School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia.
Faculty of Nursing, Avondale University College, Sydney, NSW, Australia.
Int J Chron Obstruct Pulmon Dis. 2020 Sep 25;15:2275-2287. doi: 10.2147/COPD.S263696. eCollection 2020.
Supplemental oxygen is commonly administered to patients in acute care. It may cause harm when used inappropriately. Guidelines recommend prescription of acute oxygen, yet adherence is poor. We aimed to identify barriers and facilitators to practicing in accordance with the evidence-based Thoracic Society of Australia and New Zealand (TSANZ) oxygen guideline, and to determine the beliefs and attitudes relating to acute oxygen therapy.
A national cross-sectional survey was conducted. The survey consisted of 3 sections: (1) introduction and participant characteristics; (2) opinion/beliefs, knowledge and actions about oxygen therapy and other drugs; and (3) barriers and facilitators to use of the TSANZ guideline. Convenience sampling was employed. A paper-based survey was distributed at the TSANZ Annual Scientific Meeting. An online survey was emailed to the TSANZ membership and to John Hunter Hospital's clinical staff.
Responses were received from 133 clinicians: 52.6% nurses, 30.1% doctors, and 17.3% other clinicians. Over a third (37.7%) were unaware/unsure of the oxygen guideline's existence. Most (79.8%) believe that oxygen is a drug and should be treated as one. Most (92.4%) stated they only administered it based on clinical need. For four hypothetical cases, there was only one where the majority of participants identified the optimal oxygen saturation. A number of barriers and facilitators were identified when asked about practicing in accordance with the TSANZ guideline. Lack of oxygen equipment, getting doctors to prescribe oxygen and oxygen being treated differently to other drugs were seen as barriers. The guideline itself and multiple clinician characteristics were considered facilitators.
There is discordance between clinicians' beliefs and actions regarding the administration of oxygen therapy and knowledge gaps about optimal oxygen therapy in acute care. Identified barriers and facilitators should be considered when developing evidence-based guidelines to improve dissemination and knowledge exchange.
补充氧气通常用于急性护理中的患者。如果使用不当，可能会造成伤害。指南建议处方急性氧气，但遵医嘱情况不佳。我们旨在确定与澳大利亚和新西兰胸科协会（TSANZ）氧气指南相符的实践的障碍和促进因素，并确定与急性氧气治疗相关的信念和态度。
进行了一项全国性的横断面调查。该调查包括 3 个部分：（1）介绍和参与者特征；（2）关于氧气治疗和其他药物的意见/信念、知识和行动；（3）使用 TSANZ 指南的障碍和促进因素。采用方便抽样法。在 TSANZ 年度科学会议上分发纸质调查问卷。向 TSANZ 会员和约翰·亨特医院的临床工作人员发送了在线调查。
收到了 133 名临床医生的回复：52.6%是护士，30.1%是医生，17.3%是其他临床医生。超过三分之一（37.7%）不知道/不确定氧气指南的存在。大多数（79.8%）认为氧气是一种药物，应将其视为一种药物。大多数（92.4%）表示他们仅根据临床需要使用它。对于四个假设情况，只有一种情况大多数参与者确定了最佳氧饱和度。在询问关于根据 TSANZ 指南进行实践时，确定了一些障碍和促进因素。缺乏氧气设备、让医生开氧气处方以及将氧气与其他药物区别对待被视为障碍。该指南本身和多个临床医生特征被认为是促进因素。
临床医生在管理氧气治疗方面的信念和行动以及急性护理中最佳氧气治疗的知识差距存在差异。在制定基于证据的指南以改善传播和知识交流时，应考虑确定的障碍和促进因素。
