Time for change in practice of in-patient oxygen therapy: a period-limited, multidimensional approach to improve oxygen prescription compliance: quality improvement project at Hamad General Hospital, Qatar
| Autor: | Sundus Sardar, Dabia Hamad S H Al Mohanadi, Samman Rose, Sreethish Sasi, Ahmed Al-Mohammed, Muhammad Zahid |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
quality improvement methodologies
medicine.medical_specialty Medicine (General) Quality management Leadership and Management Quality Improvement Report medicine.medical_treatment Psychological intervention quality measurement Audit Hospitals General R5-920 Electronic prescribing Oxygen therapy Medicine Humans Medical prescription Qatar Oxygen saturation (medicine) electronic prescribing business.industry Health Policy Public Health Environmental and Occupational Health Quality Improvement Oxygen Prescriptions Oxygen Saturation Emergency medicine business healthcare quality improvement PDCA |
| Zdroj: | BMJ Open Quality, Vol 10, Iss 4 (2021) BMJ Open Quality |
| ISSN: | 2399-6641 |
| Popis: | Prescription of oxygen therapy has traditionally poor compliance across the globe and mostly given to patients on verbal orders leading to under or overuse. The British Thoracic Society (BTS) guidelines (2017) recommend that oxygen therapy must be prescribed. Our study aimed to assess the prescription practice of oxygen therapy for patients admitted to acute medical assessment unit and general medical wards at Hamad General Hospital, Qatar and to achieve 80% compliance of valid oxygen therapy prescription implementing the quality improvement model against the BTS guidelines.The prescription practice of oxygen therapy was audited between April 2019 and August 2019. Using a Plan, Do, Study, Act (PDSA) model of improvement and multiple interventions was performed in the eight PDSA cycles, including (1) educational sessions for residents/fellows/nurses, (2) introduction of electronic prescription, (3) emails, posters/flyers, (4) nurse-led reminders and (5) re-enforced teaching for new residents. Data were then collected using a questionnaire assessing electronic prescriptions and documentation. Our baseline study regarding oxygen therapy showed limited awareness of BTS guidelines regarding the documentation of initiation and further adjustment of oxygen therapy. There was a lack of compliance with oxygen prescription; none of the patients had a valid prescription on our computer-based prescription (Cerner). The duration, target range and indications of Oxygen therapy were documented in 25% (18/72), 45.8% (33/72) and 42% (30/72) patients, respectively. Oxygen was initiated by communication order only. In a total of 16 weeks period, the repeated PDSA cycles showed significant improvement in safe oxygen prescription practices. Following intervention, oxygen electronic prescription, documentation of indications for oxygen therapy, target oxygen saturation and wean-off plan improved to 93%, 85%, 86 % and 80 %, respectively.We concluded that poor compliance to oxygen therapy Orders is a universal issue, which can be successfully managed using small-scale PDSA cycles to ensure sustained improvement through multidimensional interventions, continuous reinforcement and frequent reassessments. |
| Databáze: | OpenAIRE |
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