Oxygen Administration and Monitoring for Ward Adult Patients in a Teaching Hospital

Aim: The aims of this study were to describe oxygen administration and respiratory monitoring of ward patients in a tertiary teaching hospital, and to assess differences in characteristics and outcomes between patients who are receiving versus are not receiving oxygen.

Methods: Prospective clinical audit of all non-ventilated adult ward patients in a tertiary teaching hospital in Melbourne, Victoria on 26 August 2009.

Results: All 323 eligible patients were audited (medical 218, surgical 105). At assessment, 76 patients (24%) were on oxygen therapy and of these, 57 patients (74%) received oxygen by nasal prongs. Overall, oxygen saturation was documented in 301 (93.2%) patients and respiratory rate (RR) documented in 283 patients (87.6%). Patients receiving oxygen had a lower median SpO(2) (94% vs 96%, P < 0.0001), higher median RR (20/min vs 18/min, P < 0.0005); and were older (68.8 v 63.1 years, P= 0.0094). The in-hospital mortality of patients receiving oxygen therapy was 15.8% compared with 5.3% for those not on oxygen (P < 0.0056).

Conclusion: Oxygen is administered to one-quarter of ward patients in our hospital. Oxygen saturation and RR are not documented in approximately 10% of patients. Oxygen therapy in ward patients identifies individuals with increased mortality. Continuing educational interventions to increase awareness of the high-risk status of these patients and strategies to detect patients at risk of hypoxaemia are needed.