in a Community
Hospital Use of a Protocol to Improve Oxygen
Administration and Preserve Resources

• Purpose To determine how medically unnecessary
  oxygen use was minimized upon implementing an
  oxygen therapy protocol and therefore reducing
  the cost of inpatient care.

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• Method
• Group I was used to test the hypothesis of how
  oxygen was consumed inappropriately.
• Group II was used to test the hypothesis of how
  implementation of a protocol saves money.
• The study was conducted over 1 month.
• included all non-critical care hospital
  patients
• who received oxygen

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MethodPatients were excluded from the study
under three conditions

• Admittance to ICU
• Receiving mechanical ventilation
• Presented with condition affecting peripheral
  circulation making pulse ox unreliable

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Method

• The patients medical record serves as a
  valuable asset
• Lists the patients name, sex, age
• Patients medical ID
• Patients diagnosis

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Method

• The medical record contains pertinent
  information.
• The day oxygen therapy began, ended, and of
  days administered
• Baseline ABG and or SaO2

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Method

• A patients medical record may also denote
• A Resp. Care Consult
• Type of oxygen delivery device
• Liter flow of oxygen

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Method

• What SaO2 deems oxygen therapy medically
  necessary?
• SaO2 less than 92 on room air
• Patients were continuously monitored and
  evaluated via pulse ox (Nellcor N-10 Pulse Ox)
  during the entire study

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Results Table 1. Demographic data of the
Study Group

• Group1
  Group 1 Group 2
  Subgroup
• Total of PTs 161
  74 143
• Males 64 (40) 33
  (45) 58 (41)
• Females 97 (60) 41
  (55) 85 (59)
• Average Age (yrs.) 76
  75 76
• Diagnosis
• Pulmonary 51 (31) 17
  (23) 19 (13)
• Cardiac 48 (30) 40
  (54) 81 (57)
• Other 63 (39)
  10 (23) 43 (30)

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ResultsTable 2. Appropriateness of Oxygen
Use Prior To Implementation of the Oxygen
Protocol (Group 1)

• Total of patients studied
  161
• of patients in which O2 was medically
  53
• necessary
• of patients in which O2 was not medically
  127
• necessary
• of days O2 was used and was medically
  302 (32)
• necessary

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ResultsTable 2 continued

• of days O2 was used and not medically
  657 (68)
• necessary
• Median of days of unnecessary O2 use per
  3 (1-19)
• patient (range)
• Median o f liters of unnecessary O2 per
  10,800 (720-
• patient (range)
  128,160)
• Median of dollars wasted per patient
  3.63 (0.99-31.44)

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Conclusion

• It has been proven that implementation of an
  effective oxygen therapy protocol reduces the
  administration of unnecessary oxygen. As the data
  presents, it shows a substantial savings
  regarding the cost of inpatient care, as well as
  a decrease in the amount of oxygen consumed.
  Nonetheless, therapist driven protocols preserve
  resources and most definitely saves time and in
  the end everyone saves money.