Audit on oxygen prescription and administration in adult inpatient wards at Mater Dei Hospital

Abstract

BACKGROUND: Oxygen is one of the most common therapeutic agents utilised in both hospital emergency department (ED) and medical wards, therefore correct administration is paramount. The primary aim of this audit was to assess current local implementation of guidelines on oxygen prescription in the ED and medical wards, along with adequate documentation in treatment charts or plans.

METHODS: This audit involved data collection for a total of 5 weeks (in the months of November 2021 to December 2021) from patients who were being assessed at ED and then subsequently admitted to medical wards in Mater Dei Hospital (Malta).

RESULTS: 300 patients were recruited over the period of 5 weeks, all having a presenting complaint of ‘shortness of breath’; oxygen was administered to 82.7% (n=248) of patients. 260 were given a plan on oxygen administration, out of whom 253 had an oxygen prescription written in the management plan (only 92 also had documentation on the treatment chart as well).

Regarding the oxygen delivery being delivered in the ward, only 163 (62.7%) matched with the latest plan, whilst 86 (33.1%) did not match and 11 (4.2%) were started on NIV. When comparing the data to the audit performed in 2011, the greatest differences were regarding the lack of oxygen prescription in the treatment chart (35.4% in this audit, compared to 51.8% previously) and correct oxygen administration, being much higher (62.7%) when compared to the older values (7.1%).

CONCLUSION: Oxygen should be clearly mentioned in management plans and correctly written on treatment charts, the lack of which could lead to inappropriate oxygen administration. A designated oxygen prescription sheet could be utilised for possible improvements.