Oxygen Stewardship in Adult Critical Care: A Quality Improvement Initiative.
Background: Oxygen therapy is commonly administered in critical care, yet patients frequently receive oxygen above recommended saturation targets. Excessive oxygen exposure may contribute to avoidable harm and unnecessary resource use. Despite guideline recommendations, reliable adherence to oxygen...
| Publicado en: | Nursing in Critical Care Vol. 31; no. 3; pp. 1 - 10 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
May2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=194044547&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 194044547 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13621017 Q15 jtl: Nursing in Critical Care issn: 13621017 maglogo: Y pubinfo: dt: May2026 vid: 31 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 194044547 194044547 194044547 10.1111/nicc.70476 194044547 ppf: 1 ppct: 9 formats: tig: atl: Oxygen Stewardship in Adult Critical Care: A Quality Improvement Initiative. aug: au: Ong, Wei Jun Dan Li, Glen JiaXin Azul, Lawrence Matunan Ace Trajico, Anna Kristina Tan, Wee Kian Ricardo D'Souza, Jared Khan, Faheem Ahmed Kansal, Amit affil: College of Health Sciences, Rush University, Chicago Illinois,, USA sug: subj: Oxygen Supply and Distribution Critical Care Quality Improvement Guideline Adherence Oxygen Consumption Intensive Care Units In Adulthood Human Professional Compliance Critical Care Nursing Oxygen Therapy Pretest-Posttest Design Nasal Cannula Tertiary Health Care Hospitals, Public Descriptive Statistics Mann-Whitney U Test Data Analysis Software Adult Adult: 19-44 years ab: Background: Oxygen therapy is commonly administered in critical care, yet patients frequently receive oxygen above recommended saturation targets. Excessive oxygen exposure may contribute to avoidable harm and unnecessary resource use. Despite guideline recommendations, reliable adherence to oxygen titration targets in routine intensive care practice remains inconsistent. Aim: To evaluate the impact of a nurse‐engaged oxygen stewardship quality improvement initiative on adherence to oxygen saturation targets and oxygen consumption in an adult intensive care unit. Study Design: A clinician‐led, before‐and‐after quality improvement evaluation was conducted over 21 months in a mixed adult intensive care unit. The intervention integrated a standardised oxygen weaning protocol, multidisciplinary education, audit and feedback through spot checks, workflow reminders and iterative refinement informed by staff surveys and interviews. Results: The proportion of patient‐days outside target oxygen saturation ranges decreased from a median of 63% (IQR 57–65) pre‐intervention (n = 2686 patient‐days) to 20% (IQR 15–22) post‐intervention (n = 5621 patient‐days), with sustained improvement over 12 months. Median monthly oxygen consumption per patient‐day declined significantly for conventional oxygen therapy, non‐invasive ventilation and mechanical ventilation. High‐flow nasal cannula therapy remained associated with higher non‐compliance rates and showed no statistically significant reduction in oxygen consumption. Reductions in overall oxygen use were primarily attributable to decreased oxygen delivery during non‐compliant periods, while oxygen use within target ranges remained stable. Conclusions: Embedding oxygen stewardship into routine critical care workflows was associated with sustained improvements in oxygen titration practice and reduced oxygen consumption. Behavioural reinforcement and integration into daily nursing practice were key to maintaining adherence. Relevance to Clinical Practice: Structured oxygen stewardship initiatives can support critical care nurses in delivering guideline‐adherent oxygen therapy, strengthen accountability during handovers and reduce unnecessary oxygen exposure without compromising appropriate treatment. Impact Statements: What is known ○Oxygen therapy is frequently administered above recommended saturation targets in ICU practice.○Excessive oxygen exposure may contribute to patient harm and unnecessary resource use.○Previous studies suggest that education and guideline dissemination alone are insufficient to sustain practice change.What this paper adds ○A structured oxygen stewardship programme improved adherence to oxygen saturation targets in a 34‐bed ICU.○Sustained reductions in oxygen consumption were achieved alongside no identified increase in adverse respiratory events during routine clinical monitoring.○Embedding oxygen titration into nursing workflows and audit feedback mechanisms supported durable behavioural change. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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