Abstract
Introduction -
The British Thoracic Society Guidelines 2017 recommends oxygen delivery to achieve target oxygen saturation range between 94% and 98% of the majority of medically unwell adult patients, and 88% to 92% in patients at risk of hypercapnic respiratory failure. Oxygen is a drug which should be prescribed for patient’s just like any other medication and is often over-looked. For some older people oxygen treatment can impair mobility, increase deconditioning and the risk of falls. We conducted a re-audit and PDSA cycle expanding from one ward (Eashing) to all three geriatrics wards over a 9-week period, to assess and improve compliance and patient safety.
Method -
A retrospective approach gathered data on a weekly basis, using all listed in-patient electronic medical records. Patient’s identified as having an oxygen requirement after first contact with a consultant when new to the wards, were reviewed as to whether oxygen was prescribed or not. A 5-week baseline audit and then one PDSA cycle over 4 weeks was implemented; with baseline results disseminated to the ward MDT’s with posters placed in each ward, 2 weeks later ward consultants and junior doctors were e-mailed.
Results -
5-week baseline audit; total patient population: 47. Eashing 11/16 patients = 68%. Elstead 1/14 patients = 7%. Hindhead 0/17 patients = 0%. 4 weeks following PDSA cycle completion; total patient population: 25. Eashing 8/9 = 88%. Hindhead 7/11 = 64%. Elstead 2/4 = 50%.
Conclusion -
Improvement in oxygen prescription compliance was noted across all wards, a clear upward trajectory in the results. On Eashing, teamwork and the involvement of nurses and their help was key to the improvement and highest compliance rate. The main barrier to sustainability is the rotation of new junior doctors, mitigated for through MDT dissemination & posters as well as consultant awareness.