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

1. 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)

2. 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.

3.  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

4. 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

5. Method The patient�s medical record serves as a valuable asset Lists the patient�s name, sex, age Patient�s medical ID# Patient�s diagnosis

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

7. Method A patient�s medical record may also denote: A Resp. Care Consult Type of oxygen delivery device Liter flow of oxygen

8. 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

9. 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%)

10. 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

11. 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)

12. 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.