|Improving the assessment, prescription and follow up of inpatients newly commenced on home oxygen in an acute hospital
|C. Gleeson C. Gray P. Nadarajan
|St. James’s Hospital, Dublin 8.
|Click to view poster
|A local clinical audit demonstrated that the processes surrounding the provision of home oxygen to patients on discharge from hospitalisation was uncoordinated. This prompted a quality improvement (QI) project with the aim being to increase the adherence of staff to oxygen prescribing guidelines for all inpatients prescribed home oxygen from 0% to 100% over a 12-month period.
The project team used QI methodology which included stakeholder engagement, process mapping and development of a driver diagram to illustrate our ‘theory of change’ and to plan improvement activities. We used a number of Plan Do Study Act cycles to test and implement changes surrounding the assessment, prescription, education and follow up of inpatients commencing home oxygen therapy on discharge.
All home oxygen referrals were directed through a Respiratory Assessment Unit and a home oxygen care bundle (7 standards) was developed collaboratively with staff. The median number of oxygen standards met for each patient was 7 (range 6-7) by project completion and has been sustained in the months following the project (Figure 1)
Use of quality improvement methodology led to standardisation of care for patients prescribed home oxygen on discharge from hospitalisation. The principles used will be used to inform similar QI initiatives for patients commencing home non-invasive ventilation.