Initiative to improve oxygen prescribing and oxygen delivery to patients in the emergency department of a national referral hospital

Oxygen is the most commonly used drug and is used in the treatment of hypoxaemia. Like any other drug, it should be prescribed appropriately with correct dose via correct device and based on individual needs. Unmonitored and unrestricted use of oxygen can be harmful to patients. The British Thoracic Society has set guidelines about the indication of oxygen use, target goals and how we can titrate oxygen according to the needs of the patients. A quality improvement project was undertaken with the aim of improving the oxygen prescription among the health personnel and improving the appropriate delivery of oxygen to the patients in an emergency department at a national referral hospital in Bhutan for a period of 12 weeks. Our team implemented five Plan-Do-Study-Act cycles based on the data analysis of each cycle, following discussions and after reviewing previous quality improvement projects. The intervention of team education and sensitisation and frequent reminders via posters, emails and group messages were effective in improving the compliance and prescription rates. The doctors' prescription improved from 20% to 82% and nurses' oxygen record from 22% to 83%, and patients receiving oxygen consistent with valid prescription improved from 34% to 86%.