Oxygen therapy audit in two medical wards

Abstract

Oxygen therapy is the mainstay of treatment in acute respiratory
failure. Several works have shown the correct procedure is seldom
performed. We carried out an audit to identify a faulty practice
and to plan strategies to provide the best care.
The audit was performed in the first quarter of 2008. All patients
to whom oxygen was administered or prescribed were included. All
the process of oxygen therapy, from medical prescription through
nursing transcription, administration and medical and nursing
monitoring, had to be in accordance with the recommendations of
“Guideline for emergency oxygen use in adult patients: Summary
of draft guideline” by the British Thoracic Society. The administration of oxygen while patients were transported, having meals,
in hygiene and using humidifiers was also audited.
A total of 472 episodes of oxygen therapy were audited, corresponding to 178 patients. There was a medical prescription
of oxygen in 97.7% of the audited episodes. A complete “fixed
dose” oxygen prescription was present in only 51.2%. Just 51.1%
episodes of oxygen administration fully respected the transcription.
Monitoring was the same as transcribed in 86.7% episodes.
Oxygen therapy, although being a common treatment in most
hospitals for acute conditions, is not implemented according to
international recommendations of care. There are practices to
improve in oxygen prescription, transcription, administration and
monitoring. Clinical audit is an excellent tool to recognising and
improving the quality of delivering oxygen therapy.