Abstract
Background:
This QIP was held in the hospital respiratory medicine and infectious disease wards at UHCW NHS Trust which was focusing on patients who was admitted with increased Oxygen demand.
Introduction:
Oxygen is a commonly administered medication in acute care, yet inappropriate prescription can be harmful, especially for patients at risk of hypercapnia. The British Thoracic Society and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust’s guidelines mandate clear documentation of oxygen therapy, including target saturation on patients’ records. After the respiratory medicine and infectious disease departments moved from paper charts to electronic charts, it was noted that less oxygen prescriptions were documented. This project in its 1st cycle measures adherence to these guidelines on the wards followed by 2nd cycle when a prior audit and intervention cycle had been applied. This made a great outcome to UHCW clinical practice and patient safety.
Methods:
A prospective two cycles of clinical audits were conducted, 1st cycle was from 15/09/24 to 22/09/24 (n = 29) and 2ndcycle was from 28/10/2024 to 04/11/2024 (n = 41), including patients requiring oxygen on respiratory medicine and infectious disease wards. Data was collected from EPR prescription charts. Adherence was evaluated against UHCW guidelines, focusing on presence of prescriptions, correct target saturation ranges, flow rates, and oxygen delivery methods. It measured improvement from a previous audit cycle after certain interventions were implemented.
Results:
In the first clinical audit cycle, out of the 29 patients who required oxygen therapy, only 3 (10.34%) were prescribed oxygen on EPR. Of the 3 patients prescribed oxygen, all had a prescription with specified oxygen targets. In the second clinical audit cycle, out of 41 patients who required oxygen therapy, 22 (53.66%) had oxygen therapy correctly prescribed on EPR, representing a significant improvement in comparison with the first audit cycle (which showed 10.34% adherence). No correlation was found between oxygen delivery methods or flow rates and prescription adherence.
Conclusions:
This QIP demonstrates notable improvement in compliance with oxygen prescription guidelines, highlighting the effectiveness of targeted educational and procedural interventions held. Continued efforts such as regular reminders, expanded awareness campaigns and posters, and broader departmental engagement and induction meetings are recommended to sustain and enhance adherence to clinical guidelines.