Correct documentation of target and achieved oxygen saturation
Process map the documentation and daily reviews:
- Are all patients on ICU reviewed twice daily by a consultant intensivist?
- Do all intensivists agree to follow current best practice guidelines for oxygen saturation?
- What is the best point during the review when SpO2 (target and achieved) can be documented?
- Is there a way of prompting the reviewing intensivist to review this?
Correct oxygen prescribing practice
Process map a patient’s journey through ICU, from admission to discharge:
- Who sets the oxygen saturation target on admission to ICU?
- When and why is oxygen therapy changed?
- Is there an oxygen prescribing protocol for all ICU patients? Does it include a flow diagram which is easily interpretable by the bedside healthcare worker?
- Which healthcare workers are involved in titrating oxygen therapy, either in response to various therapies or progress of disease?
- How is SpO2 recorded? Is it continuous?
- Are alarms set to the correct limits to prompt health care workers to titrate oxygen therapy appropriately?
- What is needed to deliver oxygen therapy, what monitoring is available and methods of recording these. Use run charts to visualise improvements.