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?:abstract
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BACKGROUND Approximately 14% of UK hospital in-patients receive supplemental oxygen therapy, but only 57% have valid prescriptions. Oxygen must be optimally prescribed to ensure maximal therapeutic response whilst minimising adverse outcomes (including fatality). This study investigates prescription compliance. METHODS All adults admitted to medical wards (18th February - 3rd March 2020) were included. Analyses present proportions, descriptive statistics and hypothesis testing. Ethical approval was not required for this audit. RESULTS Of the 636 patients admitted, 66 (10%) were receiving oxygen therapy. Ages ranged from 34-100 years with 36 (54.5%) males and 30 (45.5%) females. The prescription was not documented in the oxygen section of the drug chart (n=37, 56.1%, p=0.389), nor did it have the physicians signature (n=40, 60.6%, p=0.110) nor date (n=46, 69.7%, p=0.002). Thirteen chronic obstructive pulmonary disease (COPD) patients (19.7%) were at risk of hypercapnic failure (p=1.582x10-6). Target oxygen saturation (SpO2) range had been documented for 30 (45.5%) patients. A target SpO2 range of 88-92% was documented for 9 patients (13.6%), a 94-98% range documented for 11 patients (16.7%). All patients had an invalid prescription. CONCLUSION We present real-world practice in naturalistic settings, immediately before pandemic-lockdown. Enhanced compliance is advocated to reduce risks of harm and mortality.
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