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The revitalization and optimization of SpO2 monitoring of patients on PCA pumps
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The revitalization and optimization of SpO2 monitoring of patients on PCA pumps

Georgette D. Coltrane
Master of Science (M.S.), Drexel University
14 Jun 2023
DOI:
https://doi.org/10.17918/00001967
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Abstract

Respiratory depression Respiratory decline Patient-controlled analgesia PCA pump Continuous oxygenation Postoperative patient monitoring SpO2 monitoring
The revitalization and optimization of continuous SpO2 monitoring of patients on a PCA pump is a quality improvement initiative that focuses on the re-implementation of this evidence-based best practice on an ortho-surgical unit. Over the last 3 years, this unit has faced challenges including staffing shortages, managerial shifts, and the unit being staffed with new graduates. The purpose of the quality improvement initiative is to re-introduce the organization's PCA policy to the nurses, incorporate appropriate stakeholders for buy-in, and implement nurse-driven tools that will ensure the sustainability of this best practice. A GAP analysis was conducted looking at current practices on the unit and the desired future state of continuous SpO2 monitoring of patients on PCA pumps. Data was collected via pre- and post-educational surveys. Both surveys resulted in less than 50% participation. Ten out of the 21 nurses completed the pre-education survey producing a 48% participation rate. Eight out of the 21 nurses completed the post-education survey producing a 38% participation rate. When analyzing the results, it was determined that the lack of compliance related to the PCA policy and continuous SpO2 monitoring was related to knowledge. During the pre-assessment, 75% of the responses were accurate and complete as it relates to proper initiation and monitoring of SpO2. Twenty-five percent of the responses were incomplete related to the policy's assessment and documentation cycle. This substantiated the need for unit wide re-education and training. Clinical implications resulting from this quality improvement project include increased patient safety, decreased hospital stay days, and continuous education and training for nurses in an ortho-surgical unit.

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