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Impact of oxygen therapy algorithm on oxygen usage in the emergency department
BACKGROUND: Although oxygen is one of the oldest drugs available, it is still one of the most inappropriately administered drugs leading to over utilization of this very expensive resource. MATERIALS AND METHODS: This prospective observational study was done in a large emergency department (ED) in I...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7542065/ https://www.ncbi.nlm.nih.gov/pubmed/32675448 http://dx.doi.org/10.4103/jpgm.JPGM_637_19 |
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author | Abhilash, KPP Acharya, H Dua, J Kumar, S Selvaraj, B Priya, G |
author_facet | Abhilash, KPP Acharya, H Dua, J Kumar, S Selvaraj, B Priya, G |
author_sort | Abhilash, KPP |
collection | PubMed |
description | BACKGROUND: Although oxygen is one of the oldest drugs available, it is still one of the most inappropriately administered drugs leading to over utilization of this very expensive resource. MATERIALS AND METHODS: This prospective observational study was done in a large emergency department (ED) in India. The pattern of oxygen usage was studied before and after the strict implementation of an oxygen treatment algorithm. The algorithm was taught to all doctors and nurses and its implementation was monitored regularly. The main outcome measures were proportion of patients receiving oxygen therapy, inappropriate usage, and avoidable direct medical cost to the patient. RESULTS: The 3-week pre-protocol observation phase in April 2016 included 3769 patients and the 3-week post-protocol observation phase in April 2017 included 4608 patients. The baseline demographic pattern was similar in both the pre-protocol and post-protocol groups. After the strict implementation of the algorithm, the number of patients receiving oxygen therapy decreased from 9.63% to 4.82%, a relative decrease of 51.4%. The average amount of total oxygen used decreased from 55.4 liters per person in pre-protocol group to 42.1 liters per person in the post-protocol group with a mean difference of 13.28 (95% CI 5.30-21.26; P = 0.001). Inappropriate oxygen usage decreased from 37.2% to 8.6%. There was a significant decrease in inappropriate oxygen use for indications like low sensorium (60.8% vs 21.7%) and trauma (88.5% vs 15.8%). The mortality rate in the pre-protocol phase was 2.7% as compared with 3.2% in the post-protocol phase. The total duration of inappropriate oxygen usage significantly decreased from 987 h to 89 h over the 21-day study period. CONCLUSION: The implementation of an oxygen therapy algorithm significantly reduces inappropriate oxygen use and decreases treatment cost to the patient with no additional mortality risk. |
format | Online Article Text |
id | pubmed-7542065 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-75420652020-10-20 Impact of oxygen therapy algorithm on oxygen usage in the emergency department Abhilash, KPP Acharya, H Dua, J Kumar, S Selvaraj, B Priya, G J Postgrad Med Original Article BACKGROUND: Although oxygen is one of the oldest drugs available, it is still one of the most inappropriately administered drugs leading to over utilization of this very expensive resource. MATERIALS AND METHODS: This prospective observational study was done in a large emergency department (ED) in India. The pattern of oxygen usage was studied before and after the strict implementation of an oxygen treatment algorithm. The algorithm was taught to all doctors and nurses and its implementation was monitored regularly. The main outcome measures were proportion of patients receiving oxygen therapy, inappropriate usage, and avoidable direct medical cost to the patient. RESULTS: The 3-week pre-protocol observation phase in April 2016 included 3769 patients and the 3-week post-protocol observation phase in April 2017 included 4608 patients. The baseline demographic pattern was similar in both the pre-protocol and post-protocol groups. After the strict implementation of the algorithm, the number of patients receiving oxygen therapy decreased from 9.63% to 4.82%, a relative decrease of 51.4%. The average amount of total oxygen used decreased from 55.4 liters per person in pre-protocol group to 42.1 liters per person in the post-protocol group with a mean difference of 13.28 (95% CI 5.30-21.26; P = 0.001). Inappropriate oxygen usage decreased from 37.2% to 8.6%. There was a significant decrease in inappropriate oxygen use for indications like low sensorium (60.8% vs 21.7%) and trauma (88.5% vs 15.8%). The mortality rate in the pre-protocol phase was 2.7% as compared with 3.2% in the post-protocol phase. The total duration of inappropriate oxygen usage significantly decreased from 987 h to 89 h over the 21-day study period. CONCLUSION: The implementation of an oxygen therapy algorithm significantly reduces inappropriate oxygen use and decreases treatment cost to the patient with no additional mortality risk. Wolters Kluwer - Medknow 2020 2020-06-25 /pmc/articles/PMC7542065/ /pubmed/32675448 http://dx.doi.org/10.4103/jpgm.JPGM_637_19 Text en Copyright: © 2020 Journal of Postgraduate Medicine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Abhilash, KPP Acharya, H Dua, J Kumar, S Selvaraj, B Priya, G Impact of oxygen therapy algorithm on oxygen usage in the emergency department |
title | Impact of oxygen therapy algorithm on oxygen usage in the emergency department |
title_full | Impact of oxygen therapy algorithm on oxygen usage in the emergency department |
title_fullStr | Impact of oxygen therapy algorithm on oxygen usage in the emergency department |
title_full_unstemmed | Impact of oxygen therapy algorithm on oxygen usage in the emergency department |
title_short | Impact of oxygen therapy algorithm on oxygen usage in the emergency department |
title_sort | impact of oxygen therapy algorithm on oxygen usage in the emergency department |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7542065/ https://www.ncbi.nlm.nih.gov/pubmed/32675448 http://dx.doi.org/10.4103/jpgm.JPGM_637_19 |
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