Knowledge of pulse oximetry among emergency and critical care nurses

BACKGROUND

The pulse oximeter is a simple, cost-effective and reliable device for estimating arterial blood oxygen saturation. Nurses are required to be knowledgeable in pulse oximeter use. Little is known about nurses' knowledge of pulse oximetry in the Middle East region.

AIM

To assess nurses' knowledge of pulse oximetry among emergency and critical care nurses and to explore predictors of nurses' knowledge of pulse oximetry.

METHODS

This is the second part of data analysis that was first presented in the 'proficiency in ECG' study conducted in Jordan. The original data used for both parts of analysis included a questionnaire with two tests; a knowledge of pulse oximeter test and an ECG proficiency test. Participants were asked to take, alone without receiving assistance, both tests. In this study, the second part of analysis, the focus is on the pulse oximeter test. The test consisted of 21 items that emphasize knowledge of basic physiological principles as well as device limitations; whether technical or interpretation. The test administration procedure also included asking participants to provide socio-demographic variables. In the original data collected in both parts of analysis, nurses working in the emergency department, cardiac care units or intensive care units from nine different hospitals (1 governmental, 6 private and 2 educational) and holding a bachelor degree or higher were asked to participate.

RESULTS

The total number of participating nurses was 210; out of 247 approached (response rate, 85%). The mean score in the nurses' knowledge of pulse oximetry test was 12.33 out of 21, corresponding to 58.7%. The clinical area currently working in predicted the knowledge of pulse oximetry test score after controlling for all other variables. Emergency department and intensive care unit nurses scored higher than cardiac care unit nurses by 1.86 and 1.63 points respectively (58.2% and 60% respectively).

CONCLUSION

Nurses consistently report inadequate education and training concerning pulse oximeter use and interpretation. A revision to hospital in-service education seminars and undergraduate nurses' curriculum to assure adequate preparation is needed.

RELEVANCE TO CLINICAL PRACTICE

Knowledge of pulse oximetry among emergency and critical care nurses is modest. This is a challenge worldwide. Predictors of nurses' knowledge of pulse oximetery are the clinical area currently working in (ICU and ED nurses are more knowledgeable than CCU nurses), proficiency in electrocardiography and taking an advanced cardiac life support course.

Clinical nurses' knowledge level on pulse oximetry: A descriptive multi-centre study

OBJECTIVES

The aim of this study was to assess the level of knowledge on pulse oximetry among nurses. Understanding this is important because insufficient knowledge can lead to misinterpretation of pulse oximetry readings and consequently compromise patient safety.

RESEARCH METHODOLOGY

The study was cross-sectional and included a sample of 198 nurses. A modified questionnaire by Kiekkas et al. was used as the research tool.

SETTING

Intensive care units, anaesthesiology and emergency departments in two tertiary health care institutions in Serbia.

MAIN OUTCOME MEASURES

Principles of pulse oximeter function and conditions that can affect accuracy and reliability of pulse oximetry readings.

RESULTS

The lower percentage of correct responses about principles of pulse oximetry function was found in items related with the alarm reliability and understanding technical limitations. The factors that might affect pulse oximetry readings which were not identified by the nurses at a satisfactory level were the body position and specific kinds of ambient light. The mean scores of knowledge level were significantly different regarding departments (p=0.015).

CONCLUSION

Since this study revealed a lower level of knowledge in some aspects of pulse oximetry, it can be concluded that the generally firm belief that "experience is everything" can be challenged. This fact is important for the quality of health care and the patient's safety.

Graduate nurses' knowledge of the functions and limitations of pulse oximetry

AIMS AND OBJECTIVES

To examine nursing graduates' knowledge of functions and limitations of pulse oximetry.

BACKGROUND

Pulse oximetry is a technology ubiquitous in its use in modern clinical settings. Although the technology's ability to accurately reflect hypoxaemia in patients has been established, its contribution to improving patient outcomes is less certain. In addition, experienced nurses have previously demonstrated poor understanding of the limitations of the technology. Pregraduate education has been identified as a potential source of knowledge deficit and has been recommended by authors as an important target of investigation.

DESIGN

Cross-sectional, comparative, multicentre study.

METHOD

A previously published and validated tool was used with the addition of eight clinical scenario questions which were validated by an expert panel. Convenience sampling was used to select participants to form one cohort of newly graduated nurses (Cohort 1: n = 210) and a second cohort of nurses completing their intensive postgraduate clinical year (Cohort 2: n = 97).

RESULTS

Significant deficits relating to the theoretical factors that affect pulse oximetry application and interpretation were identified. Results suggest some knowledge is negatively correlated with clinical experience and that pregraduate university education appears to influence the ability to effectively apply pulse oximetry knowledge to clinical scenarios.

CONCLUSIONS

This study provides insight into pulse oximetry knowledge acquisition and deficits of graduate nurses which may inform pre- and postgraduate nurse education. In particular, it suggests that some pulse oximetry knowledge and clinical application of knowledge is not enhanced by clinical experience but rather is currently gained through pregraduate experiences.

RELEVANCE TO CLINICAL PRACTICE

Inappropriate utilisation and interpretation of pulse oximetry places patients at risk of mismanagement and undetected deterioration. Improvement in pregraduate education around the appropriate use of pulse oximetry may reduce clinical costs, reduce incidents of failure to rescue and improve patient outcomes.