Knowledge and Associated Factors with Supplemental Oxygen Administration for Critically III Patients Among Nurses: A Cross-Sectional Study

Abstract

Background: Supplemental oxygen is one of the most frequently used therapeutic agents in critical care, yet inappropriate administration can precipitate serious harm, including oxygen toxicity, hypercapnic respiratory failure, and death. Although evidence-based guidelines exist, oxygen is often administered without adequate attention to updated protocols, and knowledge gaps among bedside nurses remain poorly characterized in many low-resource settings. Objective: To assess the level of knowledge and to identify the factors associated with supplemental oxygen administration for critically ill patients among nurses working in critical care areas of a tertiary care hospital. Methods: An analytical cross-sectional study was conducted among 120 nurses working in the ICU, MICU, SICU, HDU, and CCU of Tehsil Headquarter Hospital, Hasilpur, Punjab, Pakistan. Participants were recruited through convenience sampling. A structured, close-ended, modified questionnaire covering demographic characteristics, knowledge of oxygen therapy, and perceived barriers was administered. Knowledge scores were categorized as poor (<5), average (6–10), or good (11–15). The chi-square test was used to examine associations between knowledge and reported challenges, with significance set at p<0.05. Results: Most participants were aged 20–30 years (50.8%) and female (69.2%). Nurses most commonly worked in the SICU (31.7%) and HDU (30.8%). Overall, 60.0% of nurses demonstrated average knowledge (mean score 8.5 ± 2.48), 30.0% demonstrated poor knowledge, and only 10.0% demonstrated good knowledge of supplemental oxygen administration. The most frequently reported barriers were lack of knowledge/training (75.0%, p=0.015) and time constraints (66.7%, p=0.008), followed by inadequate staff support (50.0%, p=0.039) and insufficient equipment (37.5%, p=0.024); all were significantly associated with difficulties in oxygen administration. Confusion with protocols (33.3%, p=0.102) and patient complexity (25.0%, p=0.064) were not statistically significant. Conclusion: Nurses in this tertiary care setting exhibited predominantly average-to-poor knowledge of supplemental oxygen administration. Lack of training, time pressure, inadequate staffing, and insufficient equipment were the principal modifiable barriers. Structured, competency-based training programs, improved resource allocation, and standardized protocols are recommended to close this gap and improve outcomes for critically ill patients.