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Oxygen is an important drug frequently used in the management of acutely unwell hospital patients. Studies have shown that deliberately increasing oxygen delivery in critically ill patients as well as high-risk surgical patients reduces organ failure, reduces length of ICU stay and, most importantly, improves mortality. British Thoracic Society Guidelines state that oxygen must be prescribed for all patients, with target saturations stipulated on the prescription for patient safety. A quality improvement project was initiated and undertaken with the aim to improve the oxygen prescription rates across the surgical wards at Lister East and North Hertfordshire district general hospital over 2 months. This project involved leading a team of surgical doctors to gather the relevant data on a weekly basis on compliance with oxygen prescribing looking at: COPD status, target saturations, timing, route and signature and dating of prescriptions. Teaching sessions were held based on the Results of our audit and targeted to the entire surgical department. The primary aim was to remind both junior and senior doctors and other allied healthcare prescribers alike the importance of oxygen prescribing and the lack of clear documentation on it. This presentation was accompanied by a systematic process of spearheading judicious interventions to appropriately promote the prescribing of oxygen. On re-audit, the critical interventions stated led to an improvement in the documentation of target saturations (13.6% to 42.2%), the route of administration (15.9% to 28.9%), timing of oxygen delivery (11.4% to 24.4%), and the signature and dating of the prescription (15.9% to 40%). An improvement in all aspects of oxygen prescribing was shown in our audit but with areas of enhancement still potentially achievable. By leading a team of doctors, an enrichment in the care of surgical of patients was achieved with regards to oxygen prescribing.

53 Audited quality improvement project on oxygen prescribing on an acute surgical ward