Improving Physicians' Knowledge of Emergency Oxygen Therapy According to British Thoracic Society (BTS) Guidelines: A Closed-Loop Clinical Audit at Al-Managil Teaching Hospital.
19 affiliations
- 1Medicine, National Ribat University, Khartoum, SDN.
- 2Internal Medicine, Al-Managil Teaching Hospital, Al-Managil, SDN.
- 3Internal Medicine, University of Medical Sciences and Technology, Khartoum, SDN.
- 4Emergency and Acute Medicine, Response Plus Medical Services, Abu Dhabi, ARE.
- 5Internal Medicine, Hamad Medical Corporation, Doha, QAT.
- 6Internal Medicine, Port Sudan Teaching Hospital, Port Sudan, SDN.
- 7Internal Medicine, University of Gezira, Wad Madani, SDN.
- 8Medicine, Al-Managil Teaching Hospital, Al-Managil, SDN.
- 9Internal Medicine, Dongola Specialized Hospital, Dongola, SDN.
- 10Medicine, Al-Managil Teaching Hospital, Managil, SDN.
- 11Surgery, Almanagil Teaching Hospital, Almanagil, SDN.
- 12Emergency, Al-Managil Teaching Hospital, Al-Managil, SDN.
- 13Internal Medicine and General Surgery, Al-Managil Teaching Hospital, Al-Managil, SDN.
- 14Emergency Medicine, Al-Managil Teaching Hospital, Al-Managil, SDN.
- 15Emergency Department, Al-Managil Teaching Hospital, Al-Managil, SDN.
- 16General Physician, Assiut University Hospital, Assiut, EGY.
- 17Emergency Medicine, University of Sharjah, Sharjah, ARE.
- 18Internal Medicine, Assiut University Hospital, Assiut, EGY.
- 19Internal Medicine, AL-Neelain University, Khartoum, SDN.
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.
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BibTeX
@article{salih2026improving,
title = {{Improving Physicians' Knowledge of Emergency Oxygen Therapy According to British Thoracic Society (BTS) Guidelines: A Closed-Loop Clinical Audit at Al-Managil Teaching Hospital.}},
author = {Muram Mohamed Elmahadi Ali Salih and Ahmed G N Suliman and Elkhatab Abdulrahman Mustafa Abdulrahman and Mohammed Omer Elbadawi Elhassan and Abdulrahman Abbas Yusuf Mohammed and Wassan Hassan Mohammed Elmowag and Hala Aamir Abdelraouf Ahmed and Duaa Hussain Mahmoud Mohamed and Ibrahim Abdelhafiz Ibrahim Ahmed and Amal Muawia Hussein Elamen and Salaheldin Mohamed Musa Hassan and Elsheikh Elamin Ahmed Elamin and Abdalmahmoud Asadig Kanan Ahmed and Abdelgalil Esameldin Omer Eldaw and Zainab Maqboul Hasan Mohamed and Dina Abdelnaser Ahmed Hussein and Aya Abdelfattah Kaml Hassan and Israa Tariq Balla Abdalla and Amal Egbal Ibrahim Eisa and Aisha Babiker Sobahy Mohamed and Mustafa Mohamed},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117028},
url = {https://europepmc.org/article/MED/42952537},
note = {CC BY},
}
RIS
TY - JOUR
TI - Improving Physicians' Knowledge of Emergency Oxygen Therapy According to British Thoracic Society (BTS) Guidelines: A Closed-Loop Clinical Audit at Al-Managil Teaching Hospital.
AU - Muram Mohamed Elmahadi Ali Salih
AU - Ahmed G N Suliman
AU - Elkhatab Abdulrahman Mustafa Abdulrahman
AU - Mohammed Omer Elbadawi Elhassan
AU - Abdulrahman Abbas Yusuf Mohammed
AU - Wassan Hassan Mohammed Elmowag
AU - Hala Aamir Abdelraouf Ahmed
AU - Duaa Hussain Mahmoud Mohamed
AU - Ibrahim Abdelhafiz Ibrahim Ahmed
AU - Amal Muawia Hussein Elamen
AU - Salaheldin Mohamed Musa Hassan
AU - Elsheikh Elamin Ahmed Elamin
AU - Abdalmahmoud Asadig Kanan Ahmed
AU - Abdelgalil Esameldin Omer Eldaw
AU - Zainab Maqboul Hasan Mohamed
AU - Dina Abdelnaser Ahmed Hussein
AU - Aya Abdelfattah Kaml Hassan
AU - Israa Tariq Balla Abdalla
AU - Amal Egbal Ibrahim Eisa
AU - Aisha Babiker Sobahy Mohamed
AU - Mustafa Mohamed
PY - 2026
DA - 2026/09/27
JO - Cureus
DO - 10.7759/cureus.117028
UR - https://europepmc.org/article/MED/42952537
AB - 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.
SN - 2168-8184
ER -