Background British Thoracic Society (BTS) guidelines state that oxygen should be used to treat hypoxaemia and prescribed to a target saturation range.¹ Patients at risk of type 2 respiratory failure should target 88–92%, with the rest 94–98%. In the BTS national audit in 2013, out of 6214 patients, 55% had oxygen prescribed and 52% were prescribed and delivered to within a target saturation range.²

Methods We ran a Quality Improvement Project (QIP) involving three PDSA cycles to improve the delivery of oxygen to patients on the Respiratory Ward at the Princess Royal Hospital, Telford.

We set our standards as:

1. 90% of patients receiving oxygen have it prescribed on a drug chart

2. 100% of patients prescribed oxygen have a documented target saturation range

3. 100% of patients have oxygen delivered appropriately to target

The QIP process commenced in Autumn 2015. After the first cycle we used bedside prompt cards and delivered teaching sessions with doctors, nurses and healthcare assistants (HCAs). After the second cycle we appointed a nurse, HCA and two FY1 doctors as ‘O2 Ninjas’ . Data were collected at three points after each cycle from drug charts and VitalPaC.

Results See Table

Conclusions Our QIP shows that education and empowerment of ‘grass root’ healthcare workers can improve oxygen prescription on a Respiratory ward. We suggest this QIP is replicated in other trusts and specialties to improve safe oxygen delivery.

References

1. O’Driscoll BR, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax 2008;63(Suppl VI):vi1–vi68.

2. BTS Oxygen Audit 2013. https://www.brit-thoracic.org.uk/document-library/audit-and-quality-improvement/audit-reports/bts-emergency-oxygen-audit-report-2013/(accessed 21 January 2016).