A quality improvement project focusing on oxygen prescription in acute medicine at Charing Cross Hospital under Imperial College Healthcare NHS Trust

Abstract

Aim: The aim of this quality improvement project (QIP) was to improve, over a 6-week period, the percentage of hospital patients on acute oxygen with a valid oxygen prescription to 95%, in line with British Thoracic Society (BTS) national improvement objectives. The main objectives were to: (1) increase prescription rates: the goal was to increase the number of patients who received a correct oxygen prescription. (2) Improve compliance: the goal was to improve compliance with oxygen prescriptions. (3) Identify sustainable interventions: the goal was to identify interventions that can be sustained over time. (4) Raise awareness: the goal was to increase awareness of oxygen as a drug and the importance of appropriate oxygen prescriptions. Methodology: Data collection was done retrospectively from Cerner. The first cycle of the audit was done using data from all patients admitted of July 2024. Intervention was implemented throughout the months of August and September 2024 and a re-audit was conducted in October 2024. Results: In cycle 1, 38 out of 145 patients admitted between 3 and 9 July 2024 required oxygen. 32% (12 out of 38) patients who required oxygen were prescribed it within 48 h. The results of the first cycle were presented in a poster (Fig 1) and in-text and online information was shared among the current prescribers in the department.In cycle 2, 39 out of 146 patients admitted between 22 and 28 October 2024 required oxygen. 51% (20 out of 39) patients who required oxygen were prescribed it within 48 h. Conclusion: Following poster circulation and a campaign to prescribe oxygen, a 59% (51% from 32%) quality improvement was noted over a period of 4 months. However, there is still room for improvement. The results of the second cycle and the improvements shown will encourage doctors in acute medicine to prescribe oxygen as per Trust guidelines.