An audit on the effect of a hospital oxygen therapy guideline on oxygen prescription

Asciak, Rachelle; Gouder, Caroline; Ciantar, Maria; Tua, Julia; Fenech, Valerie Anne; Montefort, Stephen

doi:10.1183/13993003.congress-2016.pa3699

Cited by 1 publication

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“…who found that documentation of oxygen administration at the ED was only present in 23.5% cases and formal instructions on oxygen use were documented in 85.9% and that only half had details. [ 18 ] Therefore, to overcome this, we determined our findings by direct observation of patient care by the primary investigation team and hence were able to get information on factors like the duration and appropriateness of oxygen therapy. This is a significant strength of our study.…”

Section: Discussionmentioning

confidence: 99%

Impact of oxygen therapy algorithm on oxygen usage in the emergency department

Abhilash

Acharya

Dua

et al. 2020

Journal of Postgraduate Medicine

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Background: Although oxygen is one of the oldest drugs available, it is still one of the most inappropriately administered drugs leading to over utilization of this very expensive resource. Materials and Methods: This prospective observational study was done in a large emergency department (ED) in India. The pattern of oxygen usage was studied before and after the strict implementation of an oxygen treatment algorithm. The algorithm was taught to all doctors and nurses and its implementation was monitored regularly. The main outcome measures were proportion of patients receiving oxygen therapy, inappropriate usage, and avoidable direct medical cost to the patient. Results: The 3-week pre-protocol observation phase in April 2016 included 3769 patients and the 3-week post-protocol observation phase in April 2017 included 4608 patients. The baseline demographic pattern was similar in both the pre-protocol and post-protocol groups. After the strict implementation of the algorithm, the number of patients receiving oxygen therapy decreased from 9.63% to 4.82%, a relative decrease of 51.4%. The average amount of total oxygen used decreased from 55.4 liters per person in pre-protocol group to 42.1 liters per person in the post-protocol group with a mean difference of 13.28 (95% CI 5.30-21.26; P = 0.001). Inappropriate oxygen usage decreased from 37.2% to 8.6%. There was a significant decrease in inappropriate oxygen use for indications like low sensorium (60.8% vs 21.7%) and trauma (88.5% vs 15.8%). The mortality rate in the pre-protocol phase was 2.7% as compared with 3.2% in the post-protocol phase. The total duration of inappropriate oxygen usage significantly decreased from 987 h to 89 h over the 21-day study period. Conclusion: The implementation of an oxygen therapy algorithm significantly reduces inappropriate oxygen use and decreases treatment cost to the patient with no additional mortality risk.

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Section: Discussionmentioning

confidence: 99%