|‘Is O2 too much of a go to?’ An audit into our practice.
|St. Lukes Hospital Kilkenny
|Click to view poster
Oxygen in the hospital setting is considered to be a drug, and as such should be prescribed. Oxygen is in the same category of drugs as paracetamol and antihistamines which are not prescription drugs to be purchased privately but are required to be controlled in a healthcare setting. It has been found across the UK only 57% of patients had a valid oxygen prescription.
The objective of this study was to audit current practices and evidence based knowledge among NCHDs, nursing staff and physiotherapists across medical wards in St. Luke’s General Hospital Kilkenny with regards to oxygen prescription and documentation of oxygen parameters on all hospital admissions of 24 hours and over. The overall aim of this project was to prevent over or under oxygenation during their inpatient stay and maintain oxygen prescription practice within best practice guidelines.
This is a mixed method study.
• A chart audit took place across seven wards, between 29th March 2021 – 6th May 2021. A total of 98 charts were audited. Charts was audited using a standardised and validated audit tool provided by the British Thoracic Society.
• Inclusion criteria: Medical patient charts, EWS charts, Kardex of patients receiving oxygen therapy and admitted >24 hours.
• A survey was undertaken among medical professionals mentioned above over a three week period. Surveys were distributed at ward level for voluntary participation. Results pending.
All data collected was stored in line with GDPR guidelines and no identifying information was documented. Statistical analysis was carried out on Excel for the results of the chart audit. Ethical approval was granted by UL EHS ethics committee.
Chart audit results (n=98) demonstrated 52% of patients were receiving oxygen therapy in the absence of any form of written order, parameter or prescription. This percentage is higher than results reported in the English study. Thirty percent of patients receiving oxygen therapy had target saturations charted. Eighteen percent of patients were found to be using oxygen with varying methods of prescription, some documented only in nursing notes which were presumed to have been verbal orders on doctors rounds.
Survey results are pending, aiming to complete analysis by July 2021. The author hypothesises findings will be in line with the results of similar studies carried out in the UK and will provide an overview of barriers and facilitators to adoption of best clinical practice to oxygen prescription.
Oxygen prescription remains complex for a drug that is administered so frequently. Oxygen prescription and/or delivery are associated with significantly greater error than that seen with antibiotics. Education of medical personnel should stress more prudent prescription and use of oxygen in hospitalized patients as is can actually detrimental to many of the patients who receive it.