Doctor of Nursing Practice
Kerry A. Milner, DNSc, APRN, FNP-BC, EBP-C
Jeanie Haggan, RN, MHA, MS, CPHQ
Background and Significance: Oxygen is often administered in emergency departments (ED) in US without the nurses and other healthcare staff inputting orders for this medication. This gap in placing orders poses a risk to patient safety and poses a regulation issue.
Purpose: The goal of this quality improvement project is to increase the rate of orders placed for patients using oxygen in ED staff by 12% from March 1, 2023 to May 31, 2023.
Methods: The Model for Improvement guided this quality improvement project. Two PDSA cycles were completed.
Results: PDSA #1 Completed SWOT analysis and used information to inform education training that was developed with the ED safety manager. Training materials included posters, handouts, and pocket cards that had detailed instructions for placing oxygen orders. Staff (RN, MD, PA, APRN) were educated 1:1 during their shifts and reminders at the change of shift huddles. Ninety-five percent of staff were educated between March and May. Oxygen use and orders in were tracked using the ED oxygen safety dashboard. The baseline metric was 47.5% for February 2023 and after education rate was 48.8% March and 42.9%. PDSA #2 Additional 1:1 education and reminders in May 2023. Nurse manager reminded staff at meetings to place orders and sent reminders via emails to staff. Rate of oxygen orders increased to 73% for May and 64.6% for June.
Conclusion: Education and reminders worked to increase the oxygen orders placed. Ongoing reminders to staff were found to be needed to maintain the gains in oxygen orders. To sustain gains it is recommended that ED nurse educator and quality person continue to monitor the oxygen safety dashboard and give staff reminders.
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Wolfe, L. (2023). Oxygen therapy education to improve oxygen safety in the emergency department: A quality improvement project [Unpublished DNP project]. Sacred Heart University.