Policy Manual sample

MDT Home Health Care Agency, Inc. PULSE OXIMETRY POLICY Purpose Establish practices and standards that will ensure delivery of quality monitoring of patients. Completed only under Physician Order. POLICY Acceptable criteria for pulse oximetry monitoring are: • When the patient has a medical condition requiring ongoing and prolonged monitoring • To obtain an estimate of saturation instead of a direct measurement • When the PaO2 and acid/base status is not a requirement • During and emergency Objectives for pulse oximetry are to: • Monitor arterial saturation • Monitor the effectiveness of therapeutic intervention • Satisfy medically mandated regulations Policy • Saturation documentation should include: • FiO2 • Date • Time • Saturation • and if warranted, the patient's body position, activity level, probe site, stability of reading, clinical appearance, positive correlation between pulse rate on monitor and palpation of the heart rate. Procedure The clinical skill limitations for pulse oximetry: Saturation results may be limited by, but not exclusive to • Use of intravascular dyes • Low perfusion states • Exposure of probe to light • Skin pigmentation • Nail polish • Saturations of 83% and below are not read with the same accuracy of higher saturations • Proper placement Oximetry provides an estimate of arterial oxyhemolglobin saturation by using wavelengths in a noninvasive manner. Oximetry is contraindicated if there is a need for pH, pCO2, total hemoglobin, and abnormal hemoglobin measurements. Hazards and complications because of device limitations include false-negative hypoxemia and false-positive normoxemia lead to inappropriate intervention. Results should not be reported when a discrepancy exists between the sPO2 and SaO2 but should be explored and corrected. Expected outcomes of sPO2 should reflect the patient's condition and should be documented. Saturation monitoring should be done in conjunction with a total assessment of vital srgns. Continuous monitoring versus spot-checking should be considered when evaluating the need for sPO2. Universal precautions are recommended when using and cleaning monitors. Permanent probes and monitors should be cleaned when in the patient's room for long periods of time, soiled, and in contact with transmittable organisms. Home Health Agency Nursing Care & Procedures K-154