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Abstract
Background Guidance from the British Thoracic Society, National Patient Safety Agency and British National Formulary advises that oxygen should be treated like other drugs in terms of appropriate prescribing and monitoring. Whilst guidelines exist for the prescription of long-term oxygen [1], there is little available for its short-term use in children, similar to that for adults [2]
Aims and Methods Paediatric in-patient units in England were contacted to evaluate their practise regarding the use of oxygen based on the above guidelines. Information was obtained from the paediatric pharmacists and senior nursing staff in 68 units using a telephone questionnaire in 2010 and from paediatric pharmacists in 105 units using survey monkey in 2012.
Results Of the units contacted, 51.4% and 42% units respectively completed the survey in 2010 and 2012. The proportion of hospitals that reported they routinely prescribed oxygen increased from 11% to 42% between the two survey points. In 71% of units, prescribing was done on a drug chart. The oxygen was prescribed in percentage terms in 79% of units, and as flow rates in 81%. These were adjusted for the targeted saturations in 73%. Hospitals that have a protocol or guideline for prescribing oxygen have marginally improved from 40 to 43%.
Conclusion The results suggest that although there is an increase in the routine use of oxygen prescriptions, the majority of units neither have any guidelines for it nor use oxygen prescriptions. There is a need for the multidisciplinary development of guidelines and educational programmes to aid in the appropriate prescribing and delivery of oxygen in acute units.
References
NPSA Oxygen safety in hospitals | Rapid Response Report. http://www.nrls.npsa.nhs.uk/resources/?entryid45 = 62811 [Accessed 12th Dec, 2012]
Balfour-Lynn IM, Field DJ, Gringras P, et al BTS guidelines for home oxygen in children. Thorax 2009; 64 Suppl 2ii1–26
O’Driscoll B R, Howard L S, Davison A G. BTS guideline for emergency oxygen use in adult patients. Thorax 2008; 63: Supplement VI.