The use of oxygen prescription wristbands significantly improves patient safety on an acute respiratory ward

Abstract

Background: Medical oxygen is a drug, which without an individual prescription and with inappropriate provision carries a potentially fatal risk. British Thoracic Society (BTS) national annual audit confirms that oxygen therapy (OT) prescription and its consequent monitoring in secondary care is insufficient. Aims and objectives: This study investigates effectiveness of patient wristbands on consistency of oxygen prescription, saturation (SpO 2 ) monitoring, nursing documentation and accuracy of OT provision on an acute respiratory ward. Methods: On an acute respiratory ward, patients at risk of type 2 respiratory failure were asked to wear a brightly coloured wristband during their hospital stay. Following BTS guidance and audit, OT prescription rates, percent of nursing signatures, observation rates and actual SpO 2 vs target SpO 2 were audited once, both pre and 3 months post wristbands introduction. Results: OT prescription (60% to 64%) and observation (97% to 100%) rates remained largely unaffected. Nursing signatures on OT prescriptions increased from 25% to 75%. Accuracy of target oxygen saturation ranges improved from 67% to 100%. Conclusions: These preliminary results show that the use of patient wristbands during an acute inpatient stay can improve nursing signatures for OT prescriptions and increase accuracy of target SpO 2 . This demonstrates that once prescribed, wristbands can be an effective visual cue to prompt nursing staff both on medication rounds and in taking routine patient observations, thereby improving patient safety. Further long term data analysis and broader hospital utilisation is required to increase the reliability and validity of this intervention.