Clinical Audit of Acute Oxygen Therapy: Enhancing Patient Care at Dammar Teaching Hospital

Oxygen therapy is a critical component of acute care, yet inappropriate administration remains a frequent concern, particularly in resource-limited contexts such as Sudan. Challenges with guideline adherence, infrastructure, and staff training necessitate clinical audits for quality improvement.

The objective of the study is to assess compliance with oxygen therapy guidelines at Dammar Teaching Hospital and evaluate the impact of targeted interventions on optimizing acute oxygen delivery.

The study is a prospective two-cycle clinical audit (Cycle 1: June-July 2024, n = 50; Cycle 2: December 2024, n = 40) against standards. Interventions included staff training and standardized checklists. Compliance was measured across nine parameters (device-specific flow rates, documentation, weaning, etc.).

Compliance improved in several domains after the intervention. Correct device and flow use increased markedly for nasal cannula (50.0% to 92.3%) and non-rebreather masks (61.9% to 100.0%). Documentation also improved, with target SpO₂ recording in type 2 respiratory failure rising from 69.0% to 100.0% and routine SpO₂ monitoring from 50.0% to 82.1%. Immediate oxygen delivery for patients at risk of hypoxemia increased from 16.7% to 70.0%. However, compliance declined in oxygen weaning (76.2% to 45.0%) and timely discontinuation (78.6% to 47.5%).

Educational interventions and clinical tools were associated with improved adherence to guidelines in oxygen delivery and documentation. However, declines in weaning/discontinuation highlight persistent de-escalation challenges. Sustained progress may require iterative audits, protocol reinforcement, and integration into electronic health records, which could provide a scalable model for similar settings.