Oxygen Ward Audits 2014

Linda Pearce

Respiratory Consultant NurseWest Suffolk NHS Foundation Trust

Participated annually in BTS National Audits of the

Emergency Use of Oxygen since baseline audit in 2008.

Initially Trust performance compared very favourably

against the National findings, although the 2012

audit appeared to show falling standards

Results for the 2013 audit were generally above the National

performance reported by the BTS

Patient Safety and Implementation Group keen

to improve oxygen prescription and administration

Agreed junior doctors to audit oxygen therapy as part of established ward

audit programme

Use standard BTS audit tool

March, June, October 2014

Aim: snapshot audit conducted on all Inpatient wards on one day

11 wards participated

2 medical and 2 surgical wards did not participate

no patients on oxygen on a further ward

March 2014 Ward

Audit%

June 2014 Ward Audit

%October

2014 Ward Audit

%

Total in-patients on ward 281 307 246 Total patients on Oxygen 41 15 42 14 67 27 target range 94 - 98% 21 51 25 60 33 49

target range 88 - 92% 12 29 8 19 20 30

other target range 3 7 0 0 7 10patients using O2 by other order 0 0 4 9 1 2

patients using O2, no prescription 5 12 5 12 6 9

signatures for O2 - observation chart

81 61 87 67 144 69

Observation rounds should have taken place 374 255 287

O2 saturations actually monitored 371 99 271 106 316 110

Number of patients on Oxygen with target range 37 39 62

SPO2 within target range 30 81 31 79 43 69

SPO2 below target range by 1% 1 3 2 5 1 2

SPO2 below target range by 2% 1 3 0 0 0 0

SPO2 below target range by >2% 1 3 1 3 2 3

SPO2 above target range by 1% 1 3 0 0 5 8

SPO2 above target range by 2% 1 3 1 3 5 8

SPO2 above target range by >2% 2 5 4 10 6 10

Total patients for whom not applicable 4 3 5

March 2014 Ward Audit

%

June 2014 Ward Audit

%

October 2014 Ward Audit

%

proportion of patients maintained within target range fell by 10% (69%) compared with the previous audit level - still above the BTS audit average (63.6%)

Of the 19 patients maintained outside

target range, 16 were above target range

The result for patients using oxygen without prescription improved compared with the

previous two audits (March/June 12%, Oct 9%).

The improvement in percentage of signatures to drug rounds found in the June audit was maintained – up a further 2% to 69%.

NB. considerably higher than the national data for October 2013 (21.4% signatures to rounds).

Results for planned monitoring of O2

saturations excess monitoring level

(110%)

Watch this space…

Going paperless this Autumn