You are here

Home › Repository Homepage › Student Authored Works › Doctor of Nursing Practice

Reducing Prolonged Hyperoxia in Mechanically Ventilated Patients Through Implementation of a Conservative Oxygen Weaning Protocol Versus the Current Practice

Bookmarks:

Sansoucie, C. (2022). Reducing Prolonged Hyperoxia in Mechanically Ventilated Patients Through Implementation of a Conservative Oxygen Weaning Protocol Versus the Current Practice: A Quality-Improvement Project in Three Intensive Care Units at a Level II Trauma Tertiary Care Hospital.
PDF
Metadata
TitleReducing Prolonged Hyperoxia in Mechanically Ventilated Patients Through Implementation of a Conservative Oxygen Weaning Protocol Versus the Current Practice
AbstractBackground: Hyperoxia is known to be detrimental in healthcare, yet it continues to be a problem in mechanically ventilated patients. Oxygen weaning protocols have been discussed in many studies that have evaluated various outcome measures with mixed findings. A study completed by Cuevas et al. (2020) evaluated respiratory therapists' compliance with an oxygen weaning protocol. The conclusions of this study found that the protocol was often not followed. At a level II trauma hospital tertiary care hospital in three ICUs, patients' FIO2s were not being weaned in a timely manner. Due to the previous research on the risks of hyperoxia and poor outcomes, a conservative oxygen weaning protocol was developed. The aim of this study was to assess if implementing a conservative oxygen weaning protocol would improve oxygen weaning times in mechanically ventilated patients compared to the current oxygen weaning practice. Methods: Out weaning program evaluation was completed using the PARISH framework and Lewin’s change theory to evaluate and implement evidence-based practice. This evaluation was conducted using quantitative, retrospective, consecutive sampling; a quasi-experimental methodology was used to compare the current oxygen weaning group (before intervention group) and a conservative oxygen weaning group (after intervention group) in three ICUs at a level II trauma tertiary care hospital. Intervention: A conservative oxygen weaning protocol was developed and implemented in three ICUs at one medical center. Mechanically ventilated patients with a P/F ratio is ≥ 150 qualified for the oxygen weaning protocol. The weaning pathways are determined by the PaO2 on the ABG. After the initial FIO2 wean, the SpO2 will be used for FIO2 weaning. FIO2 weaning will be continued as long as the SpO2 level is ≥ 4% of the ordered goal SpO2 until the FIO2 is 0.3. Results: The current oxygen weaning group had 34 patients, and the conservative oxygen weaning group had 18 patients that met the inclusion criteria. Both groups had non-normal distribution. The current oxygen group had a p-value= 1.827e-08 and the conservative oxygen group had a p-value= 6.213e-06. Mann-Whitney U test was completed, and the result was a p-value = 0.05735. Therefore, there was no statistically significant finding that the implementation of the conservative oxygen weaning protocol improved oxygen weaning times. Though there was no statistical significance, the conservative oxygen weaning groups did show improvement in weaning time. Conclusions: The statistical findings for improvement in oxygen weaning time to 0.3 with the implementation of a conservative oxygen therapy protocol showed no statistical significance. Evaluating the conservative oxygen weaning groups' data showed improvement in weaning times. Further research is needed on the implementation of a conservative oxygen therapy protocol to evaluate the improvement of FIO2 weaning times in mechanically ventilated patients, as well as the effectiveness of consistent weaning protocols with staff compliance.
Date2022