Background Following the publication of the Executive Summary of the British Thoracic Society Guideline for Emergency Oxygen Use in Adult Patients 2008, a local hospice guideline for the prescribing and use of oxygen had been developed for that setting and patient population. Consequently new charts for prescribing, administering and monitoring of oxygen therapy were produced for the in-patient unit.
Aims The charts were audited to ensure that oxygen was prescribed and administered safely and appropriately and that inappropriate monitoring of oxygen saturation levels for patients approaching end-of-life was avoided.
Conclusion Fifteen oxygen charts were audited in each audit cycle. Medical staff usually judged appropriately when a patient should or shouldn't have a target oxygen saturation indicating that no unnecessary and inappropriate requests for monitoring were taking place. However on the few occasions when this was indicated it was not usually measured. A small number of patients were having oxygen saturations measured by nursing staff when not clinically indicated. Greater attention was needed in considering oxygen as a drug that was required to be prescribed and its administration recorded. The results were disseminated through the clinical team and the charts amended to highlight who was responsible for completing each section of the chart. An additional prompt in the main drug chart was added. The audit was repeated after a period of 6 months. There was a significant improvement in signing and dating an oxygen prescription from 60 to 100% of charts suggesting that oxygen was now being regarded as a drug by clinical staff. Nursing staff were now usually only checking oxygen saturations if indicated – enhancing patient safety yet avoiding unnecessary and inappropriate checks. There was a large improvement in nursing staff recording the delivery system and flow rate for oxygen at drug rounds (19–61%).
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