Bedside Pulse Oximeters with a Clinical Algorithm Make Economic Sense in the Intensive Care Unit

Abstract

OBJECTIVE: To determine the effect on arterial blood gas (ABG) and hospital resource use by introducing a strategy of using bedside oximeters with a clinical algorithm, based on the argument that bedside pulse oximeters make economic sense in the intensive care unit (ICU) if safe patient oxygenation can be ensured at a lower cost than that of existing monitoring options.DESIGN: A before and after design was used to examine the consequences of a pulse oximeter at each bedside in the ICU along with a pulse oximeter clinical algorithm (POCA) describing use for titrating oxygen therapy and for performing ABG analysis.SETTING: A 19-bed multidisciplinary ICU with a six-bed extended ICU (EICU) available to function as a 'step-down' facility.PATIENTS: All patients admitted to the ICU/EICU over two 12-month periods were included.RESULTS: The strategy yielded a 31% reduction in the mean number of ABGs per patient after POCA (20.0±26.1 versus 13.8±16.7, mean ± SD; P<0.001) as well as a potential annual cost savings of $32,831.CONCLUSIONS: Bedside oximeters within the ICU, when used with explicit guidelines, reduce ABG use and result in hospital cost savings.