Literature DB >> 25495628

Implementation of a multicomponent intervention to optimise patient safety through improved oxygen prescription in a rural hospital.

Roshan Gunathilake1, Deborah Lowe, James Wills, Anne Knight, Peter Braude.   

Abstract

OBJECTIVE: To rationalise oxygen procedures in adult medical and surgical inpatients with a view to improving patient safety.
DESIGN: Prospective pre- and post-intervention audit.
SETTING: Manning Hospital, a rural referral hospital in Taree NSW. PARTICIPANTS: Pre-intervention: 82 patients aged 72.7 ± 14.7 years. Post-intervention: 77 patients aged 73.6 ± 12.4 years. INTERVENTION: A multicomponent intervention composed of implementation of a local hospital oxygen policy, introduction of a specific oxygen prescription chart and targeted staff education. MAIN OUTCOME MEASURES: Satisfactory oxygen prescription, monitoring and titration.
RESULTS: Only 2/82 (2.4%) patients had satisfactory oxygen prescription specifying target saturation, device and initial flow rate before the intervention compared with 26/77 (34%) patients post-intervention (χ(2)  = 56.88, df = 5, P < 0.0001). Percentage of patients with conditions predisposing to hypercapnic respiratory failure who were overtreated with oxygen dropped from 9/19 (47%) to 4/22 (18%) following the study intervention (χ(2)  = 4.011, df = 1, P = 0.04). Oxygen therapy monitoring was satisfactory during the audit period, but oxygen titration was unsatisfactory and did not significantly improve following the intervention.
CONCLUSIONS: A multicomponent intervention can achieve a significantly increased rate of satisfactory oxygen prescriptions specifying target saturation, including in those who are at risk of hypercapnic respiratory failure.
© 2014 National Rural Health Alliance Inc.

Entities:  

Keywords:  multicomponent intervention; oxygen prescription; rural setting; safety and quality; target saturation

Mesh:

Year:  2014        PMID: 25495628     DOI: 10.1111/ajr.12115

Source DB:  PubMed          Journal:  Aust J Rural Health        ISSN: 1038-5282            Impact factor:   1.662


  5 in total

Review 1.  Acute oxygen therapy: a review of prescribing and delivery practices.

Authors:  Joyce L Cousins; Peter A B Wark; Vanessa M McDonald
Journal:  Int J Chron Obstruct Pulmon Dis       Date:  2016-05-24

2.  Can we improve the prescribing and delivery of oxygen on a respiratory ward in accordance with new British Thoracic Society oxygen guidelines?

Authors:  Aklak Choudhury; Gregor Young; Beshoy Reyad; Nirali Shah; Radhea Rahman
Journal:  BMJ Open Qual       Date:  2018-10-15

3.  Development and validation of a questionnaire to assess the doctors and nurses knowledge of acute oxygen therapy.

Authors:  Olufemi O Desalu; Adeniyi O Aladesanmi; Olutobi B Ojuawo; Christopher M Opeyemi; Rasheedah M Ibraheem; Zakari A Suleiman; Olanrewaju O Oyedepo; Kikelomo T Adesina; Taofeek Oloyede; Emmanuel O Sanya
Journal:  PLoS One       Date:  2019-02-04       Impact factor: 3.240

4.  Understanding Clinicians' Perceived Barriers and Facilitators to Optimal Use of Acute Oxygen Therapy in Adults.

Authors:  Joyce L Cousins; Peter A B Wark; Sarah A Hiles; Vanessa M McDonald
Journal:  Int J Chron Obstruct Pulmon Dis       Date:  2020-09-25

5.  [A cross-sectional study in three German hospitals regarding oxygen therapy characteristics].

Authors:  Thomas Fühner; Jens Gottlieb; Oana Joean; Maria Petronella Vanʼt Klooster; Moritz Z Kayser; Christina Valtin; Raphael Ewen; Heiko Golpon
Journal:  Dtsch Med Wochenschr       Date:  2022-07-22       Impact factor: 0.653

  5 in total

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