An audit of the effect of oxygen prescription charts on clinical practice.
OBJECTIVE
The need to improve the prescription, administration and monitoring of oxygen therapy.


METHODS
An interventional, prospective audit.


METHODS
Wellington Hospital, a teaching and tertiary referral hospital in New Zealand in 2007 and 2008.


METHODS
Demonstration of adequate oxygen prescribing, administration and monitoring of oxygen therapy.


METHODS
The introduction of a new drug chart with a specific oxygen prescription section. Targeted educational lectures primarily to medical staff.


RESULTS
610 and 566 patients were reviewed in the first and second audits. After introduction of the new oxygen prescription section on the drug chart the proportion of patients whose oxygen therapy was prescribed increased from 15/85 (17.6%) to 39/98 (39.8%), relative risk 2.3 (95% CI 1.3 to 3.9). The proportion with adequate oxygen prescription, with documentation of device, flow rate or inspired oxygen concentration, and the target oxygen saturation increased from 5/85 (5.9%) to 36/98 (36.7%), relative risk 6.2 (95% CI 2.5 to 15.0). Introduction of the new charts was not associated with changes in clinical practice in terms of assessment of oxygen saturations on room air and commencement if < or = 92%, or the titration of oxygen therapy in response to oxygen saturations < or = 92%.


CONCLUSIONS
An oxygen prescription section on hospital drug charts improved the prescription of oxygen but did not improve clinical practice. Additional strategies are required to improve the administration of oxygen therapy in hospitals.
Wijesinghe
Meme
M
Medical Research Institute of New Zealand, PO Box 10055, Wellington 6143, New Zealand.
Shirtcliffe
Philippa
P
Perrin
Kyle
K
Healy
Bridget
B
James
Kate
K
Weatherall
Mark
M
Beasley
Richard
R
D006784:Hospitals, Teaching; D006801:Humans; D008485:Medical Audit; D008499:Medical Records / Q000592:standards*; D009520:New Zealand; D010092:Oximetry / Q000592:standards; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy / Q000592:standards*; D055656:Prescriptions / Q000592:standards*; D011364:Professional Practice / Q000592:standards; D011446:Prospective Studies
D010100:Oxygen