VBCH Ambulatory (Exercise) Oximetry Testing

Start

VBCH Ambulatory (Exercise) Oximetry Testing

It meets documentation requirements for home oxygen prescriptions

It determines flow rate of oxygen required for exertion/exercise

It provides information on exercise induced oxygen desaturation/hypoxemia

Why perform ambulatory (exercise)oximetry testing?

*and other licensed personnel as deemed competent

Who can perform ambulatory (exercise) oximetry testing?

Registered Nurses (RN)

Licensed Practical Nurses (LPN)

Respiratory Therapists (RT)

Physical Therapists (PT)

Occupational Therapists (OT)

Things to Know Before the Test:

• Always ensure the patient's safety before, during, and after the test
• There is no minimum or maximum distance/time the patient has to walk
• The goal is for the patient to exert themselves enough to verify oxygen needs with exercise to maintain an oxygen saturation greater than 88%.
• You must increase O2 incrementally and document the O2 sat with each increase. See example below.

Ex: If on 2LPM (liters per minute) and O2 sat 86%, stop the walk and increase the O2 to 3LPM - allow the patient to recover to O2 sat > 88%. If they do not recover, document the O2 saturation and increase the flow rate by 1 LPM. Continue this process until the patient can maintain a saturation greater than 88% with ambulation, ensuring accurate documentation with each increase.

For a patient on OXYGEN at REST

For a patient on ROOM AIR at REST

How to perform the test:

Click each situation below for more information on how to perform the ambulatory (exercise) oximetry testing.

Documentation of Ambulatory (Exercise) Oximetry Testing

• All formal Ambulatory (exercise) Oximetry Testing should be documented in the “Home Oxygen Screening (inpatient)” nursing flowsheet in eSTAR.

• Once "Home Oxygen Screening" is filed, highlight the data, and right click. From the options, choose "New Note".

Documentation of Ambulatory (Exercise) Oximetry Testing

• Once note opens, click "Insert Data" and type any additional information needed such as additional incremental increases of O2.

Documentation of Ambulatory (Exercise) Oximetry Testing

See if you know the answer BEFORE clicking the checkmark below

Knowledge check

What are the steps for documentation of an Ambulatory (exercise) Oximetry Test?

If a patient is on oxygen at rest, you will attach a SpO2 monitor to the patient, and turn off their oxygen. If the patient maintains > 88% SpO2, how long will you wait before ambulating?

What step would you take next when ambulating your patient down the hallway and their SpO2 becomes 86% on 2LNC?

True or False? An Ambulatory (exercise) oximetry test can be delegated to a care partner?

Refer to the Ambulatory (Exercise) Oximetry Testing Standard Operating Procedure (SOP) for more information.

Thank You!

By submitting this education, you agree to follow the Standard Operating Procedure (SOP) for Ambulatory (exercise) Oximetry Testing and understand the education within this presentation.

For a patient on ROOM AIR at REST

1. Place a portable oximetry probe/monitor on the patient’s finger. Document oxygen saturation and pulse (heart rate) 2.Place a nasal cannula on the patient. 3. Attach the nasal cannula to a portable oxygen tank, but do not turn it on 4. Begin walking (no set time or distance required)

1. Place a portable oximetry probe/monitor on the patient’s finger. Document oxygen saturation and pulse (heart rate) 2. Turn off the oxygen (be sure to attach the nasal cannula to a portable oxygen tank for ambulation)-If the oxygen saturation falls below 88%, document the saturation and pulse and turn on the oxygen to 2LPM. -If the oxygen saturation DOES NOT fall below 88%, continue to wait for 5 minutes from the time you turned off the oxygen. 3. Once oxygen saturation is above 88% (with or without oxygen), instruct the patient to begin walking. 4. If the oxygen saturation decreases BELOW 88%, STOP the walk. -Initiate oxygen at 1 LPM if not otherwise started OR -Increase from 2LPM to 3LPM. -Simple Nasal Cannulas max of 6 LPM. -High Flow Nasal Cannula used for flows greater than 6 LPM. 5. Allow the patient to recover to a saturation of greater than 88% and document. 6. Resume walking if the patient can tolerate it. 7. Upon completion of the walk document resting pulse (heart rate) and oxygen saturation.

For a patient on OXYGEN at REST