The effect of a hospital oxygen therapy guideline on the prescription of oxygen therapy

Abstract

Aim: To assess the effect of a hospital oxygen therapy guideline on oxygen prescription and administration at the emergency Department (ED) and medical wards of Mater Dei Hospital, Malta. Methods: Patients admitted to medical wards through the ED with conditions most likely to require oxygen therapy were recruited over 2 months in 2011. Data was collected on oxygen therapy prescription and administration. A hospital guideline on oxygen therapy was introduced and disseminated in 2015, following which data was collected again and compared to the 2011 data. A p value <0.05 was deemed to be statistically significant. Results: 248 and 293 patients were recruited in 2011 and 2015 respectively. Oxygen therapy was indicated in 34.3% and 31.4% of patients respectively (p=0.47). Oxygen saturation on air was not documented in 14.1% (2011) and 4.4% (2015) (p<0.01). In patients in whom oxygen therapy was indicated, correct documentation (including delivery device and flow rate) of oxygen therapy administered at ED improved from 23.5% to 73.9% (p<0.01), and correct oxygen therapy prescription in the management plan improved from 34.1% to 76.1% (p<0.01). In the medical wards, correct oxygen therapy administration according to prescription improved from 7.1% to 48.9% (p<0.01). 56.8% of patients in whom oxygen therapy was not indicated were prescribed oxygen anyway in 2011, improving to 27.1% after the guideline (p<0.05). Conclusion: Oxygen saturation, oxygen therapy prescription and documentation at the ED and oxygen therapy administration in the medical wards improved significantly at Mater Dei hospital, Malta, after a hospital guideline was introduced.