Improved oxygen prescribing using a nurse-facilitated reminder

Area of Science:

• Medical Education
• Patient Safety
• Quality Improvement in Healthcare

Background:

• Poor oxygen prescribing and administration practices are prevalent despite existing educational efforts and prescription tools.
• Suboptimal oxygen therapy can lead to adverse patient outcomes.
• Junior medical staff often struggle with appropriate oxygen prescription.

Purpose of the Study:

• To evaluate the impact of medical admissions unit (MAU) nurse education and a nurse-mediated reminder system on oxygen prescribing and therapy appropriateness.
• To assess if a nurse-facilitated strategy can improve junior medical staff's oxygen prescribing behavior.

Main Methods:

• A prospective, single-center quality improvement study involving pre- and post-intervention audits.
• Educational intervention for MAU nurses.
• Implementation of a nurse-facilitated reminder strategy for junior medical staff regarding oxygen prescribing.
• Measurement of oxygen prescription rates and appropriateness of oxygen therapy.

Main Results:

• Oxygen prescribing rates increased significantly from 0% to 49% (p < 0.0001).
• Overall appropriate oxygen prescription showed a non-significant improvement (70.6% to 76.5%, p = 0.65).
• A marked reduction in Type 1 respiratory failure errors (18.4% to 3.8%) and a less marked reduction in Type 2 respiratory failure errors (61.3% to 44.0%) were observed.

Conclusions:

• A nurse-facilitated reminder strategy can achieve significant and rapid improvements in oxygen prescribing behavior.
• This intervention effectively reduces inappropriate oxygen prescribing and improves therapy appropriateness.
• The demonstrated strategies are transferable to other hospital ward settings and various aspects of patient care.