Kamran Anam, Chia Elisa, Tobin Claire
Acute Medical Unit, Royal Perth Hospital, Perth, Western Australia, Australia.
Department of Respiratory Medicine, Royal Perth Hospital, Perth, Western Australia, Australia.
Intern Med J. 2018 Feb;48(2):151-157. doi: 10.1111/imj.13612.
Oxygen is a widely used drug in the hospital setting. However, international audits suggest that oxygen administration practices are often not compliant with prescribed standards. This can place patients at risk and cause serious adverse events.
To analyse data related to recent practices of oxygen prescription and administration at Royal Perth Hospital (RPH), Western Australia. The results of this audit aim to guide further research on possible interventional studies implementing key solutions.
All patients who received care in the Acute Medical Unit at RPH between 1 September and 14 September 2015 were included in this audit. Patients who were given supplemental oxygen during their admission were selected for further review of records. Appropriate medically indicated target oxygen saturations for each patient were judged under consultation with a respiratory specialist.
A total of 65 patients received oxygen supplementation within the study period; 36 of these patients (55.4%) had target oxygen saturations prescribed by doctors, and 25% of the prescribed targets were judged to be inappropriate. In total, 49 patients (75.4%) were exposed to a potential risk from oxygen therapy due to prescription error and/or delivery error. A real risk was identified in 19 patients (29.2%) as they received oxygen at levels outside their appropriate medically indicated target range.
The current practices of oxygen prescription and administration within RPH are suboptimal. Patients are placed at risk of oxygen toxicity due to deviation from oxygen prescription guidelines.
氧气是医院环境中广泛使用的药物。然而，国际审计表明，氧气给药实践往往不符合规定标准。这可能使患者面临风险并导致严重不良事件。
分析与西澳大利亚皇家珀斯医院（RPH）近期氧气处方和给药实践相关的数据。本次审计结果旨在指导对实施关键解决方案的可能干预性研究的进一步研究。
本次审计纳入了2015年9月1日至9月14日期间在RPH急性医疗科接受治疗的所有患者。选择入院期间接受补充氧气的患者进行进一步的记录审查。在与呼吸专科医生协商后判断每位患者适当的医学指示目标氧饱和度。
在研究期间共有65名患者接受了氧气补充；其中36名患者（55.4%）有医生规定的目标氧饱和度，且25%的规定目标被判定为不适当。总共49名患者（75.4%）因处方错误和/或输送错误而面临氧气治疗的潜在风险。19名患者（29.2%）存在实际风险，因为他们接受的氧气水平超出了适当的医学指示目标范围。
RPH目前的氧气处方和给药实践并不理想。由于偏离氧气处方指南，患者面临氧中毒风险。
