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Introduction: Both hypoxia and hyperoxia can be harmful, so the correct prescription of oxygen therapy, and it9s use only when it is indicated, is important. Aim: To assess the effect of a hospital oxygen therapy guideline on oxygen prescription and administration at the Emergency Department (ED) and medical wards of Mater Dei Hospital Malta. Methods: Patients attending ED with conditions most likely to require oxygen therapy were recruited over 2 months in 2011, and again in 2015 after a hospital guideline on oxygen therapy was introduced. Data was collected on oxygen therapy. A p value of Results: 248 and 293 patients were recruited in 2011 and 2015 respectively. Oxygen therapy was indicated in 34.3% and 31.4% of patients respectively ( p =0.47). Oxygen saturation on air was not documented in 14.1% (2011) and 4.4% (2015) ( p In patients in whom oxygen therapy was indicated, correct documentation (delivery device and flow rate) of oxygen therapy administered at ED improved from 23.5% to 73.9% ( p p p =0.35). In the medical wards, correct oxygen therapy administration according to prescription improved from 7.1% to 48.9% ( p Oxygen therapy prescription in patients in whom oxygen therapy was not indicated improved from 56.8% to 27.1% ( p Conclusions: Oxygen saturation, oxygen therapy prescription and documentation at the ED and oxygen therapy administration in wards improved significantly after the hospital guideline was introduced.

Introduction: Both hyperoxia and hypoxia can be harmful, yet oxygen therapy prescription is often incomplete and with errors. Frequent long work shifts have been shown to increase medical errors (LK Barger et al. PLoS Med. 2006), but evidence of the effect of time, ie day vs night shifts, on oxygen prescription errors is scarce. Aim: To compare oxygen therapy administration and prescription during social and unsocial hours at the emergency department (ED), Mater Dei hospital, Malta, where doctors9 night shifts are usually between 20:00-08:00. Method: 277 patients hospitalised with medical conditions likely to require oxygen therapy were recruited over 2 months. Data was collected on oxygen therapy administered and prescribed at the ED. A p value Results: 138 patients presented between 8:00-19:59 (9Day9 group), 89 between 20:00-07:59 (9Night9 group). Oxygen therapy was indicated in 30.4% in Day, 38.2% in Night ( p =0.2). Oxygen saturation on air was not documented in 2.9% in Day, 6.7% in Night ( p =0.2), so it was not possible to determine whether oxygen was indicated or not. Where oxygen therapy was indicated: administration of oxygen therapy documented in 95.2% in Day, 94.1% in Night ( p =0.8), and the documentation was complete (delivery device and flow rate) in 73.8% in Day, 74.5% in Night ( p =0.9). In patients in whom oxygen therapy was indicated, it was prescribed in the admission plan in 85.7% in Day and 85.3% ( p =0.9) in Night. Prescription was complete in 76.2% in Day and 70.6% ( p =0.6) in Night. Conclusion: Although frequent long work shifts are associated with increased medical errors, the time of day did not influence oxygen prescription errors.