Evaluation and Improving the Quality of Arterial Blood Gas Interpretation Among Junior Doctors in Aswan University Hospital: A Clinical Audit.

BACKGROUND

Arterial blood gas (ABG) analysis is a vital diagnostic tool in clinical settings, particularly for assessing oxygenation, ventilation, and acid-base status in critically ill patients. Misinterpretation of ABG can lead to delayed or inappropriate management of critical conditions such as respiratory failure, metabolic disturbances, and sepsis, increasing morbidity and mortality. ABG interpretation is essential for timely and effective clinical decision-making. Accurate interpretation of ABG results is essential but challenging, especially when both respiratory and metabolic disturbances are present. This study aims to evaluate and enhance the quality of ABG interpretation among healthcare professionals at Aswan University Hospitals, following the American Thoracic Society (ATS) guidelines.

MATERIALS AND METHODS

This prospective cross-sectional study was conducted at Aswan University Hospitals from August to October 2024, involving 273 healthcare professionals, including house officers, medical officers, registrars, and residents. Participants were assessed in two audit cycles: the first without intervention and the second following targeted educational interventions. These interventions, implemented over two weeks, included lectures, educational posters, and focus group discussions focused on ABG interpretation. Data were collected using a validated questionnaire and analyzed to evaluate changes in ABG interpretation accuracy.

RESULTS

The results revealed significant improvements in ABG interpretation skills between the two cycles. The accuracy in verifying ABG results increased from 71.8% to 90.2%, distinguishing acidemia and alkalemia improved from 82.9% to 95.4%, and differentiating respiratory and metabolic disturbances rose from 82.1% to 96.7%. Additionally, proficiency in assessing compensatory mechanisms and calculating the anion gap showed substantial gains, with correct interpretation rates improving from 47% to 78.4% and 69.2% to 98%, respectively.

CONCLUSION

The educational interventions effectively enhanced ABG interpretation skills among healthcare professionals, demonstrating the importance of targeted training in promoting accurate diagnosis and effective patient care. This study highlights the need for ongoing training in ABG analysis to improve diagnostic accuracy and clinical decision-making in critical care settings.