An audit of oxygen supplementation in a large tertiary hospital–we should treat oxygen as any other drug

Objectives: To examine the current state of practice of oxygen (O2) supplementation in adults hospitalized in a tertiary hospital admitted to medical-surgical floors. Methods: We recorded: the proportion of patients on O2; their peripheral O2 saturation (SpO2); if the SpO2 was within, above, or below the target range; if patients had an order for O2 supplementation and a target SpO2 range. Results: Among 811 hospitalized patients, 153 (19%) were on supplemental O2. Forty-nine percent were in the recommended range, 55% above, and 1% below. All patients with COPD on O2 supplementation had a SpO2 of more than 92% exposing them to the risk of hypercarbia. Only 43% of patients on oxygen had an associated order and only 52% of patients with an O2 order had an order for a goal SpO2 range. Conclusions: Our results demonstrate widespread hyperoxia among hospitalized patients and that oxygen, a very common therapy, is being administered frequently without any written order. These findings highlight the opportunity to implement safe prescribing measures for O2, similar to other prescribed medications.