Further targeted interventions have shown improvements in oxygen prescriptions and could lead to better clinical practice, patient care and safety. However, these recommendations alone are ineffective at achieving compliance among prescribers. The current guidelines from the British Thoracic Society, and hospital’s own guidelines, advise good oxygen prescribing. This was based on a BMJ Open Quality published improvement method. Use of a targeted intervention where stickers were placed above oxygen taps significantly improved prescription rate from 20% in the non-targeted group to 60% in the targeted group. The initial interventions of poster reminders and multidisciplinary team education failed to significantly improve the rates of oxygen prescription.
Quality improvement methods were implemented based on data analysis at each stage, following discussion with senior doctors and specialist nurses, and after reviewing previous quality improvement projects published on BMJ Open Quality. A quality improvement project was undertaken with the aim to improve the oxygen prescription rate across the respiratory ward at a district general hospital, over a period of 3 months. British Thoracic Society Guidelines state that oxygen must be prescribed for all patients, with target saturations stipulated on the prescription for patient safety. However, oxygen overuse can have fatal side effects particularly for those patients at risk of iatrogenic hypercapnia. Oxygen is an important drug frequently used in the management of acutely unwell hospital patients.
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