P204 Quality improvement project for emergency oxygen delivery on a respiratory ward

Abstract

BackgroundBritish 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 MethodsWe 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:90% of patients receiving oxygen have it prescribed on a drug chart100% of patients prescribed oxygen have a documented target saturation range100% of patients have oxygen delivered appropriately to targetThe 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.ResultsSee TableAbstract P204 Table 1National Audit 2013National Audit 2015Telford Audit Autumn 2015Telford Re-audit Spring 2016Telford Re-audit Summer 2016Target StandardsNumber of patients on oxygen 62147741707531–Prescribed 55%58%61%79%84%90%Prescribed & Targeted –53%95%98%100%100%Prescribed, Targeted & Delivered 52%69%63%62%62%100%ConclusionsOur 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.ReferencesO’Driscoll BR, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax 2008;63(Suppl VI):vi1–vi68.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).