Background Many newborns require oxygen; this should be prescribed as with other medical gases. In babies due to the risks from both hypoxia and hyperoxia oxygen saturation targeting to provide optimal safe oxygenation is commonly utilized.
Guidelines for the appropriate target saturations and hence monitoring alarm limits have changed locally in light of evidence from the SUPPORT1 and BOOST II2 trials.
A previous audit demonstrated that the guidance for target saturations was not being followed appropriately in all cases.
Methods Our aim was to review compliance with oxygen targeting prescriptions and the alarm limits used during saturation monitoring.
We collected data over three consecutive weeks during December 2011 for all babies on the neonatal unit who were monitored (n=102).
Results Compared to the previous audit we found there was an improvement in the set alarm limits to target oxygen within the guidelines to be correct 88% versus 69%. However compliance with oxygen prescribing was suboptimal with 78% at best.
Conclusions Despite a change in the target saturation guidelines compliance with saturation alarm limits has improved. However further work is needed to ensure that all babies have their alarm limits set within the target range and also have their requirements for oxygen prescribed as per trust guidance.
It is also important to remember that setting the alarms correctly is only a step in oxygen targeting and that ideally the percentage of time in the target range should also be assessed.