Improving Physicians’ Knowledge of Emergency Oxygen Therapy According to British Thoracic Society (BTS) Guidelines: A Closed-Loop Clinical Audit at Al-Managil Teaching Hospital
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Background Oxygen is an essential medication that should be prescribed and administered according to evidence-based guidelines to prevent both hypoxaemia and hyperoxia. Despite the availability of the British Thoracic Society (BTS) guideline, deficiencies in physicians' knowledge of oxygen therapy remain common and may compromise patient safety. This study aimed to assess changes in physicians' knowledge of evidence-based oxygen therapy following a structured educational intervention through a closed-loop clinical audit. Methods A prospective closed-loop clinical audit was conducted in the Internal Medicine Department of Al-Managil Teaching Hospital, Sudan. A total-coverage sampling strategy was employed, with 64 physicians participating in the baseline audit and 64 physicians participating in the re-audit. Knowledge was assessed using the same structured 15-item questionnaire derived from BTS oxygen therapy standards. Following the baseline assessment, a one-month multifaceted educational intervention was implemented. The second audit cycle was conducted using the same assessment tool, and physicians' knowledge before and after the intervention was compared. Results Knowledge improved across all fifteen assessed BTS standards following the educational intervention. The greatest improvement was observed in prescribing target oxygen saturation ranges for all admitted patients, which increased from 16 (25.0%) to 37 (57.8%) (χ² = 14.20, p < 0.001). Significant improvements were also observed in knowledge of oxygen humidification, pulse oximetry limitations, arterial blood gas interpretation, oxygen prescription documentation, and oxygen-induced hypercapnia. Overall, improvements ranged from 14.1 to 32.8 percentage points across the assessed standards. Despite these gains, only one standard exceeded the predefined performance target, indicating persistent knowledge gaps requiring further quality improvement. Conclusion A structured educational intervention was associated with significant improvements in departmental-level physicians' knowledge of evidence-based oxygen therapy. However, persistent deficiencies in several key domains highlight the need for continuous professional education, regular re-audit, and ongoing quality improvement initiatives to strengthen guideline adherence and promote safer oxygen prescribing practices.
Source: Cureus
Authors: Muram Mohamed Elmahadi Ali Salih, Ahmed G. N Suliman, Elkhatab Abdulrahman Mustafa Abdulrahman, Mohammed Omer Elbadawi Elhassan, Abdulrahman Abbas Yusuf Mohammed, Wassan Hassan Mohammed Elmowag, Hala Aamir Abdelraouf Ahmed, Duaa Hussain Mahmoud Mohamed, Ibrahim Abdelhafiz Ibrahim Ahmed, Amal Muawia Hussein Elamen, Salaheldin Mohamed Musa Hassan, Elsheikh Elamin Ahmed Elamin, Abdalmahmoud Asadig Kanan Ahmed, Abdelgalil Esameldin Omer Eldaw, Zainab Maqboul Hasan Mohamed, Dina Abdelnaser Ahmed Hussein, Aya Abdelfattah Kaml Hassan, Israa Tariq Balla Abdalla, Amal Egbal Ibrahim Eisa, Aisha Babiker Sobahy Mohamed, Mustafa Mohamed
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7214545888