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.
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.
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. Method Patients 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 patientís medical record serves as a valuable asset
Lists the patientís name, sex, age
Patientís medical ID#
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 patientís 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
Pulmonary 51 (31%) 17 (23%) 19 (13%)
Cardiac 48 (30%) 40 (54%) 81 (57%)
Other 63 (39%) 10 (23%) 43 (30%)
10. Results Table 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
# of patients in which O2 was not medically 127
# of days O2 was used and was medically 302 (32%)
11. Results Table 2 continued
# of days O2 was used and not medically 657 (68%)
Median # of days of unnecessary O2 use per 3 (1-19)
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.