Are O2 sats a vital sign?

[roxhannah]

Can I ask a quick question of any inpatient nurses. Does your floor (I am mostly looking at med/surg and PCU/stepdown) consider O2 sats a vitals sign (completed on every patient with their HR and temp etc) or does it have to be ordered separately by the physician that the o2 sats are checked? If it does have to be ordered separately, are the nurses responsible for it or your respiratory therapists? I work for a large, top 10 hospital, and I find it so strange that their requirements are not the same I have experienced at other facilities.

[Davey Do]

Heck, roxhannah, I work inpatient psych and we count O2 sats as a VS!

[pedsrn1027]

Absolutely considered a VS. The doctor can specify if they want it checked more frequently than other VS, or if they want it continuous... but everyone absolutely gets it checked with all other VS. Also, nursing staff checks the O2sat, not respiratory therapy, as a general rule of thumb.

[pixierose, BSN, RN]

Like Davey, even the inpatient psych floor I work on absolutely uses this as a VS (mostly intermittent).

I had a patient come back from ECT Monday with 91-92%; it then dropped and stayed at 84% so intervention was needed.

What are your requirements?

[NRSKarenRN, BSN, RN]

Hpme Health: Pulse ox done as part of standing orders for vital signs Q visit with pulse oximeter provided by agency.

[Jory, MSN, APRN, CNM]

O2 Saturation levels or any other vital sign should not need a physician's order.

Physicians order if they need to be taken less often or more often than the protocol for that floor or not at all, if it is a hospice patient, etc.

So if you think your patient doesn't seem right, you are always free to take them more often or spot check at any time.

[PeakRN]

14 hours ago, roxhannah said:

...I work for a large, top 10 hospital...

I hate to tell you this, but you don't.

It truly confounds me that any hospital would not have a pulse ox check as part of their standards of care. I mean, pulse oximetry has been a standard of care for 40 years.

Honestly it isn't even a order on our tele and step down floors, adult and pediatric. It is the standard of care that all tele and step down patients have continuous pulse ox and 3 lead. All inpatients will at a minimum have their vitals, including SP02, checked at a minimum of Q4 hours unless they are a withdraw of care/comfort care. This isn't something that the docs can order against, if they want to be privileged in our facility this is one of the things that they get.

[JKL33]

On 2/13/2019 at 9:26 AM, roxhannah said:

Can I ask a quick question of any inpatient nurses. Does your floor (I am mostly looking at med/surg and PCU/stepdown) consider O2 sats a vitals sign (completed on every patient with their HR and temp etc) or does it have to be ordered separately by the physician that the o2 sats are checked? If it does have to be ordered separately, are the nurses responsible for it or your respiratory therapists? I work for a large, top 10 hospital, and I find it so strange that their requirements are not the same I have experienced at other facilities.

I'm completely reading between the lines, so disregard if off base.

It sounds like you need an order in your facility?

Are you sure you're not confusing the idea of obtaining an order for continuous pulse ox for the purposes of billing, with the concept of a nurse checking or monitoring a pulse-ox?

In other words, is pulse-ox not a part of order sets, so that your facility is asking for it to be specifically ordered so that it can be billed?

Again - I'm just guessing/wondering.

In any case, you should not confused any of this with what you know about taking proper care of patients. ?

[0.9%NormalSarah, BSN, RN]

All the hospitals around here in SoCal where I’m at consider it a VS and the nursing staff (including nursing assistants where appropriate, or techs) are responsible for it, according to my nursing school experience. No order needed and that should fall in line with the nursing process anyway since it’s an assessment, right?

[Seeing Myself Out]

O2 Sat was one of the most important vital signs when I was at the PACU for my LVN preceptorship. But of course there are other tools such as end tidal capnography, ABG, and CMP. But at end of the day we have to check the patient like skin condition, work of breathing, lung sounds and not rely on numbers alone.

[2BS Nurse, BSN]

We are not required to check pulse ox in Urgent Care unless the patient is exhibiting signs of respiratory distress, cough, etc. The nurses check it anyway. Technically, we are supposed to enter a charge, but we don't.

[Nurse Beth, MSN]

Pulse ox is a standard just like a B/P and doesn't require a provider's order. Now capnography is becoming more widely used.

I checked with the CA BRN and an order is not needed for capnography.