Abstract
Valid oxygen prescriptions for hospital inpatients have been a long-standing problem and have been described extensively in BMJ Open Quality with numerous quality improvement projects (QIPs) with the aim of improving compliance with oxygen prescribing.The British Thoracic Society recommends that all inpatients should have oxygen target saturation set on admission: this is motivated by risks of both undertreatment and overtreatment with oxygen. The discrepancy between the recommendation and the reality produced a number of interventions studied in QIPs over the past years, all aiming at bringing the local ward teams closer to the target. This has become even more important during the COVID-19 pandemic, where non-standard oxygen saturation targets and oxygen scarcity led hospital systems to rethink their internal guidelines on the subject.We propose three novel interventions to improve compliance: a remote, personally directed email communication to a ward pharmacist, a similar communication to ward nurses, and a remote, personally directed WhatsApp communication to junior ward doctors. We undertake a QIP which compares novel interventions developed in-house with the most successful interventions from oxygen prescribing initiatives that have previously been published by BMJ Open Quality. The main outcome measure was the proportion of patients with valid oxygen prescription on a ward.The series of novel interventions in three plan, do study, act cycles led to improvement in the outcome measure from 0% at baseline to 70% at the end of the QIP. The successful interventions from previous QIPs were ran in parallel on a similar ward and achieved improvement from 17.9% at baseline to 55.6% at the end of the QIP.This QIP demonstrates adapted interventions performed in context of social distancing aimed at members of multidisciplinary team which achieve superiority in increasing proportion of patients with a valid oxygen prescription, when compared with previously described methods from BMJ Open Quality.
Subject
Public Health, Environmental and Occupational Health,Health Policy,Leadership and Management
Reference8 articles.
1. O'Driscoll BR . British thoracic Society emergency oxygen audit report, 2015. Available: https://www.brit-thoracic.org.uk/document-library/ audit-and-quality-improvement/audit-reports/bts-emergencyoxygen-audit-report-2015/
2. BBC News . North Middlesex Hospital patient rang 999 after oxygen refusal [online], 2021. Available: https://www.bbc.co.uk/news/uk-england-london-56606386 [Accessed 26 Apr 2021].
3. Oxygen prescription: improving compliance using methods from BMJ Open Quality journal
4. Changing an ingrained culture: improving the safety of oxygen therapy at university hospitals Bristol NHS Foundation trust;Gatter;BMJ Qual Improv Rep,2015
5. Improving oxygen prescribing rates by tailoring interventions for specific healthcare professional groups;Helliar;BMJ Qual Improv Rep,2016
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献