Oxygen prescription: improving compliance using methods from journal

Research output: Contribution to journalArticlepeer-review

Authors

  • Onn Shaun Thein
  • Cathleen Man Ting Chan
  • Eleanor McCance
  • Maria Mullins
  • Davinder Dosanjh

Colleges, School and Institutes

External organisations

  • Institute of Inflammation and Ageing, Centre for Translational Inflammation Research, University of Birmingham, Edgbaston, Birmingham, UK.
  • Rheumatology Department-University Hospitals Birmingham NHS Foundation Trust, Old Queen Elizabeth Hospital, Birmingham.
  • Respiratory Medicine, Heart of England NHS Foundation Trust, Birmingham, UK.

Abstract

Oxygen is an important drug frequently used in the management of acutely unwell hospital patients. However, oxygen overuse can have fatal side effects particularly for those patients at risk of iatrogenic hypercapnia. British Thoracic Society Guidelines state that oxygen must be prescribed for all patients, with target saturations stipulated on the prescription for patient safety. 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. 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. The initial interventions of poster reminders and multidisciplinary team education failed to significantly improve the rates of oxygen prescription. 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. This was based on a BMJ Open Quality published improvement method. The current guidelines from the British Thoracic Society, and hospital's own guidelines, advise good oxygen prescribing. However, these recommendations alone are ineffective at achieving compliance among prescribers. Further targeted interventions have shown improvements in oxygen prescriptions and could lead to better clinical practice, patient care and safety.

Details

Original languageEnglish
Article numbere000288
JournalBMJ open quality
Volume7
Issue number2
Early online date4 Jun 2018
Publication statusE-pub ahead of print - 4 Jun 2018

Keywords

  • compliance, healthcare quality improvement, pdsa, quality improvement methodologies