Aim:  To document nurses’ opinions about their assessments of oxygen requirements in ventilated preterm infants receiving oxygen supplementation. Methods:  Survey design with descriptive statistics. The sample consisted of 111 nurses employed in clinical positions in neonatal intensive care units within Norway’s five regional hospitals. The questionnaire included questions about physiological and clinical observations used when assessing oxygen administration in ventilated preterm infants. Results:  A major finding was the gap between the criteria laid down in professional and research literature, vs the criteria nurses perceived they were using when they assessed the oxygen requirements of preterm infants. The respondents stated that they used oxygen saturation to assess the infants’ oxygen requirements when adjusting oxygen supplementation. Only 17% of the nurses used the oxygen‐haemoglobin dissociation curve in their assessments. Those who responded that they used the curve did not use it correctly. Conclusion:  Assessment of O2 requirement is based on insufficient information and calls for evaluation of local, national as well as international education. Close collaboration between doctors and nurses is essential in planning care for individual patients.

BackgroundVentilator treatment exposes newborns to both hyperoxemia and hyperventilation. It is not known how common hyperoxemia and hyperventilation are in neonatal intensive care units in Norway. The purpose of this study was to assess the quality of current care by studying deviations from the target range of charted oxygenation and ventilation parameters in newborns receiving mechanical ventilation.MethodsSingle centre, retrospective chart review that focused on oxygen and ventilator treatment practices.ResultsThe bedside intensive care charts of 138 newborns reflected 4978 hours of ventilator time. Arterial blood gases were charted in 1170 samples. In oxygen-supplemented newborns, high arterial pressure of oxygen (PaO2) values were observed in 87/609 (14%) samples. In extremely premature newborns only 5% of the recorded PaO2 values were high. Low arterial pressure of CO2 (PaCO2) values were recorded in 187/1170 (16%) samples, and 64 (34%) of these were < 4 kPa. Half of all low values were measured in extremely premature newborns. Tidal volumes above the target range were noted in 22% of premature and 20% of full-term newborns.ConclusionsThere was a low prevalence of high PaO2 values in premature newborns, which increased significantly with gestational age (GA). The prevalence of low PaCO2 values was highest among extremely premature newborns and decreased with increasing GA. Further studies are needed to identify whether adherence to oxygenation and ventilation targets can be improved by clearer communication and allocation of responsibilities between nurses and physicians.

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