6655 Oxygen saturation practice in PICU

Objectives Aim: To understand the management of oxygen saturation (SpO2) levels in invasively ventilated patients receiving supplemental oxygen on Paediatric Intensive Care Unit (PICU) Objectives: To identify prescribed SpO2 for patients on PICU. To ascertain the adherence to patients' set SpO2 targets. Methods A single-site audit was conducted by student nurses using retrospective and prospective data in a UK tertiary hospital. The audit was conducted over four weeks in August/September 2023. Patients were separated into three groups; PICU, neonatal and cyanotic – due to availability of specific guidelines for each. Specific trust guideline used for the neonate and cyanotic patient groups. Due to the lack of specific trust guidelines for the PICU group, NICE guidelines were used. Inclusion criteria for each grou shown in table 1. All parents and nurses were given the opportunity to decline participation. Participants with a high risk of death, ECLS referral or ACP were excluded. To understand oxygen titration, 90-minute observation periods were conducted. A questionnaire was created, piloted, and distributed to bedside nurses to gain context on management practice. Results Out of 128 screened patients, 28 were eligible (21.9%). The PICU group had the most eligible patients (n=16). The majority of patients had a documented SpO2 target (85.7 n=24/28), however, only 12.5% (n=3/24) of these complied with the guidelines (table 2). The mean SpO2 complied with the guidelines for all groups. However, the PICU group spent a significant time (45%) outside of the guideline range (table 2). The PICU grou also the only group with any deviations. Deviations are defined as greater than three hours spent outside of the guideline SpO2 range with no appropriate change to oxyge requirement (FiO2). Bedside nurses were given questionnaires, with a 96% response rate (n=48/50). The responses revealed variations in oxygen weaning practice. A third of nurses stated a SpO2 value above the guideline to begin weaning. Conclusion Inconsistencies were identified in SpO2 target compliance and weaning practice. The lack of trust guidelines for the PICU group may be a factor in the number of deviations and hours spent outside of the guidelines. Specific trust guidelines for this group be introduced to alleviate any confusion and discrepancies. Education on patient specific SpO2 targets within the relevant guidelines is recommended. Guidelines should b reviewed to include weaning practice, aiding a standardised approach for oxygen management in PICU.