The effect of brief education on the prescription of Oxygen in an inpatient electronic medical chart (EMC)

Abstract

Background: Oxygen is often administered to patients without a prescription, potentially increasing mortality, morbidity and hospital stay. When we implemented an EMC in 2018, oxygen prescription by our medical officers (MOs) dropped. Our MOs should change the medical review criteria according to target oxygen saturations. Aim and Objectives: We hypothesised that education on oxygen therapy improves its EMC prescription. We investigated the effect of education on EMC oxygen prescription, review criteria and oxygen delivery. Methods: We collected baseline data from inpatients on oxygen over 6 weeks, spanning 2 rotations of MOs. We then delivered a brief education program to MOs and nurses, focussing on oxygen prescription, devices and saturation targets based on TSANZ guidelines. In the next 10 weeks, we collected outcome data and provided monthly feedback to our MOs. Outcome data are EMC oxygen prescription (device, flow rate/FiO2 & target saturation) and appropriate changes to the medical review criteria. We assessed if oxygen delivery on patients matched the prescription. Results: Oxygen was not prescribed before education. EMC oxygen prescription improved after education, but the rate was low (36%), and the higher rate of review criteria change was not significant. When prescribed, nurses accurately administered oxygen. Conclusion: EMC Oxygen prescription is improved with a brief education program, but more research is needed to improve prescription rates and investigate sustainability.