Adjustment of oxygen use by means of pulse oximetry: an important tool for patient safety

Mendes, Telma de Almeida Busch; Andreoli, Paola Bruno de Araújo; Cavalheiro, Leny Vieira; Talerman, Claudia; Laselva, Claudia

doi:10.1590/S1679-45082010AO1377

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Original Article • Einstein (São Paulo) 8 (4 ) • Oct-Dec 2010 • https://doi.org/10.1590/S1679-45082010AO1377 copy

Adjustment of oxygen use by means of pulse oximetry: an important tool for patient safety

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To assess patient's level of oxygenation by means of pulse oximetry, avoiding hypoxia (that causes rapid and severe damage), hyperoxia, and waste.

Methods:

Calculations were made with a 7% margin of error and a 95% confidence interval. Physical therapists were instructed to check pulse oximetry of all patients with prescriptions for physical therapy, observing the scheduled number of procedures.

Results:

A total of 129 patients were evaluated. Hyperoxia predominated in the sectors in which the patient was constantly monitored and hypoxia in the sectors in which monitoring was not continuous.

Conclusions:

Professionals involved in patient care must be made aware of the importance of adjusting oxygen use and the risk that non-adjustment represents in terms of quality of care and patient safety.

Keywords:
Anoxia; Oximetry; Oxygen therapy/adverse effects

SaO₂ (%)	Accuracy range (%)
> 90	± 2%
80-90	± 5%
< 80	± 12%

Variable	Category	1st progression audited
		Normal (≥92%)		Altered
		n	%	n	%
In-patient unit	Geriatrics, Chronic pts, Oncology, Pneumology, Orthopedics, Neurology and Gastrology	42	58.4	15	26.3
Critical patient's unit	ICU and Step-down	30	41.6	42	73.7
Total		72	100.0	57	100.0

Variable	Category	1st progression audited
		Hyperoxia		Hypoxia
		n	%	n	%
In-patient unit	Geriatrics, Chronic pts, Oncology, Pneumology, Orthopedics, Neurology and Gastrology	6	13.0	9	82.0
Critical patient's unit	ICU and Step-down	40	87.0	2	18.0
Total		46	100.0	11	100.0

Variable	Category	1st progression audited
		Corrected		Justified
		n	%	n	%
In-patient unit	Geriatrics, Chronic pts, Oncology, Pneumology, Orthopedics, Neurology and Gastrology	9	41.0	5	33.0
Critical patient's unit	ICU and Step-down	13	59.0	10	66.0
Total		22	100.0	15	100.0

Variable	Category	2nd progression audited
		Normal (≥92%)		Altered
		n	%	n	%
In-patient unit	Geriatrics, Chronic pts, Oncology, Pneumology, Orthopedics, Neurology and Gastrology	20	54.1	9	28.0
Critical patient's unit	ICU and Step-down	17	45.9	23	72.0
Total		37	100.0	32	100.0

Variable	Category	2nd progression audited
		Hyperoxia		Hypoxia
		n	%	n	%
In-patient unit	Geriatrics, Chronic pts, Oncology, Pneumology, Orthopedics, Neurology and Gastrology	7	23.3	2	100.0
Critical patient's unit	ICU and Step-down	23	76.6	0	0,0
Total		30	100.0	2	100.0

Variable	Category	2nd progression audited
		Corrected		Justified
		n	%	n	%
In-patient unit	Geriatrics, Chronic pts, Oncology, Pneumology, Orthopedics, Neurology and Gastrology	5	50.0	2	25.0
Critical patient's unit	ICU and Step-down	5	50.0	6	75.0
Total		10	100.0	8	100.0

Variable	1st progression audited
	Critical patients		Non-critical patients (unit)
	n	%	n	%
Change in clinical picture	5	50.0	1	33.4
Nursing procedure	0	0.0	1	33.3
Speaking valve	1	10.0	0	0.0
Attempt to wean	1	10.0	0	0.0
NIV	1	10.0	0	0.0
Discomfort	1	10.0	0	0.0
Desaturation	1	10.0	0	0.0
Bath	0	0.0	1	33.3
Total	10	100.0	3	100.0

Variable	2nd progression audited
	Critical patients		Non-critical patients (unit)
	n	%	n	%
Change in clinical picture	3	75.0	0	0.0
Nursing procedure	0	0.0	1	33.4
Speaking valve	0	0.0	0	0.0
Attempt to wean	0	0.0	0	0.0
NIV	1	25.0	0	0.0
Discomfort	0	0.0	0	0.0
Desaturation	0	0.0	0	0.0
Bath	0	0.0	2	66.6
Total	4	100.0	3	100.0

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E-mail: revista@einstein.br

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[1] Corresponding author: Telma de Almeida Busch Mendes – Rua Deputado João Sussumo Hirata, 770 – apto. 12 – Morumbi – CEP 05715-010 – São Paulo (SP), Brasil – Tel.: 11 3742-7565 – e-mail: busch@einstein.br