Critical care nurses' opinion and self-reported practice of oxygen therapy: a survey

BACKGROUND: Critical care nurses frequently and independently manage oxygen therapy. Despite the importance of oxygen therapy, there is limited evidence to inform or support critical care nurses' oxygen therapy practices. AIM: To establish if there is variability in oxygen therapy practices of critical care nurses and examine the degree of variability. METHOD: On-line questionnaire of ACCCN members between April and June 2010. RESULTS: The response rate was 36% (542/1523 critical care nurses). Overall, 378 (70%) respondents practiced in metropolitan critical care units; 278 (51%) had ≥14 years of specialty practice. In response to falling SpO(2), 8.9% of nurses would never escalate oxygen therapy without a doctor's request, and 51% of nurses would not routinely escalate oxygen therapy in the absence of medical orders. Only 56% of nurses reported always increasing FiO(2) prior to endotracheal suctioning. In mechanically ventilated patients, 33% of nurses believed oxygen toxicity was a greater threat to lung injury than barotrauma. More than >60% of respondents reported a tolerance for a stable SpO(2) of 90%. Nurses in rural critical care units were less likely to independently titrate oxygen to their own target SpO(2), but more likely to independently treat a falling SpO(2) with higher FiO(2). CONCLUSION: Critical care nurses varied in their self-reported oxygen therapy practices justifying observational and interventional studies aimed at improving oxygen therapy for critically ill patients.