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Increasing oxygen prescribing during the COVID-19 pandemic
Valid oxygen prescriptions for hospital inpatients have been a long-standing problem and have been described extensively in BMJ Open Quality with numerous quality improvement projects (QIPs) with the aim of improving compliance with oxygen prescribing. The British Thoracic Society recommends that al...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671842/ https://www.ncbi.nlm.nih.gov/pubmed/34903524 http://dx.doi.org/10.1136/bmjoq-2021-001544 |
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author | Sahota, Ramandeep Kamieniarz, Lukasz |
author_facet | Sahota, Ramandeep Kamieniarz, Lukasz |
author_sort | Sahota, Ramandeep |
collection | PubMed |
description | Valid oxygen prescriptions for hospital inpatients have been a long-standing problem and have been described extensively in BMJ Open Quality with numerous quality improvement projects (QIPs) with the aim of improving compliance with oxygen prescribing. The British Thoracic Society recommends that all inpatients should have oxygen target saturation set on admission: this is motivated by risks of both undertreatment and overtreatment with oxygen. The discrepancy between the recommendation and the reality produced a number of interventions studied in QIPs over the past years, all aiming at bringing the local ward teams closer to the target. This has become even more important during the COVID-19 pandemic, where non-standard oxygen saturation targets and oxygen scarcity led hospital systems to rethink their internal guidelines on the subject. We propose three novel interventions to improve compliance: a remote, personally directed email communication to a ward pharmacist, a similar communication to ward nurses, and a remote, personally directed WhatsApp communication to junior ward doctors. We undertake a QIP which compares novel interventions developed in-house with the most successful interventions from oxygen prescribing initiatives that have previously been published by BMJ Open Quality. The main outcome measure was the proportion of patients with valid oxygen prescription on a ward. The series of novel interventions in three plan, do study, act cycles led to improvement in the outcome measure from 0% at baseline to 70% at the end of the QIP. The successful interventions from previous QIPs were ran in parallel on a similar ward and achieved improvement from 17.9% at baseline to 55.6% at the end of the QIP. This QIP demonstrates adapted interventions performed in context of social distancing aimed at members of multidisciplinary team which achieve superiority in increasing proportion of patients with a valid oxygen prescription, when compared with previously described methods from BMJ Open Quality. |
format | Online Article Text |
id | pubmed-8671842 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-86718422021-12-15 Increasing oxygen prescribing during the COVID-19 pandemic Sahota, Ramandeep Kamieniarz, Lukasz BMJ Open Qual Quality Improvement Report Valid oxygen prescriptions for hospital inpatients have been a long-standing problem and have been described extensively in BMJ Open Quality with numerous quality improvement projects (QIPs) with the aim of improving compliance with oxygen prescribing. The British Thoracic Society recommends that all inpatients should have oxygen target saturation set on admission: this is motivated by risks of both undertreatment and overtreatment with oxygen. The discrepancy between the recommendation and the reality produced a number of interventions studied in QIPs over the past years, all aiming at bringing the local ward teams closer to the target. This has become even more important during the COVID-19 pandemic, where non-standard oxygen saturation targets and oxygen scarcity led hospital systems to rethink their internal guidelines on the subject. We propose three novel interventions to improve compliance: a remote, personally directed email communication to a ward pharmacist, a similar communication to ward nurses, and a remote, personally directed WhatsApp communication to junior ward doctors. We undertake a QIP which compares novel interventions developed in-house with the most successful interventions from oxygen prescribing initiatives that have previously been published by BMJ Open Quality. The main outcome measure was the proportion of patients with valid oxygen prescription on a ward. The series of novel interventions in three plan, do study, act cycles led to improvement in the outcome measure from 0% at baseline to 70% at the end of the QIP. The successful interventions from previous QIPs were ran in parallel on a similar ward and achieved improvement from 17.9% at baseline to 55.6% at the end of the QIP. This QIP demonstrates adapted interventions performed in context of social distancing aimed at members of multidisciplinary team which achieve superiority in increasing proportion of patients with a valid oxygen prescription, when compared with previously described methods from BMJ Open Quality. BMJ Publishing Group 2021-12-13 /pmc/articles/PMC8671842/ /pubmed/34903524 http://dx.doi.org/10.1136/bmjoq-2021-001544 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Quality Improvement Report Sahota, Ramandeep Kamieniarz, Lukasz Increasing oxygen prescribing during the COVID-19 pandemic |
title | Increasing oxygen prescribing during the COVID-19 pandemic |
title_full | Increasing oxygen prescribing during the COVID-19 pandemic |
title_fullStr | Increasing oxygen prescribing during the COVID-19 pandemic |
title_full_unstemmed | Increasing oxygen prescribing during the COVID-19 pandemic |
title_short | Increasing oxygen prescribing during the COVID-19 pandemic |
title_sort | increasing oxygen prescribing during the covid-19 pandemic |
topic | Quality Improvement Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671842/ https://www.ncbi.nlm.nih.gov/pubmed/34903524 http://dx.doi.org/10.1136/bmjoq-2021-001544 |
work_keys_str_mv | AT sahotaramandeep increasingoxygenprescribingduringthecovid19pandemic AT kamieniarzlukasz increasingoxygenprescribingduringthecovid19pandemic |