This audit tool has been designed to audit patients in hospital who are receiving oxygen. This audit is designed to collect data from hospitals across the country prior to the publication of the BTS guideline on emergency oxygen use in adult patients in October 2008. Organisations are free to choose the most suitable date for this audit bearing in mind that online data collection for this audit will close on 30 September 2008. Results of the audit will be made available on the BTS website in autumn 2008.
Oxygen is a drug and should be prescribed in accordance with the hospital oxygen policy. In order to undertake this audit effectively, all ward managers should allocate about one hour and audit all patients on the ward receiving oxygen therapy. If the ward is large with a lot of patients using oxygen, it would be reasonable to undertake a partial audit such as half of the ward or the first 10 patients using oxygen.
Step 1 - Ward Managers or Deputies
Please use one individual patient audit record form for each patient - the form is available below. You will need to print one copy of this Audit Record Card for each patient on your ward. The drug chart and the observation chart should also be used to answer the questions on the audit card for each patient. The ward manager or a nominated deputy should proceed to each bedside and identify patients who are on oxygen.
Individual patient audit record form available here
Step 2 - Ward Managers or Deputies
On completion of the collection of data, enter the aggregate audit data on the summary data form, available below. This form should then be submitted to the nominated “Oxygen Champion” in your hospital as part of a hospital-wide audit of oxygen use (but keep a copy for discussion at your ward audit meetings). Please pass this form to your hospital’s “Oxygen Champion” and this will allow you to compare your results with data from other wards in the hospital. The Oxygen Champion” should give you this feedback information.
Ward summary data form available here
Step 3 - Oxygen Champion
The Oxygen Champion should collate the data from each ward summary sheet and enter the summary data for that hospital on the National Hospital Oxygen Audit system. The link to this online data collection system is available by clicking on this link:
http://www.btssurveys.com/TakeSurvey.aspx?SurveyID=8lKHm78
In due course the BTS website will display results of oxygen audits across the country so you will be able to compare your ward audit data with what is happening all over the UK.
Notes about PRN oxygen and “Weaning off oxygen”
PRN oxygen therapy is not the same as weaning from continuous oxygen therapy
PRN oxygen therapy means “as required” (from the Latin words Pro Re Nata). An example would be the use of oxygen for a few minutes to palliate breathlessness for an otherwise stable patient who desaturates and feels breathless after activities such as dressing or going to the bathroom.
Weaning off oxygen therapy
Patients who are prescribed continuous oxygen may be weaned from oxygen in accordance with the hospital oxygen policy once they are medically stable. This is not PRN oxygen. Patients who have stopped oxygen for weaning purposes should have a code identifying that they are on air but weaning from oxygen (AW). The prescription may be changed to PRN oxygen if weaning is successful because some recovering patients may require PRN oxygen after exertion such as visiting the bathroom.
If you have any queries about this audit please contact: bts@brit-thoracic.org.uk