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Expert Rev Respir Med ; 15(2): 277-284, 2021 02.
Article in English | MEDLINE | ID: covidwho-780250

ABSTRACT

BACKGROUND: Approximately 14% of UK hospital in-patients receive supplemental oxygen therapy, only 57% have valid prescriptions. Oxygen must be optimally prescribed to ensure maximal therapeutic response whilst minimizing adverse outcomes (including fatality). This study investigates prescription compliance. METHODS: All adults admitted to medical wards (18 February to 3 March 2020) were included. Analyses present proportions, descriptive statistics, and hypothesis testing. Ethical approval was unnecessary for this audit. RESULTS: Of the 636 patients admitted, 66 (10%) were receiving oxygen therapy. Ages ranged from 34 to 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.


Subject(s)
Clinical Audit , Documentation/statistics & numerical data , Hospitalization , Oxygen Inhalation Therapy/statistics & numerical data , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Community-Acquired Infections/therapy , Cross-Sectional Studies , Electronic Health Records , Female , Humans , Hypercapnia/etiology , Male , Middle Aged , Oxygen/blood , Pandemics , Pulmonary Disease, Chronic Obstructive/blood , Pulmonary Disease, Chronic Obstructive/therapy , Respiratory Insufficiency/therapy , United Kingdom/epidemiology
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