839 Improving Oxygen Prescribing on Kardex in Ward Level Care

Abstract

Abstract Aim The aim of the QIP was to raise awareness about the importance of oxygen prescription amongst healthcare staff and improve the oxygen prescription rate on Kardex by 50% in 3 weeks at both surgical and medical wards. Background Oxygen is considered a type of drug and should be prescribed on the Kardex. The administration of inappropriate oxygen concentration can have fatal consequences such as prolonged hypoxaemia or hyperoxia. Therefore, it is good practice to prescribe oxygen on the Kardex. Method Data was collected from 25 patients from surgical and medical wards once weekly. 3 plan-do-study-act (PDSA) interventions were undertaken. Source of information were the Kardex, NEWS observation chart, direct observation of oxygen delivery at patient's bedside and ward round documentation. The reason both surgical and medical wards were selected was to showcase just how prevalent the use of oxygen is in the hospital regardless of the underlying diagnosis. Results In PDSA 1, only 8% of the patients had oxygen prescribed. First intervention was to educate the doctors and nurses at the wards on the importance of oxygen prescription and the harmful effects of inaccurate target oxygen saturations. Following this, oxygen prescription increased to 45% in PDSA 2. In the second intervention, visual prompts were displayed in the wards. The oxygen prescription rate in PDSA 3 reached 53%. Conclusions We achieved our goal of this QI project through 3 PDSA cycles, which is to improve oxygen prescription by 50%. However, there is still room for improvement to sustain this good clinical practice.