Learning safe practice by improving care: student-led intervention on oxygen prescribing in a respiratory ward.
BACKGROUND AND OBJECTIVE
The primary aim of this intervention was to improve oxygen prescribing in accordance with the 2008 British Thoracic Society guidelines for the prescription of emergency oxygen in adults.


METHODS
Eight final year medical students reviewed the drug charts of all patients admitted to the respiratory ward on a daily basis in order to collect data on five audit questions: (1) Has oxygen (O2) been prescribed? (2) Has an O2 target saturation level been indicated? (3) Has O2 been prescribed as an 'as required' (PRN) or 'continuous therapy'? (4) Has the prescription been signed? (5) Has O2 been signed for in every drug round since the original prescription? Following an initial audit cycle an educational poster was distributed to all clinical staff via email and hard copies of the poster were placed strategically throughout the ward before its effectiveness was measured.


RESULTS
During the pre-intervention phase, compliance with all five measures varied from 0 to 25%. There was an increase in the variation in compliance after the poster intervention to 14-44%; however, this masked better overall compliance with all five investigative questions with figures of 44%, 39% and 42% being recorded in three of the four post-intervention days. Overall there was increased compliance with four of the five audit questions. Indeed compliance with question 3 rose from 14% to 83%.


CONCLUSIONS
The poster intervention was marginally effective while also showing that students can improve prescribing in a clinical setting.
['Dolan|R|R|', 'Linden|D|D|', 'Johnston|T|T|', 'Paterson|G|G|', 'Rossi|J|J|', 'Lynch|N|N|', 'Arbuckle|S|S|', 'MacLean|A|A|', 'Davey|P|P|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D004502:Education, Medical, Continuing D004504:Education, Medical, Undergraduate D004635:Emergency Medicine D005260:Female D019983:Guideline Adherence D006801:Humans D008297:Male D008485:Medical Audit D008875:Middle Aged D010102:Oxygen Inhalation Therapy D017410:Practice Guidelines as Topic D010818:Practice Patterns, Physicians' D017009:Professional Autonomy D017749:Total Quality Management D006113:United Kingdom
guidelines audit PDSA patient safety quality of care