1. Oxygen With Love: Reducing Complications of Oxygen Administration in Preterm Infants
Team Members
Marianne Chybik, APN/CCNS, Neonatal Case Manager
Pat Hummel, APN/CNNP, Neonatal Nurse Practioner
Elaine Trulis RN, BSN, Nurse Manager, NICU
Jeanette Cronin RNC, BSN, Barb Hering, RNC, MSN &
Joanne Kurek RNC, BSN, NICU Staff Nurses
Marc Weiss, MD, Director of Neonatology

2. Background:
Oxygen With Love
Oxygen is a commonly administered drug in the Neonatal Intensive Care Unit
Oxygen is vital to survival, but also has toxic effects in the premature infant, such as contributing in the development of Retinopathy of Prematurity (ROP)
Recent research has demonstrated that the incidence of severe ROP may be reduced by maintaining the premature infant’s oxygen saturation levels (SaO2) within lower, controlled, specific ranges

3. Problem statement
Oxygen With Love
Retinopathy Of Prematurity is a common complication of prematurity associated with high levels of oxygen administration. Baseline data indicates that at Loyola’s NICU, premature infants are within the correct oxygen saturation range 33% of the time.

4. Contributing Causes
Oxygen With Love
Lack of awareness of current best practice guidelines
Difficulty in maintaining SaO2 within tight control at all times – intensive surveillance at bedside is required, with frequent adjustments in percentage of oxygen administered

5. GOAL:
Oxygen With Love
Oxygen saturation levels are within the ordered saturation range 75 % of the time for the target population, which includes all premature infants receiving oxygen, weighing less than 1500 grams (3 lbs 5 oz)

6. Solutions Implemented
Oxygen With Love
Participation in Tufts Medical Center NOPOP survey (Nursing Opinions and Practices for Oxygenation in Prematures)
Multidisciplinary staff education: nursing, respiratory, and medical from January - April 2005 “Oxygen is a Toxic Drug”
Seemore the OWL (Oxygen With Love) cards at each bedside with ordered SaO2 range
SaO2 ranges added to EPIC admission order sets
Follow up evaluations at 6 and 12 months

7. Results: DRAMATIC Improvement in maintaining oxygen saturations within tight controls
Oxygen With Love

8. Recommendations for Further Action
Oxygen With Love
Monthly chart review to evaluate continued compliance with ordered oxygen saturation levels
EPIC SaO2 orders and Seemore the OWL cards have been incorporated into practice.
The original in-service presented to all staff “Oxygen is a Toxic Drug” is incorporated into nursing orientation in the NICU.
Follow laser ablation intervention to assess impact of current changes in practice in infants with ROP (Retinopathy of prematurity)

9. Oxygen With Love

10. “Be an OWL (Oxygen With Love) kind of person!”
Seemore the Owl says
“Be an OWL (Oxygen With Love) kind of person!”
My OWL sat range is 85 – 92% since I am less than 28 weeks gestation.
**Keep my oxygen saturation alarm limits set at 80 – 95%
and wean my oxygen as needed**

11. Seemore the Owl says “Be an OWL (Oxygen With Love) kind of person!”
Seemore the Owl says
“Be an OWL (Oxygen With Love) kind of person!”
My OWL sat range is 90 – 95% since I am 28 – 34 weeks gestation.
**Keep my oxygen saturation alarm limits set at 85 – 98%
and wean my oxygen as needed**