for NRS 445 For this discussion question, you will create a clinical guiding question known as a PICOT question Subject of my interest is how application of continues pulse oximetry monitoring technique in postoperative patients can improve their health outcomes

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. “Evidence shows that most respiratory depression events occur during the first 24 h following surgery and could be prevented with close monitoring”, in accordance of author (Hardy, 2023). Respiratory depression often happens after procedures under general anesthesia due to opioid use, obesity, pre-existing health conditions that could be dangerous in circumstances of procedure.

In postoperative population, how does continues oximetry monitoring technique comparing to non-continues affect patients’ breathing within 24 hours after surgery. There are scientifically proven research evidences that show that continues monitoring of patient’s oxygenation levels help prevent nursing fatigue and help prevent events of hypoxia episodes in patients. That also contributes in prevention of irreversible in some cases of patients stopping breathing, and unnoticed by staff.  Nurses pay more close attention to patient’s saturation levels when alarms go off. In qualitative research conducted and described in article I evidences showed that 90% of alarms were false, continues oxygenation monitoring of patients links to technical care part of patients. Studies conducted on ICU units and post-op units on-participants’ observation with consideration of knowledge of nurses and their training specialties. It showed that nurses have not chart events of false alarms, and did not follow with protocols when alarms were not false, did not notify ICU nurses of alarms. “Results from observation have shown that monitoring should be more rigorously carried out following the administration of opioids”, (Dallaire, 2023).

In quantitative research article II showed reduction in ICU transfer and mortality rate when continues oximetry used in post-operative care patients. As explained “comparing the CPOX group versus the standard monitoring group, there was 34% risk reduction in ICU transfer (P = .06) and odds of recognizing desaturation (oxygen saturation [SpO2] <90% >1 hour) was 15 times higher” in article II, (Lam, 2018). There is strong evidences that proved by calculated data showing how important application of continues oximetry in post-operative patients that can help manage their heath outcome and even reduce mortality rates. Nurses able pay attentions to alarms with low oxygen levels and attend patients immediately. Post-op nurses’ job is to assure patients recover from procedure: re-establish normal breathing with normal saturation levels, re-gained conciseness.

Patient/population-problem, intervention, comparison, outcome, time as format that helps in research process have significant difference in time of data collection in both research with quantitative much longer. In both articles post-operative patients’ oxygen saturation levels evaluated, its levels and frequency of monitoring by nurses. Interventions nurses implemented: pulse oximeter placements, alarm evaluations, analyzing levels of saturation, respirations, perfusion, and evaluation of breathing patterns. Outcomes: decreasing levels of saturation through recovery phase, stable steady, or no changes, and nurses charting. Time – 24 hours observation, and weeks of research.  By comparison of both articles I and II accordingly quantitative research results have been proven effectiveness of continues oximetry monitoring on patients and positive outcomes on patient’s safety and staff efficient performance. Therefore, use of continues oximetry is vital in post-operative patients who have induced respiratory suppression by anesthesia. Nurses can by closely monitoring oxygenation levels in post-op patients promote their safe successful recovery with avoidance of irreversible respiratory events that are unnoticeable.

References

  1. Hardy, M. S., Dallaire, C., Bouchlaghem, M. A., & Hajji, I. (2023). The impact of the use of continuous pulse oximetry monitoring to monitor patients at high risk of respiratory depression on nursing practice. Nursing open, 10(9), 6136–6142. https://doi.org/10.1002/nop2.1835
  2. Lam T, Nagappa M, Wong J, et al. Continuous Pulse Oximetry and Capnography Monitoring for Postoperative Respiratory Depression and Adverse Events: A Systematic Review and Meta-analysis. Anesthesia and Analgesia. 2017 Dec;125(6):2019-2029. DOI: 10.1213/ane.0000000000002557. PMID: 29064874.

McClinton TD. A guided search: Formulating a PICOT from assigned areas of inquiry. Worldviews Evid Based Nurs. 2022 Oct;19(5):426-427. doi: 10.1111/wvn.12598. Epub 2022 Jul 16. PMID: 35842743.

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