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Oxygen Use in UK Hospitals: BTS Audits 2008-2009

Detailed analysis of oxygen use in UK hospitals based on BTS audits conducted in 2008 and 2009, before and after guideline launch. The audits reveal insights into oxygen prescription, modes of delivery, and compliance with guidelines.

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Oxygen Use in UK Hospitals: BTS Audits 2008-2009

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  1. Oxygen use in UK hospitals BTS Audits 2008 and 2009Audit 1 July-Sept 2008Before Guideline Launch in October 2008Audit 2 November 2009One year after Guideline Launch • Oxygen champions conducted audits • Methodology- BTS online Audit tool Acknowledgements: Sally Welham, Christine Bucknall, Chris Routh

  2. 2008 99 data sets 14,830 patients 712 wards 2009 47 data sets 7,113 patients 300 wards

  3. Use of oxygen at time of audit • 17.5% of patients using oxygen or had oxygen prescription in 2008 • 18.4% of patients using oxygen or had oxygen prescription in 2009

  4. Prescription of oxygen • 32% of patients who were using oxygen had some sort of written order for oxygen use in 2008 • 69% of patients who were using oxygen had some sort of written order for oxygen use in 2009

  5. Prescription of oxygen 20091307 patients “On oxygen” • 40% prescription with target range (10% in 2008) • 31% on oxygen but no written order (68% in 2008) • 9% documented at bedside but no target range • 7% had a prescription but no target range • 8% other written order without target range • 4% written order in case notes with target range

  6. Continuous or PRN oxygen? • 56% Continuous oxygen( 38% in 2008) • 18% “PRN” Oxygen( 8% in 2008) • 26% not stated or not clear( 54% in 2008)

  7. Modes of oxygen delivery • 59% Nasal Cannulae ( 54% in 2008) • 21% Venturi Mask ( 18% in 2008) • 7% Simple Face Mask ( 8% in 2008) • 6% Humidified oxygen systems ( 7% in 2008) • 4% Reservoir Mask ( 4% in 2008) • 1% NIV Systems ( 2% in 2008) • 1% Tracheostomy Masks ( 1% in 2008)

  8. Drug rounds & Observation Rounds • 27% of drug rounds for patients on O2 had a signature for oxygen(2008 5%) • 93% of scheduled observation rounds were documented to have taken place(2008 94%) • 62% of patients using device and flow rate shown in the bedside documents(2009 47%)

  9. Observations Rounds for patients on O2 with a Target Range • 82% of patients within the target range (2008 78%) • 12% above the target range (2008 15%) • 6% below the target range (2008 7%) • If above target range, 19% had FIO2 reduced(2008 10%) • If below target range, 12% had FIO2 increased (2008 9%)

  10. Implementation Audit February and November2009

  11. Conclusions • The proportion of patients with a prescription or written order for oxygen has risen from 32% to 69% in the year since the Guideline was introduced • Proportion with target range risen from 10% to 40% • Local implementation of policies and training is progressing slowly (training is especially difficult) • The true picture in 2009 may be exaggerated slightly because some Trusts did not re-audit in 2009 due to delays in implementation of the new systems

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