Knowledge and Associated Factors Regarding Oxygen Therapy among Emergency Department Clinicians at a Tertiary Referral Hospital in Ethiopia: A Cross-Sectional Study

Knowledge and Associated Factors Regarding Oxygen Therapy among Emergency Department Clinicians at a Tertiary Referral Hospital in Ethiopia: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Knowledge and Associated Factors Regarding Oxygen Therapy among Emergency Department Clinicians at a Tertiary Referral Hospital in Ethiopia: A Cross-Sectional Study Hulugrigesh Derib, Selamawit Zemene Tadesse, Chernet Tesfahun Mengistie, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9136633/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Oxygen therapy is life-saving, but inappropriate administration causes morbidity and mortality. Knowledge gaps among emergency clinicians in resource-limited, high-acuity settings may compromise patient safety. This study aimed to assess the level of knowledge and associated factors regarding oxygen therapy among clinicians at the adult Emergency Department of Tikur Anbessa Specialized Hospital, the largest tertiary referral center in Ethiopia. Methods: We conducted an institution-based cross-sectional study from June to November 2025. A stratified random sample of 108 clinicians (51 residents, 57 nurses) completed a validated, pretested 15-domain self-administered questionnaire. Satisfactory knowledge was defined as a score above or equal to 60 %, based on the modified Bloom's cut-off point. Bivariate and multivariable logistic regression identified independent predictors, with statistical significance established at p <= 0.05. Results: Overall, 60.2% (65/108) achieved satisfactory knowledge. Residents outperformed nurses (70.6% vs 50.9%). In adjusted analysis, prior formal training showed the strongest association with satisfactory knowledge (AOR 37.04, 95% CI 10.16–134.98, p=0.001). Availability of oxygen therapy guidelines in the working area increased odds nearly fivefold (AOR 4.94, 95% CI 1.57–15.59, p=0.006). Professional role (resident versus nurse) remained significant (AOR 3.65, 95% CI 1.16–11.43, p=0.027). Notable gaps included humidification indications (17.6% correct) and recognition of risks from prolonged low-dose oxygen (43.5% correct). Conclusion: Satisfactory knowledge regarding oxygen therapy was observed in only three out of five emergency department clinicians, with significant professional disparities. Training and guideline availability emerged as modifiable factors strongly associated with knowledge. Mandatory in-service simulation-based training programs and the implementation of accessible oxygen therapy protocols are required to optimize patient safety in this and similar high-acuity settings. Oxygen therapy knowledge emergency medicine residents nurses Ethiopia Figures Figure 1 Background Oxygen is among the most frequently administered drugs in emergency medicine, yet its therapeutic window is narrow; both hypoxemia and hyperoxia are associated with increased morbidity and mortality ( 1 , 2 ). Emergency departments represent particularly high-risk settings. Patients present with undifferentiated critical illness requiring rapid intervention amid time pressure, high patient volumes, and limited monitoring. ( 3 – 5 ). The World Health Organization (WHO) estimates that inadequate or improper oxygen therapy contributes to hundreds of thousands of deaths annually, with a disproportionate burden in low- and middle-income countries where oxygen systems remain fragmented ( 6 , 7 ). In low- and middle-income countries (LMICs), safe oxygen provision is undermined by structural and educational barriers ( 8 ). Many LMICs' health systems have struggled with a persistent deficit in medical oxygen supply, a gap that was dramatically widened by the COVID-19 pandemic, which exposed limitations in production, logistics, and bedside delivery infrastructure ( 9 ). The British Thoracic Society (BTS) guidelines emphasize that oxygen should be prescribed with specific targets, administered using appropriate devices, and monitored systematically, yet evidence from multiple African settings suggests substantial deviations from these standards ( 1 , 10 – 12 ). In Sub-Saharan Africa (SSA), constrained infrastructure combined with variable clinician expertise elevates the risk of oxygen-related harm ( 13 , 14 ). For example, a Nigerian study found that 85.5% of practitioners reported no formal oxygen training, while 95% identified equipment malfunction as a key barrier to correct use. In Ethiopia, although the national government launched the Medical Oxygen Roadmap in 2015 to scale up production through Pressure Swing Adsorption (PSA) plants, significant unmet needs persist, particularly at the primary and secondary levels of care ( 15 ). In settings like this, where oxygen concentrators and cylinder supplies remain limited, the safe and effective use of available oxygen depends critically on clinician knowledge ( 11 , 16 ). Even when oxygen is available, its administration is frequently suboptimal due to gaps in knowledge and practice ( 10 ). Evidence suggests that many clinicians lack a detailed understanding of the pharmacological properties of oxygen, the appropriate selection of delivery devices, and the necessary safety precautions for monitoring and titration( 17 ). In Ethiopia, the pooled prevalence of good knowledge regarding oxygen therapy among HCPs has been estimated at only 52.13%, with studies showing that many professionals are unaware of the clinical signs of oxygen toxicity or the specific target saturation ranges recommended by international guidelines ( 11 ). These knowledge gaps are associated with adverse patient outcomes, including inappropriate dosing, prolonged hospital stays, and increased morbidity and mortality ( 18 ). Tikur Anbessa Specialized Hospital (TASH) serves as the leading tertiary referral and teaching institution in Ethiopia, providing complex emergency and critical care services to a high volume of patients from across the country. The adult ED at TASH operates as a high-pressure environment where residents and nurses must make rapid decisions regarding the initiation and titration of oxygen therapy. Residents, as primary prescribers, and nurses, as frontline administrators, play pivotal roles in the oxygen stewardship process ( 19 ). However, the specific knowledge levels and factors influencing competency in this setting have not been comprehensively evaluated in the post-pandemic era. In resource-limited settings like Ethiopia, improper oxygen use not only compromises patient safety but also leads to significant economic waste ( 10 ). Therefore, this study aimed to assess the level of knowledge and associated factors regarding oxygen therapy among residents and nurses working in the adult emergency department of TASH. Methods and Materials Study Design, Setting, and Period This institution-based cross-sectional study was conducted at the Adult Emergency Department of TASH in Addis Ababa, Ethiopia, over six months (June–November 2025). As the country's largest referral and teaching hospital, TASH provides 24-hour specialized emergency care via a multidisciplinary team. The department is equipped with 40 oxygen cylinders, 8 concentrators, and 8 pressure gauges to support therapy in high-acuity areas. Study Population and Eligibility Criteria The source population comprised all staff nurses and residents (from Internal Medicine, Surgery, Anesthesia, Family Medicine, or Emergency Medicine) assigned to the adult Emergency Department during the study period. Eligibility required active involvement in initiating, administering, or monitoring oxygen therapy. We excluded individuals on leave during data collection and nursing staff in purely administrative roles without direct patient care involving oxygen. Sample Size and Sampling Strategy The sample size was calculated using a single-population proportion formula, assuming a 95% confidence level (Z = 1.96), a 5% margin of error (d = 0.05), and an estimated prevalence of good oxygen therapy knowledge (p = 0.52) based on prior Ethiopian data. After applying a finite population correction for the source population (N ≈ 120) and adding a 10% non-response adjustment, the requirement was 101. The final target sample size was set at 108 participants, representing the maximum requirement derived from power calculations for key exposure variables (Table 1 ). Participants were selected using stratified random sampling, with the total sample (n = 108) allocated proportionally to two strata: nurses (n = 57) and resident physicians (n = 51). Within each stratum, simple random sampling was performed using up-to-date departmental rosters. Table 1 Sample size calculation based on associated factors Factors Proportion 1 Proportion 2 Unadjusted Sample size (no) n adjusted for finite population (N = 120) Final sample size after 10% non-respondent Years of work experience 0.627 0.504 502 97 108 Availability of guideline 0.632 0.502 486 97 108 Exposure Variables and Covariates The primary independent variables included socio-demographic and professional characteristics; age (24–30, 31–35, ≥ 36 years), sex (male/female), professional category (nurse versus resident), education (diploma/degree), and training level (for residents: 1st, 2nd, or 3rd year). Years of work experience were recorded and categorized (≤ 5 years or ≥ 6 years). Specialty areas (for residents) were noted as emergency and critical care medicine (ECCM) versus other specialties. Institutional factors: availability of guidelines, history of formal training on oxygen therapy, perceived adequacy of oxygen supply, and perceived impact of workload were also assessed. Outcome Measures The primary outcome of this study was "satisfactory knowledge" of oxygen therapy, evaluated through a criterion-referenced framework. We utilized the Modified Bloom’s Cut-off Point benchmark to determine professional proficiency. Knowledge was assessed using a validated 15-item structured tool covering critical dimensions: indications for use, delivery systems (device selection and flow rates), physiological targets (SpO2 thresholds), and safety protocols (toxicity risks and storage). Each correct response was assigned 1 point, while incorrect or "unsure" responses received 0 points, resulting in a total score range of 0–15. Based on the Modified Bloom's criteria, clinician scores were categorized into three tiers of competence: High/Good Knowledge: >= 80% (12–15 points) Moderate/Satisfactory Knowledge: 60–79% (9–11 points) Poor/Low Knowledge: < 60% (< 9 points) For the binary logistic regression analysis, "satisfactory knowledge" was operationally defined as a score greater than or equal to 60% (cumulative correct response rate), which represents the minimum baseline competence required for safe clinical practice in high-acuity settings. Data Collection Instruments and Procedures Data were collected in English using a pretested, self-administered questionnaire adapted from previously validated instruments. Participants completed the questionnaire electronically using a secure Google Forms platform. Content validity was confirmed by emergency medicine faculty. The tool was pretested on 10% of the sample (who were later excluded from the main analysis), and the reliability of the knowledge items was acceptable (Cronbach's alpha = 0.70). All subjects received information on the study’s purpose and provided written informed consent. Submissions were systematically screened for completeness and consistency prior to analysis. Statistical Analysis Data were entered and analyzed using SPSS version 25. Descriptive statistics were computed for all variables. Bivariate associations between each independent variable and the knowledge outcome were first assessed using chi-square tests or unadjusted logistic regression. Variables with a p-value < 0.20 were entered into a multivariable binary logistic regression model to adjust for potential confounders. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated to quantify associations between exposures and satisfactory knowledge. A two-sided p-value ≤ 0.05 was considered statistically significant. Model fit was checked using standard diagnostic tests. Ethical Considerations Ethical approval for the study was obtained from the Research Committee of the Department of Emergency and Critical Care Medicine at Addis Ababa University, following a full protocol review (Approval Date: August 27, 2025). Permission to conduct the study was obtained from the hospital administration. Written informed consent was obtained from each participant. Participation was voluntary, and participants were assured that they could withdraw at any time without consequences. Confidentiality was maintained throughout: questionnaires were de-identified with unique codes, and personal identifiers were neither recorded nor reported. All data were stored in password-protected files accessible only to the research team. Results Socio-demographic and Professional Profiles A total of 108 healthcare professionals participated, yielding a 100% response rate. The sample included 55 (50.9%) men and 53 (49.1%) women. Most participants (64, 59.3%) were aged 24-30 years; 33 (30.6%) were 31–35 years, and 11 (10.2%) were ≥36 years. By profession, 57 (52.8%) were nurses, and 51 (47.2%) were resident physicians. The majority (98, 90.7%) held a university degree; the remainder (10, 9.3%) had a diploma or master's qualification. Among residents, 37 (72.5%) were in the ECCM program, and the rest were in other specialties (such as surgery, anesthesiology, internal medicine, or family medicine). Of the residents, 16 (31.4%) were first-year, 20 (39.2%) second-year, and 15 (29.4%) third-year trainees. Most respondents (85, 78.7%) had ≤5 years of clinical experience, while 23 (21.3%) had ≥6 years. Only 49 (45.4%) reported that oxygen therapy guidelines were available in their department. Half of the participants (54, 50.0%) had received formal training on oxygen therapy. Adequacy of oxygen supply was reported as sufficient by 46 (42.6%) and insufficient by 62 (57.4%). Regarding workload, 97 (89.8%) perceived that a heavy workload negatively affected oxygen therapy provision, whereas 11 (10.2%) did not (Table 2). Table 2: Socio-demographic and professional characteristics of participants Variables Category Response N % Sex Male 55 50.9 Female 53 49.1 Age 24-30 years 64 59.3 31-35 years 33 30.6 >=36 years 11 10.2 Profession Nurse 57 52.8 Residents 51 47.2 Level of education Diploma or master's 10 9.3 Degree 98 90.7 Specialty ECCM 37 72.6 Others (surgery &anesthesia) 7 13.7 Others 2(IM &FM) 7 13.7 Work experience =6 years 23 21.3 Availability of guidelines on oxygen therapy at the ED No 59 54.6 Yes 49 45.4 Training on oxygen therapy No 54 50.0 Yes 54 50.0 Years of residency 1 st year 16 31.4 2 nd year 20 39.2 3 rd year 15 29.4 Adequacy of oxygen supply and delivery systems at the ED No 62 57.4 Yes 46 42.6 Workload effect on oxygen therapy No 11 10.2 yes 97 89.8 Knowledge of Oxygen Therapy The overall knowledge score among all participants had a mean of 71.9%. Using the predefined cutoff, 65 participants (60.19%) achieved satisfactory knowledge of oxygen therapy, and 43 (39.81%) were classified as having unsatisfactory knowledge (Figure 1). Overall knowledge levels were high for several domains: all participants (100%) correctly identified low-flow oxygen delivery devices, Almost all of the participants (99.1%) knew that oxygen cylinders should be stored upright and secured, 103 (95.4%) correctly identified the normal oxygen saturation range and complications of prolonged oxygen therapy, 93 (86.1%) recognized indications for oxygen therapy and methods to detect hypoxemia, and 92 (85.2%) knew the maximum recommended flow rate for nasal cannulae. However, substantial knowledge gaps were identified: only 19 (17.6%) correctly answered that humidification is not always necessary, 42 (38.9%) correctly identified FiO₂ levels for different delivery devices, 52 (48.1%) correctly identified parameters not requiring monitoring during oxygen therapy, and 47 (43.5%) understood that prolonged low-dose oxygen administration carries risks (Table 3). Question N % What is the normal oxygen saturation range in a healthy adult <70years old? 103 95.4 What is /are the indications of Oxygen therapy? 93 86.1 Hypoxemia can be detected by? 93 86.1 Which device is appropriate for delivering low-flow oxygen therapy? 108 100.0 Choose the correct answer about the oxygen therapy device and its FiO2 42 38.9 At what saturation level is oxygen typically indicated in an acutely ill patient? 64 59.3 What is the maximum recommended oxygen flow rate for a nasal cannula? 92 85.2 Which of the following is a complication of prolonged oxygen therapy? 103 95.4 What is the clinical sign of oxygen toxicity? 85 78.7 Which of the following is not monitored during oxygen therapy? 52 48.1 Humidification is always necessary when using oxygen therapy. 19 17.6 Oxygen cylinders should be stored upright and secured. 107 99.1 Oxygen therapy requires a physician's prescription. 89 82.4 Oxygen can be safely administered to the patient for a long time at low doses without any complications. 47 43.5 Oxygen can be safely administered to any patient without monitoring 91 84.3 Table 3: Knowledge questions and correct responses with frequency and percentage (N=108) Knowledge Scores by Profession When disaggregating the data by profession, residents demonstrated higher knowledge scores than nurses across several clinical domains. For instance, for the saturation threshold indicating oxygen therapy, 36 (56.2%) of residents versus 28 (43.8%) of nurses answered correctly. For FiO₂ delivery device knowledge, 23 (54.8%) of residents versus 19 (45.2%) of nurses responded correctly. However, nurses performed better on humidification requirements and cylinder safety. Overall, 36 (70.6%) of residents achieved satisfactory knowledge compared to 29 (50.9%) of nurses (Table 4) Question Profession Response N % What is the normal oxygen saturation range in a healthy adult <70years old? Nurse 53 51.5 Resident 50 48.5 What is /are the indications of Oxygen therapy? Nurse 46 49.5 Resident 47 51.5 Hypoxemia can be detected by? Nurse 50 48.5 Resident 43 46.2 Which device is appropriate for delivering low-flow oxygen therapy? Nurse 57 52.8 Resident 51 47.2 Choose the correct answer about the oxygen therapy device and its FiO2 Nurse 19 45.2 Resident 23 54.8 At what saturation level is oxygen typically indicated in an acutely ill patient? Nurse 28 43.8 Resident 36 56.2 What is the maximum recommended oxygen flow rate for a nasal cannula? Nurse 50 54.3 Resident 42 45.7 Which of the following is a complication of prolonged oxygen therapy? Nurse 54 52.4 Resident 49 47.6 What is the clinical sign of oxygen toxicity? Nurse 43 50.6 Resident 42 49.4 Which of the following is not monitored during oxygen therapy? Nurse 25 48.1 Resident 27 51.9 Humidification is always necessary when using oxygen therapy. Nurse 8 42.1 Resident 11 57.9 Oxygen cylinders should be stored upright and secured. Nurse 57 53.3 Resident 50 46.7 Oxygen therapy requires a physician's prescription. Nurse 44 49.4 Resident 45 50.6 Oxygen can be safely administered to the patient for a long time at a low dose without any complications. Nurse 22 46.8 Resident 25 53.2 Oxygen can be safely administered to any patient without monitoring Nurse 43 47.8 Resident 47 52.2 Table 4: Knowledge questions and correct responses stratified by profession Factors Associated with Knowledge Level Among residents, knowledge levels increased with training year: 10 (62.5%) of first-year, 14 (70.0%) of second-year, and 12 (80.0%) of third-year residents achieved satisfactory scores. Participants who received training on oxygen therapy demonstrated substantially higher satisfactory knowledge (49, 90.7%) compared to those without training (16, 29.6%) (Table 5). Variable Category Knowledge score Total Chi square P value Unsatisfactory N (%) Satisfactory N (%) Profession Nurses Residents 28(49.1) 15(29.4) 29(50.9) 36(70.6) 57 51 .029 Years of residency for residents only 1 st year 2 nd year 3 rd year 6(37.5) 6(30) 3(20) 10(62.5) 14(70) 12(80) 16 20 15 .147 Work experience 5 33(38.8) 10(43.5) 52(61.2) 13(56.5) 85 23 .431 Guideline availability on oxygen therapy in the current working emergency room no yes 31(52.5) 12(24.5) 28(47.5) 37(75.5) 59 49 .003 Have you trained on oxygen therapy/ administration? no yes 38(70.4) 5(9.3) 16(29.6) 49(90.7) 54 54 .001 Is there an adequate supply of oxygen and delivery systems in the emergency room no yes 22(35.5) 21(45.7) 40(64.5) 25(54.3) 62 46 .192 Table 5: Factors associated with knowledge level of health professionals working in the adult emergency department of TASH: Bivariate analysis (N=108) In bivariable analysis, profession, guideline availability, and training on oxygen therapy were associated with knowledge level at p ≤ 0.2 and were included in multivariable logistic regression. In multivariable analysis, all three factors remained significantly associated with satisfactory knowledge. Participants who received training on oxygen therapy were 37 times more likely to have satisfactory knowledge than those who did not (adjusted odds ratio [AOR] = 37.037; 95% confidence interval [CI]: 10.163–134.976; p = 0.001). Knowledge of the availability of oxygen therapy guidelines in the working area was associated with nearly five times higher odds of satisfactory knowledge (AOR = 4.943; 95% CI: 1.567–15.591; p = 0.006). Residents had approximately 3.6 times higher odds of satisfactory knowledge compared to nurses (AOR = 3.646; 95% CI: 1.163–11.431; p = 0.027) (Table 6). Years of work experience, adequacy of oxygen supply, and perceived workload effect were not significantly associated with knowledge level. Factor Variables Category Knowledge COR, 95%CI AOR, 95%CI P value Unsatisfactory N Satisfactory N Profession Nurse 28 29 1 0.027 Resident 15 36 2.317 3.646(1.163-11.431) Guideline’s availability No 31 28 1 0.006 Yes 12 37 3.413 4.943(1.567-15.591) Training on oxygen therapy No 38 16 1 0.001 Yes 5 49 23.275 37.037(10.163-134.976) Table 6: Factors associated with knowledge level of health professionals working in the adult emergency department of TASH: Multivariable logistic regression analysis (N=108) Discussion This study evaluated oxygen therapy knowledge among emergency department clinicians at Tikur Anbessa Specialized Hospital, Ethiopia's largest tertiary referral center, revealing that 60.19% of participants achieved satisfactory knowledge. This prevalence substantially exceeds the East African regional pooled estimate of 45% (95% CI: 38–52%) reported in a recent meta-analysis of 25 studies involving 4,433 healthcare providers ( 11 ). Our findings align with individual country data showing Uganda at 76% (the regional high) and Tanzania at 62.5%, while remaining considerably higher than reports from Egypt (6–18%) and Sudan (9.4% good, 47.2% moderate) ( 11 , 20 ). The relatively higher knowledge at TASH likely reflects its unique position as Ethiopia's premier teaching hospital, managing complex referral cases with concentrated academic resources. However, persistent knowledge gaps remain, presenting significant implications for patient safety in high-acuity settings. A significant professional disparity emerged, with residents achieving 3.6-fold higher odds of satisfactory knowledge compared to nurses (70.6% vs. 50.9%; AOR 3.65, 95% CI 1.16–11.43). This differential mirrors findings from other settings, where physicians demonstrated superior technical proficiency, while nurses exhibited stronger operational safety practices ( 21 , 22 ). The Australian and New Zealand ICU-ROX trial substudy similarly found that nurses were significantly less likely than physicians to access and apply research evidence regarding oxygen management, suggesting that dissemination strategies systematically overlook nursing staff ( 23 ). Given that nurses at TASH function as the frontline monitors and adjusters of oxygen therapy during critical patient surges in Ethiopia's highest-acuity setting, this quantified knowledge gap represents a significant patient safety concern. Formal training on oxygen therapy demonstrated the strongest association with knowledge (AOR 37.04, 95% CI 10.16–134.98), an effect size substantially larger than the pooled estimate from Ethiopian meta-analyses ( 10 ). This unprecedented magnitude at TASH suggests that in highly specialized, academically intense environments, formal training may act as a transformative catalyst, compensating for gaps in undergraduate curricula and unstructured bedside learning. The Indian National Oxygen Stewardship Programme also demonstrated that structured two-day training incorporating hands-on sessions, group discussions, and protocol dissemination produced significant improvements in device selection (68% to 90%, p = 0.014) and oxygen demand estimation (26% to 61.2%, p < 0.001) ( 24 ). Similarly, guideline availability in the workplace increased knowledge odds nearly fivefold (AOR 4.94, 95% CI 1.57–15.59) at TASH, consistent with the British Thoracic Society's emphasis that written protocols reduce inappropriate oxygen use from 37.2% to 8.6% when implemented with monitoring systems ( 1 ). However, the fact that 54.6% of TASH participants were unaware of existing guidelines reveals the significant gap between national policy development and bedside implementation ( 15 , 25 ). Specific knowledge deficits with direct patient safety implications were also identified. Only 17.6% of participants correctly recognized that humidification is not routinely required for low-flow oxygen (< 4 L/min), a misconception associated with unnecessary equipment use, increased infection risk from contaminated humidifiers, and wasted nursing time in resource-constrained settings ( 26 ). Furthermore, only 43.5% appreciated that prolonged low-dose oxygen administration carries risks, reflecting what has been termed "low-dose complacency" toward reactive oxygen species-mediated pulmonary and neurological damage ( 27 , 28 ). While 95.4% acknowledged general oxygen complications, the specific failure to recognize cumulative toxicity from seemingly "safe" low-dose therapy likely prevents appropriate downward titration, sustaining unnecessary hyperoxia that accelerates cylinder depletion and worsens systemic oxygen shortages ( 29 ). In settings like TASH, where 57.4% of clinicians report inadequate oxygen supply, this knowledge gap may contribute to a paradoxical cycle: fearing hypoxia, clinicians over-prescribe oxygen, which rapidly depletes scarce resources, ultimately increasing the frequency of critical supply failures ( 29 , 30 ). These findings suggest that educational interventions must emphasize not only indications for oxygen initiation but equally the indications for oxygen weaning, a competency that conserves resources while improving long-term outcomes. Certain limitations should be considered when interpreting the findings of this study. The cross-sectional design precludes causal inference. Self-administered questionnaires are susceptible to social desirability bias and measure theoretical knowledge rather than clinical bedside practice. Furthermore, high knowledge scores do not always translate into quality practice in resource-limited environments, where workloads and inadequate equipment force protocol deviations. As a single-center study in a tertiary capital hospital, these findings may not generalize to rural or primary Ethiopian facilities. Finally, the sample size (N = 108), while representative, may lack power for subtle associations. Future research should incorporate multi-center designs and prospective audits of actual clinical delivery to provide a more holistic view of oxygen therapy performance in Ethiopia. Conclusion The evaluation of oxygen therapy knowledge among residents and nurses at TASH reveals a clinician population that is moderately informed but hampered by critical gaps in technical understanding and systemic application. With approximately 60% of participants achieving satisfactory knowledge scores, the workforce at this leading Ethiopian facility demonstrates a foundational competency that exceeds national averages, yet falls short of the precision required for high-stakes emergency medicine. In conclusion, optimizing oxygen therapy in the Ethiopian emergency department requires a transition from viewing oxygen as a generic commodity to a potent pharmacological agent with specific dosing, monitoring, and weaning requirements. By integrating formal training, disseminating bedside guidelines, and addressing systemic barriers such as workload and supply inconsistencies, TASH and similar institutions can significantly enhance patient safety, reduce resource wastage, and ultimately improve the survival rates of critically ill patients in the region. Abbreviations AOR Adjusted Odds Ratio ARDS Acute Respiratory Distress Syndrome BTS British Thoracic Society CI Confidence Interval COR Crude Odds Ratio ECCM Emergency and Critical Care Medicine ED Emergency Department FiO₂ Fraction of Inspired Oxygen HCP Healthcare Professional ICU Intensive Care Unit LMIC Low- and Middle-Income Country PSA Pressure Swing Adsorption ROS Reactive Oxygen Species SaO₂ Arterial Oxygen Saturation SpO₂ Peripheral Capillary Oxygen Saturation TASH Tikur Anbessa Specialized Hospital WHO World Health Organization L/min Liters per minute mmHg Millimeters of mercury PaO₂ Partial Pressure of Arterial Oxygen Declarations Ethical Approval and Consent to Participate: The study protocol was reviewed and approved by the Emergency and Critical Care Medicine Research Committee of Addis Ababa University on August 27, 2025. Participants received information about the study objectives and procedures, and written informed consent was obtained from all participants before data collection. Confidentiality was assured by assigning unique codes and using pseudonyms in transcripts. Participants were informed of their right to withdraw at any time without consequence. All procedures conformed to national and international ethical guidelines for research. Consent for Publication: Not Applicable Availability of Data and Materials: The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing Interests: None Funding: None Received Authors’ Contributions-: Hulugrigesh Derib : Conceptualization, Methodology, Investigation, Writing – Original Draft; Selamawit Z. Tadesse: Data Curation, Investigation, Writing – Original Draft, Visualization; Chernet T. Mengistie: Methodology, Investigation, Software, Writing – Review & Editing; Biruk T. Mengistie: Resources, Investigation, Writing – Review & Editing; Mikiyas G. Teferi: Validation, Software, Writing – Review & Editing; Bitania debalikew : Writing – Review & Editing, Mentorship; Ayenew A. Wolie: Conceptualization, Supervision, Writing – Review & Editing Acknowledgment: N/A Clinical Trial Number: Not Applicable This work has not been submitted for publication in any other journal, and all the references are acknowledged. References O’Driscoll BR, Howard LS, Earis J, Mak V. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax. 2017;72(Suppl 1):ii1-ii90. doi:10.1136/thoraxjnl-2016-209729 Siemieniuk RAC, Chu DK, Kim LHY, et al. Oxygen therapy for acutely ill medical patients: a clinical practice guideline. BMJ. Published online October 24, 2018:k4169. doi:10.1136/bmj.k4169 Obiefuna AG, Nwosu NI, Nlewedim IP, et al. Oxygen therapy use and barriers among doctors and nurses. 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Lancet Glob Health. 2025;13(3):e401-e402. doi:10.1016/S2214-109X(24)00529-1 Bizuneh YB, Getahun YA, Melesse DY, Chekol WB. Assessment of knowledge, attitude, and factors associated with oxygen therapy for critically ill patients among nurses at the University of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia, 2021. Ann Med Surg. 2022;80. doi:10.1016/j.amsu.2022.104334 Mian N, Sami A, Hussain S. Assessing Knowledge, Attitude, and Practice of Nurses Regarding Oxygen Therapy in the Critical Care Units at Tertiary Care Hospital Swat, Pakistan. Medtigo J Med. 2025;1(1):1-5. doi:10.63096/medtigo3092216 Eshetie Y, Abere Y, Belay BM, et al. Oxygen administration practice and associated factors among nurses in Ethiopia: A systematic review and meta-analysis. Int J Afr Nurs Sci. 2026;24:100970. doi:10.1016/j.ijans.2025.100970 Awad MSA, Mohamednour MFA, Rafat FA, et al. An exploration of healthcare professionals’ knowledge and perceived barriers about acute oxygen therapy: a survey in a tertiary care hospital, Sudan. BMC Med Educ. 2024;24(1):1551. doi:10.1186/s12909-024-06533-5 Desalu OO, Ojuawo OB, Adeoti AO, et al. Doctors’ and Nurses’ Knowledge and Perceived Barriers Regarding Acute Oxygen Therapy in a Tertiary Care Hospital in Nigeria. Adv Med Educ Pract. 2022;Volume 13:1535-1545. doi:10.2147/AMEP.S378533 Bollucuoglu K, Kucukosman G, Altuncu S, Ayoglu H. Training and Knowledge Status of Doctors and Nurses on Oxygen Therapy in a Level Three Hospital-Survey Study. J Anesthesiol Reanim Spec Soc. 2024;32(4):206-218. doi:10.54875/jarss.2024.46548 Mackle DM, Nelson K, Beasley RW, Eathorne A, Young PJ. The Influence of Participation in an Intensive Care Trial on Health Practitioners’ Knowledge of the Results-A Self‐Reported Survey. J Adv Nurs. 2025;81(11):7480-7488. doi:10.1111/jan.16641 Oza V, Kanabar B, Parmar V, Piparva K, Patel D, Chauhan J. Impact of Oxygen Stewardship Training on Knowledge and Practice for Oxygen Administration Among Healthcare Professionals Working in the Rajkot District. Cureus. Published online May 15, 2025. doi:10.7759/cureus.84152 Federal Ministry of Health (Ethiopia). Ethiopian Medical Oxygen Roadmap II (2022–2027). Federal Ministry of Health; 2023 Belete AB, Kristinawati B. Medical Oxygen Service Delivery and Utilization in Ethiopian Healthcare Facilities: Assessment of hospitals in Ethiopia. J Ber Ilmu Keperawatan. 2025;18(1):69-76. doi:10.23917/bik.v18i1.8351 Dean JB, Mulkey DK, Henderson RA, Potter SJ, Putnam RW. Hyperoxia, reactive oxygen species, and hyperventilation: oxygen sensitivity of brain stem neurons. J Appl Physiol. 2004;96(2):784-791. doi:10.1152/japplphysiol.00892.2003 Lius EE, Syafaah I. Hyperoxia in the management of respiratory failure: A literature review. Ann Med Surg. 2022;81. doi:10.1016/j.amsu.2022.104393 Coloretti I, Tosi M, Biagioni E, Girardis M. Oxygen: a powerful drug to handle with care. J Thorac Dis. 2019;11(S3):S226-S229. doi:10.21037/jtd.2019.01.84 Abhilash K, Acharya H, Dua J, Kumar S, Selvaraj B, Priya G. Impact of oxygen therapy algorithm on oxygen usage in the emergency department. J Postgrad Med. 2020;66(3):128-132. doi:10.4103/jpgm.JPGM_637_19 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9136633","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":625252156,"identity":"51fecc73-bff3-4ca0-b8ec-6fac09361ea4","order_by":0,"name":"Hulugrigesh Derib","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Hulugrigesh","middleName":"","lastName":"Derib","suffix":""},{"id":625252158,"identity":"60ba1e55-2ca4-4772-8623-382280e353cd","order_by":1,"name":"Selamawit Zemene Tadesse","email":"data:image/png;base64,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","orcid":"","institution":"Addis Ababa University","correspondingAuthor":true,"prefix":"","firstName":"Selamawit","middleName":"Zemene","lastName":"Tadesse","suffix":""},{"id":625252159,"identity":"29971267-e908-4f93-ad2c-0081398426ff","order_by":2,"name":"Chernet Tesfahun Mengistie","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Chernet","middleName":"Tesfahun","lastName":"Mengistie","suffix":""},{"id":625252162,"identity":"8b399e7a-f46a-41d9-9405-af65da0f7eec","order_by":3,"name":"Biruk Tesfahun Mengistie","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Biruk","middleName":"Tesfahun","lastName":"Mengistie","suffix":""},{"id":625252164,"identity":"0c4ad57d-eb88-4bf7-b94c-b91a204365c3","order_by":4,"name":"Mikiyas Gifawosen Teferi","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Mikiyas","middleName":"Gifawosen","lastName":"Teferi","suffix":""},{"id":625252165,"identity":"4b3d0ac0-1e0a-49e4-a10b-83c82ee09be0","order_by":5,"name":"Bitania debalikew","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Bitania","middleName":"","lastName":"debalikew","suffix":""},{"id":625252167,"identity":"4881f40b-2e7a-40c4-9d00-3c41aa36733a","order_by":6,"name":"Ayenew Amare Wolie","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Ayenew","middleName":"Amare","lastName":"Wolie","suffix":""}],"badges":[],"createdAt":"2026-03-16 10:38:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9136633/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9136633/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107619167,"identity":"f5a8c1de-4f64-439e-9c8f-6a06f18834af","added_by":"auto","created_at":"2026-04-23 09:27:30","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":26527,"visible":true,"origin":"","legend":"\u003cp\u003eOverall knowledge score among participants\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9136633/v1/8245af7605706819a3f44636.png"},{"id":108414845,"identity":"2e02723e-1188-42b1-a538-0111d16156a2","added_by":"auto","created_at":"2026-05-04 11:10:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":507125,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9136633/v1/400ff2a6-7c4f-4aa8-add5-9f926958cc87.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge and Associated Factors Regarding Oxygen Therapy among Emergency Department Clinicians at a Tertiary Referral Hospital in Ethiopia: A Cross-Sectional Study","fulltext":[{"header":"Background","content":"\u003cp\u003eOxygen is among the most frequently administered drugs in emergency medicine, yet its therapeutic window is narrow; both hypoxemia and hyperoxia are associated with increased morbidity and mortality (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Emergency departments represent particularly high-risk settings. Patients present with undifferentiated critical illness requiring rapid intervention amid time pressure, high patient volumes, and limited monitoring. (\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The World Health Organization (WHO) estimates that inadequate or improper oxygen therapy contributes to hundreds of thousands of deaths annually, with a disproportionate burden in low- and middle-income countries where oxygen systems remain fragmented (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn low- and middle-income countries (LMICs), safe oxygen provision is undermined by structural and educational barriers (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Many LMICs' health systems have struggled with a persistent deficit in medical oxygen supply, a gap that was dramatically widened by the COVID-19 pandemic, which exposed limitations in production, logistics, and bedside delivery infrastructure (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe British Thoracic Society (BTS) guidelines emphasize that oxygen should be prescribed with specific targets, administered using appropriate devices, and monitored systematically, yet evidence from multiple African settings suggests substantial deviations from these standards (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In Sub-Saharan Africa (SSA), constrained infrastructure combined with variable clinician expertise elevates the risk of oxygen-related harm (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). For example, a Nigerian study found that 85.5% of practitioners reported no formal oxygen training, while 95% identified equipment malfunction as a key barrier to correct use.\u003c/p\u003e \u003cp\u003eIn Ethiopia, although the national government launched the Medical Oxygen Roadmap in 2015 to scale up production through Pressure Swing Adsorption (PSA) plants, significant unmet needs persist, particularly at the primary and secondary levels of care (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). In settings like this, where oxygen concentrators and cylinder supplies remain limited, the safe and effective use of available oxygen depends critically on clinician knowledge (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Even when oxygen is available, its administration is frequently suboptimal due to gaps in knowledge and practice (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Evidence suggests that many clinicians lack a detailed understanding of the pharmacological properties of oxygen, the appropriate selection of delivery devices, and the necessary safety precautions for monitoring and titration(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). In Ethiopia, the pooled prevalence of good knowledge regarding oxygen therapy among HCPs has been estimated at only 52.13%, with studies showing that many professionals are unaware of the clinical signs of oxygen toxicity or the specific target saturation ranges recommended by international guidelines (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). These knowledge gaps are associated with adverse patient outcomes, including inappropriate dosing, prolonged hospital stays, and increased morbidity and mortality (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTikur Anbessa Specialized Hospital (TASH) serves as the leading tertiary referral and teaching institution in Ethiopia, providing complex emergency and critical care services to a high volume of patients from across the country. The adult ED at TASH operates as a high-pressure environment where residents and nurses must make rapid decisions regarding the initiation and titration of oxygen therapy. Residents, as primary prescribers, and nurses, as frontline administrators, play pivotal roles in the oxygen stewardship process (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). However, the specific knowledge levels and factors influencing competency in this setting have not been comprehensively evaluated in the post-pandemic era.\u003c/p\u003e \u003cp\u003eIn resource-limited settings like Ethiopia, improper oxygen use not only compromises patient safety but also leads to significant economic waste (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Therefore, this study aimed to assess the level of knowledge and associated factors regarding oxygen therapy among residents and nurses working in the adult emergency department of TASH.\u003c/p\u003e"},{"header":"Methods and Materials","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy Design, Setting, and Period\u003c/h2\u003e\n \u003cp\u003eThis institution-based cross-sectional study was conducted at the Adult Emergency Department of TASH in Addis Ababa, Ethiopia, over six months (June\u0026ndash;November 2025). As the country\u0026apos;s largest referral and teaching hospital, TASH provides 24-hour specialized emergency care via a multidisciplinary team. The department is equipped with 40 oxygen cylinders, 8 concentrators, and 8 pressure gauges to support therapy in high-acuity areas.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eStudy Population and Eligibility Criteria\u003c/h3\u003e\n\u003cp\u003eThe source population comprised all staff nurses and residents (from Internal Medicine, Surgery, Anesthesia, Family Medicine, or Emergency Medicine) assigned to the adult Emergency Department during the study period. Eligibility required active involvement in initiating, administering, or monitoring oxygen therapy. We excluded individuals on leave during data collection and nursing staff in purely administrative roles without direct patient care involving oxygen.\u003c/p\u003e\n\u003ch3\u003eSample Size and Sampling Strategy\u003c/h3\u003e\n\u003cp\u003eThe sample size was calculated using a single-population proportion formula, assuming a 95% confidence level (Z\u0026thinsp;=\u0026thinsp;1.96), a 5% margin of error (d\u0026thinsp;=\u0026thinsp;0.05), and an estimated prevalence of good oxygen therapy knowledge (p\u0026thinsp;=\u0026thinsp;0.52) based on prior Ethiopian data. After applying a finite population correction for the source population (N\u0026thinsp;\u0026asymp;\u0026thinsp;120) and adding a 10% non-response adjustment, the requirement was 101. The final target sample size was set at 108 participants, representing the maximum requirement derived from power calculations for key exposure variables (Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Participants were selected using stratified random sampling, with the total sample (n\u0026thinsp;=\u0026thinsp;108) allocated proportionally to two strata: nurses (n\u0026thinsp;=\u0026thinsp;57) and resident physicians (n\u0026thinsp;=\u0026thinsp;51). Within each stratum, simple random sampling was performed using up-to-date departmental rosters.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSample size calculation based on associated factors\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eFactors\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c2\"\u003e\n \u003cp\u003eProportion 1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c3\"\u003e\n \u003cp\u003eProportion 2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c4\"\u003e\n \u003cp\u003eUnadjusted Sample size (no)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c5\"\u003e\n \u003cp\u003en adjusted for finite population (N\u0026thinsp;=\u0026thinsp;120)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colname=\"c6\"\u003e\n \u003cp\u003eFinal sample size after 10% non-respondent\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eYears of work experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e0.627\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e0.504\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e502\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colname=\"c1\"\u003e\n \u003cp\u003eAvailability of guideline\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\n \u003cp\u003e0.632\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\n \u003cp\u003e0.502\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\n \u003cp\u003e486\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003ch3\u003eExposure Variables and Covariates\u003c/h3\u003e\n\u003cp\u003eThe primary independent variables included socio-demographic and professional characteristics; age (24\u0026ndash;30, 31\u0026ndash;35, \u0026ge;\u0026thinsp;36 years), sex (male/female), professional category (nurse versus resident), education (diploma/degree), and training level (for residents: 1st, 2nd, or 3rd year). Years of work experience were recorded and categorized (\u0026le;\u0026thinsp;5 years or \u0026ge;\u0026thinsp;6 years). Specialty areas (for residents) were noted as emergency and critical care medicine (ECCM) versus other specialties. Institutional factors: availability of guidelines, history of formal training on oxygen therapy, perceived adequacy of oxygen supply, and perceived impact of workload were also assessed.\u003c/p\u003e\n\u003ch3\u003eOutcome Measures\u003c/h3\u003e\n\u003cp\u003eThe primary outcome of this study was \u0026quot;satisfactory knowledge\u0026quot; of oxygen therapy, evaluated through a criterion-referenced framework. We utilized the Modified Bloom\u0026rsquo;s Cut-off Point benchmark to determine professional proficiency. Knowledge was assessed using a validated 15-item structured tool covering critical dimensions: indications for use, delivery systems (device selection and flow rates), physiological targets (SpO2 thresholds), and safety protocols (toxicity risks and storage). Each correct response was assigned 1 point, while incorrect or \u0026quot;unsure\u0026quot; responses received 0 points, resulting in a total score range of 0\u0026ndash;15. Based on the Modified Bloom\u0026apos;s criteria, clinician scores were categorized into three tiers of competence:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eHigh/Good Knowledge: \u0026gt;= 80% (12\u0026ndash;15 points)\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eModerate/Satisfactory Knowledge: 60\u0026ndash;79% (9\u0026ndash;11 points)\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003ePoor/Low Knowledge: \u0026lt; 60% (\u0026lt;\u0026thinsp;9 points)\u003c/p\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eFor the binary logistic regression analysis, \u0026quot;satisfactory knowledge\u0026quot; was operationally defined as a score greater than or equal to 60% (cumulative correct response rate), which represents the minimum baseline competence required for safe clinical practice in high-acuity settings.\u003c/p\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eData Collection Instruments and Procedures\u003c/h2\u003e\n \u003cp\u003eData were collected in English using a pretested, self-administered questionnaire adapted from previously validated instruments. Participants completed the questionnaire electronically using a secure Google Forms platform. Content validity was confirmed by emergency medicine faculty. The tool was pretested on 10% of the sample (who were later excluded from the main analysis), and the reliability of the knowledge items was acceptable (Cronbach\u0026apos;s alpha\u0026thinsp;=\u0026thinsp;0.70). All subjects received information on the study\u0026rsquo;s purpose and provided written informed consent. Submissions were systematically screened for completeness and consistency prior to analysis.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003ch2\u003eStatistical Analysis\u003c/h2\u003e\n \u003cp\u003eData were entered and analyzed using SPSS version 25. Descriptive statistics were computed for all variables. Bivariate associations between each independent variable and the knowledge outcome were first assessed using chi-square tests or unadjusted logistic regression. Variables with a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.20 were entered into a multivariable binary logistic regression model to adjust for potential confounders. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated to quantify associations between exposures and satisfactory knowledge. A two-sided p-value\u0026thinsp;\u0026le;\u0026thinsp;0.05 was considered statistically significant. Model fit was checked using standard diagnostic tests.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003eEthical approval for the study was obtained from the Research Committee of the Department of Emergency and Critical Care Medicine at Addis Ababa University, following a full protocol review (Approval Date: August 27, 2025). Permission to conduct the study was obtained from the hospital administration. Written informed consent was obtained from each participant. Participation was voluntary, and participants were assured that they could withdraw at any time without consequences. Confidentiality was maintained throughout: questionnaires were de-identified with unique codes, and personal identifiers were neither recorded nor reported. All data were stored in password-protected files accessible only to the research team.\u003c/p\u003e"},{"header":"Results","content":"\u003ch2\u003eSocio-demographic and Professional Profiles\u003c/h2\u003e\n\u003cp\u003eA total of 108 healthcare professionals participated, yielding a 100% response rate. The sample included 55 (50.9%) men and 53 (49.1%) women. Most participants (64, 59.3%) were aged 24-30 years; 33 (30.6%) were 31\u0026ndash;35 years, and 11 (10.2%) were \u0026ge;36 years. By profession, 57 (52.8%) were nurses, and 51 (47.2%) were resident physicians. The majority (98, 90.7%) held a university degree; the remainder (10, 9.3%) had a diploma or master\u0026apos;s qualification. Among residents, 37 (72.5%) were in the ECCM program, and the rest were in other specialties (such as surgery, anesthesiology, internal medicine, or family medicine). Of the residents, 16 (31.4%) were first-year, 20 (39.2%) second-year, and 15 (29.4%) third-year trainees. Most respondents (85, 78.7%) had \u0026le;5 years of clinical experience, while 23 (21.3%) had \u0026ge;6 years. Only 49 (45.4%) reported that oxygen therapy guidelines were available in their department. Half of the participants (54, 50.0%) had received formal training on oxygen therapy. Adequacy of oxygen supply was reported as sufficient by 46 (42.6%) and insufficient by 62 (57.4%). Regarding workload, 97 (89.8%) perceived that a heavy workload negatively affected oxygen therapy provision, whereas 11 (10.2%) did not (Table 2).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Table 2: Socio-demographic and professional characteristics of participants\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eVariables\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Category\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Response\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eN\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e%\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eSex\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e50.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eFemale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e49.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAge\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e24-30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e59.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e31-35 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e30.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026gt;=36 years\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eProfession\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNurse\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e52.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eResidents\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e47.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003eLevel of education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eDiploma or master\u0026apos;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eDegree\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e90.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003eSpecialty\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eECCM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e72.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eOthers (surgery \u0026amp;anesthesia)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e13.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eOthers 2(IM \u0026amp;FM)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e13.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003eWork experience\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026lt;=5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e78.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026gt;=6 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e21.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003eAvailability of guidelines on oxygen therapy at the ED\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e54.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e45.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003eTraining on oxygen therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eYears of residency\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e1\u003csup\u003est\u003c/sup\u003e\u0026nbsp; year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e31.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u0026nbsp;2\u003csup\u003end\u003c/sup\u003e\u0026nbsp; year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e39.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e3\u003csup\u003erd\u003c/sup\u003e\u0026nbsp; year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e29.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003eAdequacy of oxygen supply and delivery systems at the ED\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e57.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e42.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003eWorkload effect on oxygen therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eyes \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e89.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch2\u003eKnowledge of Oxygen Therapy\u003c/h2\u003e\n\u003cp\u003eThe overall knowledge score among all participants had a mean of 71.9%. Using the predefined cutoff, 65 participants (60.19%) achieved satisfactory knowledge of oxygen therapy, and 43 (39.81%) were classified as having unsatisfactory knowledge (Figure 1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOverall knowledge levels were high for several domains: all participants (100%) correctly identified low-flow oxygen delivery devices, Almost all of the participants (99.1%) knew that oxygen cylinders should be stored upright and secured, 103 (95.4%) correctly identified the normal oxygen saturation range and complications of prolonged oxygen therapy, 93 (86.1%) recognized indications for oxygen therapy and methods to detect hypoxemia, and 92 (85.2%) knew the maximum recommended flow rate for nasal cannulae. However, substantial knowledge gaps were identified: only 19 (17.6%) correctly answered that humidification is not always necessary, 42 (38.9%) correctly identified FiO₂ levels for different delivery devices, 52 (48.1%) correctly identified parameters not requiring monitoring during oxygen therapy, and 47 (43.5%) understood that prolonged low-dose oxygen administration carries risks (Table 3).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"614\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 481px;\"\u003e\n \u003cp\u003eQuestion\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003e\u0026nbsp;What is the normal oxygen saturation range in a healthy adult \u0026lt;70years old?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e95.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eWhat is /are the indications of Oxygen therapy?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e86.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003e\u0026nbsp;Hypoxemia can be detected by?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e86.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eWhich device is appropriate for delivering low-flow oxygen therapy?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eChoose the correct answer about the oxygen therapy device and its FiO2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e38.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eAt what saturation level is oxygen typically indicated in an acutely ill patient?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e59.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003e\u0026nbsp;What is the maximum recommended oxygen flow rate for a nasal cannula?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e85.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eWhich of the following is a complication of prolonged oxygen therapy?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e95.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eWhat is the clinical sign of oxygen toxicity?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e78.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eWhich of the following is not monitored during oxygen therapy?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e48.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eHumidification is always necessary when using oxygen therapy.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e17.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eOxygen cylinders should be stored upright and secured.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e99.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eOxygen therapy requires a physician\u0026apos;s prescription.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e82.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eOxygen can be safely administered to the patient for a long time at low doses without any complications.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e43.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 432px;\"\u003e\n \u003cp\u003eOxygen can be safely administered to any patient without monitoring\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e84.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 3: Knowledge questions and correct responses with frequency and percentage (N=108)\u003c/p\u003e\n\u003ch2\u003eKnowledge Scores by Profession\u003c/h2\u003e\n\u003cp\u003eWhen disaggregating the data by profession, residents demonstrated higher knowledge scores than nurses across several clinical domains. For instance, for the saturation threshold indicating oxygen therapy, 36 (56.2%) of residents versus 28 (43.8%) of nurses answered correctly. For FiO₂ delivery device knowledge, 23 (54.8%) of residents versus 19 (45.2%) of nurses responded correctly. However, nurses performed better on humidification requirements and cylinder safety. Overall, 36 (70.6%) of residents achieved satisfactory knowledge compared to 29 (50.9%) of nurses (Table 4)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"622\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"bottom\" style=\"width: 359px;\"\u003e\n \u003cp\u003eQuestion \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;Profession\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 168px;\"\u003e\n \u003cp\u003eResponse\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003e\u0026nbsp;What is the normal oxygen saturation range in a healthy adult \u0026lt;70years old?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e51.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e48.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003eWhat is /are the indications of Oxygen therapy?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e49.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e51.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003e\u0026nbsp;Hypoxemia can be detected by?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e48.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e46.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003eWhich device is appropriate for delivering low-flow oxygen therapy?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 57 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;52.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e47.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003e\u0026nbsp;Choose the correct answer about the oxygen therapy device and its FiO2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e45.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e54.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003eAt what saturation level is oxygen typically indicated in an acutely ill patient?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e43.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e56.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003e\u0026nbsp;What is the maximum recommended oxygen flow rate for a nasal cannula?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e54.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e45.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003eWhich of the following is a complication of prolonged oxygen therapy?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e52.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e47.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003eWhat is the clinical sign of oxygen toxicity?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e50.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e49.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003eWhich of the following is not monitored during oxygen therapy?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e48.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e51.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003eHumidification is always necessary when using oxygen therapy.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e42.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e57.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003eOxygen cylinders should be stored upright and secured.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e53.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e46.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003eOxygen therapy requires a physician\u0026apos;s prescription.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e49.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e50.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003e\u0026nbsp;Oxygen can be safely administered to the patient for a long time at a low dose without any complications.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e46.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e53.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 319px;\"\u003e\n \u003cp\u003eOxygen can be safely administered to any patient without monitoring\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e47.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e52.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Table 4: Knowledge questions and correct responses stratified by profession\u003c/p\u003e\n\u003ch2\u003eFactors Associated with Knowledge Level\u003c/h2\u003e\n\u003cp\u003eAmong residents, knowledge levels increased with training year: 10 (62.5%) of first-year, 14 (70.0%) of second-year, and 12 (80.0%) of third-year residents achieved satisfactory scores. Participants who received training on oxygen therapy demonstrated substantially higher satisfactory knowledge (49, 90.7%) compared to those without training (16, 29.6%) (Table 5).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 145px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCategory\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 249px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Knowledge score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eChi square\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003eUnsatisfactory\u003c/p\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eSatisfactory N (%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 145px;\"\u003e\n \u003cp\u003eProfession\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNurses\u003c/p\u003e\n \u003cp\u003eResidents\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e28(49.1)\u003c/p\u003e\n \u003cp\u003e15(29.4)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e29(50.9)\u003c/p\u003e\n \u003cp\u003e36(70.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e.029\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 145px;\"\u003e\n \u003cp\u003eYears of residency \u0026nbsp; for residents only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1\u003csup\u003est\u003c/sup\u003e year\u003c/p\u003e\n \u003cp\u003e2\u003csup\u003end\u003c/sup\u003e year\u003c/p\u003e\n \u003cp\u003e3\u003csup\u003erd\u003c/sup\u003e year\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e6(37.5)\u003c/p\u003e\n \u003cp\u003e6(30)\u003c/p\u003e\n \u003cp\u003e3(20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e10(62.5)\u003c/p\u003e\n \u003cp\u003e14(70)\u003c/p\u003e\n \u003cp\u003e12(80)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e.147\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 145px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eWork experience\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026lt;=5\u003c/p\u003e\n \u003cp\u003e\u0026gt;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e33(38.8)\u003c/p\u003e\n \u003cp\u003e10(43.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e52(61.2)\u003c/p\u003e\n \u003cp\u003e13(56.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e.431\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 145px;\"\u003e\n \u003cp\u003eGuideline availability on oxygen therapy in the current working emergency room\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003cp\u003eyes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e31(52.5)\u003c/p\u003e\n \u003cp\u003e12(24.5)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e28(47.5)\u003c/p\u003e\n \u003cp\u003e37(75.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 145px;\"\u003e\n \u003cp\u003eHave you trained on oxygen therapy/ administration?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e38(70.4)\u003c/p\u003e\n \u003cp\u003e5(9.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e16(29.6)\u003c/p\u003e\n \u003cp\u003e49(90.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 145px;\"\u003e\n \u003cp\u003eIs there an adequate supply of oxygen and delivery systems in the emergency room\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e22(35.5)\u003c/p\u003e\n \u003cp\u003e21(45.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e40(64.5)\u003c/p\u003e\n \u003cp\u003e25(54.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e.192\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 5: Factors associated with knowledge level of health professionals working in the adult emergency department of TASH: Bivariate analysis (N=108)\u003c/p\u003e\n\u003cp\u003eIn bivariable analysis, profession, guideline availability, and training on oxygen therapy were associated with knowledge level at p \u0026le; 0.2 and were included in multivariable logistic regression. In multivariable analysis, all three factors remained significantly associated with satisfactory knowledge. Participants who received training on oxygen therapy were 37 times more likely to have satisfactory knowledge than those who did not (adjusted odds ratio [AOR] = 37.037; 95% confidence interval [CI]: 10.163\u0026ndash;134.976; p = 0.001). Knowledge of the availability of oxygen therapy guidelines in the working area was associated with nearly five times higher odds of satisfactory knowledge (AOR = 4.943; 95% CI: 1.567\u0026ndash;15.591; p = 0.006). Residents had approximately 3.6 times higher odds of satisfactory knowledge compared to nurses (AOR = 3.646; 95% CI: 1.163\u0026ndash;11.431; p = 0.027) (Table 6). Years of work experience, adequacy of oxygen supply, and perceived workload effect were not significantly associated with knowledge level.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFactor Variables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003eKnowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCOR, 95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAOR, 95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eUnsatisfactory N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003eSatisfactory N\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eProfession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eNurse\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eResident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e2.317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e3.646(1.163-11.431)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eGuideline\u0026rsquo;s availability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e3.413\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e4.943(1.567-15.591)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eTraining on oxygen therapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e23.275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e37.037(10.163-134.976)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 6: \u0026nbsp;Factors associated with knowledge level of health professionals working in the adult emergency department of TASH: Multivariable logistic regression analysis (N=108)\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study evaluated oxygen therapy knowledge among emergency department clinicians at Tikur Anbessa Specialized Hospital, Ethiopia's largest tertiary referral center, revealing that 60.19% of participants achieved satisfactory knowledge. This prevalence substantially exceeds the East African regional pooled estimate of 45% (95% CI: 38\u0026ndash;52%) reported in a recent meta-analysis of 25 studies involving 4,433 healthcare providers (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Our findings align with individual country data showing Uganda at 76% (the regional high) and Tanzania at 62.5%, while remaining considerably higher than reports from Egypt (6\u0026ndash;18%) and Sudan (9.4% good, 47.2% moderate) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). The relatively higher knowledge at TASH likely reflects its unique position as Ethiopia's premier teaching hospital, managing complex referral cases with concentrated academic resources. However, persistent knowledge gaps remain, presenting significant implications for patient safety in high-acuity settings.\u003c/p\u003e \u003cp\u003eA significant professional disparity emerged, with residents achieving 3.6-fold higher odds of satisfactory knowledge compared to nurses (70.6% vs. 50.9%; AOR 3.65, 95% CI 1.16\u0026ndash;11.43). This differential mirrors findings from other settings, where physicians demonstrated superior technical proficiency, while nurses exhibited stronger operational safety practices (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). The Australian and New Zealand ICU-ROX trial substudy similarly found that nurses were significantly less likely than physicians to access and apply research evidence regarding oxygen management, suggesting that dissemination strategies systematically overlook nursing staff (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Given that nurses at TASH function as the frontline monitors and adjusters of oxygen therapy during critical patient surges in Ethiopia's highest-acuity setting, this quantified knowledge gap represents a significant patient safety concern.\u003c/p\u003e \u003cp\u003eFormal training on oxygen therapy demonstrated the strongest association with knowledge (AOR 37.04, 95% CI 10.16\u0026ndash;134.98), an effect size substantially larger than the pooled estimate from Ethiopian meta-analyses (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). This unprecedented magnitude at TASH suggests that in highly specialized, academically intense environments, formal training may act as a transformative catalyst, compensating for gaps in undergraduate curricula and unstructured bedside learning. The Indian National Oxygen Stewardship Programme also demonstrated that structured two-day training incorporating hands-on sessions, group discussions, and protocol dissemination produced significant improvements in device selection (68% to 90%, p\u0026thinsp;=\u0026thinsp;0.014) and oxygen demand estimation (26% to 61.2%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Similarly, guideline availability in the workplace increased knowledge odds nearly fivefold (AOR 4.94, 95% CI 1.57\u0026ndash;15.59) at TASH, consistent with the British Thoracic Society's emphasis that written protocols reduce inappropriate oxygen use from 37.2% to 8.6% when implemented with monitoring systems (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). However, the fact that 54.6% of TASH participants were unaware of existing guidelines reveals the significant gap between national policy development and bedside implementation (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSpecific knowledge deficits with direct patient safety implications were also identified. Only 17.6% of participants correctly recognized that humidification is not routinely required for low-flow oxygen (\u0026lt;\u0026thinsp;4 L/min), a misconception associated with unnecessary equipment use, increased infection risk from contaminated humidifiers, and wasted nursing time in resource-constrained settings (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Furthermore, only 43.5% appreciated that prolonged low-dose oxygen administration carries risks, reflecting what has been termed \"low-dose complacency\" toward reactive oxygen species-mediated pulmonary and neurological damage (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). While 95.4% acknowledged general oxygen complications, the specific failure to recognize cumulative toxicity from seemingly \"safe\" low-dose therapy likely prevents appropriate downward titration, sustaining unnecessary hyperoxia that accelerates cylinder depletion and worsens systemic oxygen shortages (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). In settings like TASH, where 57.4% of clinicians report inadequate oxygen supply, this knowledge gap may contribute to a paradoxical cycle: fearing hypoxia, clinicians over-prescribe oxygen, which rapidly depletes scarce resources, ultimately increasing the frequency of critical supply failures (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). These findings suggest that educational interventions must emphasize not only indications for oxygen initiation but equally the indications for oxygen weaning, a competency that conserves resources while improving long-term outcomes.\u003c/p\u003e \u003cp\u003eCertain limitations should be considered when interpreting the findings of this study. The cross-sectional design precludes causal inference. Self-administered questionnaires are susceptible to social desirability bias and measure theoretical knowledge rather than clinical bedside practice. Furthermore, high knowledge scores do not always translate into quality practice in resource-limited environments, where workloads and inadequate equipment force protocol deviations. As a single-center study in a tertiary capital hospital, these findings may not generalize to rural or primary Ethiopian facilities. Finally, the sample size (N\u0026thinsp;=\u0026thinsp;108), while representative, may lack power for subtle associations. Future research should incorporate multi-center designs and prospective audits of actual clinical delivery to provide a more holistic view of oxygen therapy performance in Ethiopia.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe evaluation of oxygen therapy knowledge among residents and nurses at TASH reveals a clinician population that is moderately informed but hampered by critical gaps in technical understanding and systemic application. With approximately 60% of participants achieving satisfactory knowledge scores, the workforce at this leading Ethiopian facility demonstrates a foundational competency that exceeds national averages, yet falls short of the precision required for high-stakes emergency medicine.\u003c/p\u003e \u003cp\u003eIn conclusion, optimizing oxygen therapy in the Ethiopian emergency department requires a transition from viewing oxygen as a generic commodity to a potent pharmacological agent with specific dosing, monitoring, and weaning requirements. By integrating formal training, disseminating bedside guidelines, and addressing systemic barriers such as workload and supply inconsistencies, TASH and similar institutions can significantly enhance patient safety, reduce resource wastage, and ultimately improve the survival rates of critically ill patients in the region.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAdjusted Odds Ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eARDS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAcute Respiratory Distress Syndrome\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBTS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBritish Thoracic Society\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eConfidence Interval\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCrude Odds Ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eECCM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEmergency and Critical Care Medicine\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eED\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEmergency Department\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFiO₂\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFraction of Inspired Oxygen\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHCP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHealthcare Professional\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eICU\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIntensive Care Unit\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLMIC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLow- and Middle-Income Country\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePSA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePressure Swing Adsorption\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eROS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eReactive Oxygen Species\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSaO₂\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eArterial Oxygen Saturation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSpO₂\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePeripheral Capillary Oxygen Saturation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTASH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTikur Anbessa Specialized Hospital\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eL/min\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLiters per minute\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003emmHg\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMillimeters of mercury\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePaO₂\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePartial Pressure of Arterial Oxygen\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval and Consent to Participate:\u003c/strong\u003e The study protocol was reviewed and approved by the Emergency and Critical Care Medicine Research Committee of Addis Ababa University on August 27, 2025. Participants received information about the study objectives and procedures, and written informed consent was obtained from all participants before data collection. Confidentiality was assured by assigning unique codes and using pseudonyms in transcripts. Participants were informed of their right to withdraw at any time without consequence. All procedures conformed to national and international ethical guidelines for research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication:\u0026nbsp;\u003c/strong\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials:\u0026nbsp;\u003c/strong\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u0026nbsp;\u003c/strong\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eNone Received\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ Contributions-:\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eHulugrigesh Derib\u003c/strong\u003e \u003cstrong\u003e:\u003c/strong\u003e Conceptualization, Methodology, Investigation, Writing – Original Draft; \u003cstrong\u003eSelamawit Z. Tadesse:\u003c/strong\u003e Data Curation, Investigation, Writing – Original Draft, Visualization; \u003cstrong\u003eChernet T. Mengistie:\u003c/strong\u003e Methodology, Investigation, Software, Writing – Review \u0026amp; Editing; \u003cstrong\u003eBiruk T. Mengistie:\u003c/strong\u003e Resources, Investigation, Writing – Review \u0026amp; Editing; \u003cstrong\u003eMikiyas G. Teferi:\u003c/strong\u003e Validation, Software, Writing – Review \u0026amp; Editing;\u0026nbsp;\u003cstrong\u003eBitania debalikew\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Writing – Review \u0026amp; Editing, Mentorship; \u003cstrong\u003eAyenew A. Wolie:\u003c/strong\u003e Conceptualization, Supervision, Writing – Review \u0026amp; Editing\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment:\u0026nbsp;\u003c/strong\u003eN/A\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Number:\u0026nbsp;\u003c/strong\u003e Not Applicable\u003c/p\u003e\n\u003cp\u003eThis work has not been submitted for publication in any other journal, and all the references are acknowledged.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eO\u0026rsquo;Driscoll BR, Howard LS, Earis J, Mak V. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax. 2017;72(Suppl 1):ii1-ii90. doi:10.1136/thoraxjnl-2016-209729\u003c/li\u003e\n \u003cli\u003eSiemieniuk RAC, Chu DK, Kim LHY, et al. Oxygen therapy for acutely ill medical patients: a clinical practice guideline. BMJ. Published online October 24, 2018:k4169. doi:10.1136/bmj.k4169\u003c/li\u003e\n \u003cli\u003eObiefuna AG, Nwosu NI, Nlewedim IP, et al. Oxygen therapy use and barriers among doctors and nurses. J Pan Afr Thorac Soc. 2026;6:39-46. doi:10.25259/JPATS_11_2025\u003c/li\u003e\n \u003cli\u003eHyde AS, Brown CE. Educational Recommendations for Medical Students Regarding Assessment and Management of Patients of Undifferentiated Criticality. Trauma Care. 2024;4(4):294-311. doi:10.3390/traumacare4040025\u003c/li\u003e\n \u003cli\u003eVisser M, Rossi D, Bouma HR, Ter Maaten JC. Exploiting the Features of Clinical Judgment to Improve Assessment of Disease Severity in the Emergency Department: An Acutelines Study. J Clin Med. 2024;13(5):1359. doi:10.3390/jcm13051359\u003c/li\u003e\n \u003cli\u003eWorld Health Organization, UNICEF. WHO-UNICEF Technical specifications and guidance for oxygen therapy devices. Geneva: World Health Organization; 2019. 163 p. (WHO Medical device technical series). ISBN: 9789241516914\u003c/li\u003e\n \u003cli\u003eGraham HR, Bakare AA, Ayede AI, et al. Oxygen systems to improve clinical care and outcomes for children and neonates: A stepped-wedge cluster-randomised trial in Nigeria. Greenwood B, ed. PLOS Med. 2019;16(11):e1002951. doi:10.1371/journal.pmed.1002951\u003c/li\u003e\n \u003cli\u003eRoss M, Wendel SK. Oxygen Inequity in the COVID-19 Pandemic and Beyond. Glob Health Sci Pract. 2023;11(1):e2200360. doi:10.9745/GHSP-D-22-00360\u003c/li\u003e\n \u003cli\u003eGraham HR, King C, Rahman AE, et al. Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security. Lancet Glob Health. 2025;13(3):e528-e584. doi:10.1016/S2214-109X(24)00496-0\u003c/li\u003e\n \u003cli\u003eAynalem ZB, Abera MN, Yazew BG, et al. Knowledge, attitude, practice and associated factors of oxygen therapy among health professionals in Ethiopia: A systematic review and meta-analysis. Ahmed SK, ed. PLOS ONE. 2024;19(9):e0309823. doi:10.1371/journal.pone.0309823\u003c/li\u003e\n \u003cli\u003eGeta Hardido T, Atinafu B, Israel E, Bolado GN, Elifios E. Healthcare providers\u0026rsquo; practice and knowledge towards oxygen therapy in East African countries: a systematic review and meta-analysis. BMC Health Serv Res. 2025;26(1):3. doi:10.1186/s12913-025-13797-0\u003c/li\u003e\n \u003cli\u003eL. W. KB, J. O, S. O, C. M, M. Z, I. N. Knowledge of Oxygen Therapy among Nurses in a Tertiary Hospital in Kenya: Implications for Patient Care and Training Needs. Afr J Health Nurs Midwifery. 2024;7(1):108-124. doi:10.52589/AJHNM-SGF3XZIT\u003c/li\u003e\n \u003cli\u003eBelle JM, Cohen HJ, Shindo N, et al. Influenza preparedness in low-resource settings: a look at oxygen delivery in 12 African countries. J Infect Dev Ctries. 2010;4(07):419-424. doi:10.3855/jidc.859\u003c/li\u003e\n \u003cli\u003eBradley BD, Light JD, Ebonyi AO, et al. Implementation and 8-year follow-up of an uninterrupted oxygen supply system in a hospital in The Gambia. Int J Tuberc Lung Dis. 2016;20(8):1130-1134. doi:10.5588/ijtld.15.0889\u003c/li\u003e\n \u003cli\u003eSmith V, Changoor A, Rummage S, et al. An Oxygen Supply Is Not Enough: A Qualitative Analysis of a Pressure Swing Adsorption Oxygen Plant Program in Ethiopian Hospitals. Glob Health Sci Pract. 2024;12(4):e2300515. doi:10.9745/GHSP-D-23-00515\u003c/li\u003e\n \u003cli\u003eFeyssa MD, Cherinet MM, Teko EB, Wasse AB. Enhancing medical oxygen security in Ethiopia: a model for global health. Lancet Glob Health. 2025;13(3):e401-e402. doi:10.1016/S2214-109X(24)00529-1\u003c/li\u003e\n \u003cli\u003eBizuneh YB, Getahun YA, Melesse DY, Chekol WB. Assessment of knowledge, attitude, and factors associated with oxygen therapy for critically ill patients among nurses at the University of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia, 2021. Ann Med Surg. 2022;80. doi:10.1016/j.amsu.2022.104334\u003c/li\u003e\n \u003cli\u003eMian N, Sami A, Hussain S. Assessing Knowledge, Attitude, and Practice of Nurses Regarding Oxygen Therapy in the Critical Care Units at Tertiary Care Hospital Swat, Pakistan. Medtigo J Med. 2025;1(1):1-5. doi:10.63096/medtigo3092216\u003c/li\u003e\n \u003cli\u003eEshetie Y, Abere Y, Belay BM, et al. Oxygen administration practice and associated factors among nurses in Ethiopia: A systematic review and meta-analysis. Int J Afr Nurs Sci. 2026;24:100970. doi:10.1016/j.ijans.2025.100970\u003c/li\u003e\n \u003cli\u003eAwad MSA, Mohamednour MFA, Rafat FA, et al. An exploration of healthcare professionals\u0026rsquo; knowledge and perceived barriers about acute oxygen therapy: a survey in a tertiary care hospital, Sudan. BMC Med Educ. 2024;24(1):1551. doi:10.1186/s12909-024-06533-5\u003c/li\u003e\n \u003cli\u003eDesalu OO, Ojuawo OB, Adeoti AO, et al. Doctors\u0026rsquo; and Nurses\u0026rsquo; Knowledge and Perceived Barriers Regarding Acute Oxygen Therapy in a Tertiary Care Hospital in Nigeria. Adv Med Educ Pract. 2022;Volume 13:1535-1545. doi:10.2147/AMEP.S378533\u003c/li\u003e\n \u003cli\u003eBollucuoglu K, Kucukosman G, Altuncu S, Ayoglu H. Training and Knowledge Status of Doctors and Nurses on Oxygen Therapy in a Level Three Hospital-Survey Study. J Anesthesiol Reanim Spec Soc. 2024;32(4):206-218. doi:10.54875/jarss.2024.46548\u003c/li\u003e\n \u003cli\u003eMackle DM, Nelson K, Beasley RW, Eathorne A, Young PJ. The Influence of Participation in an Intensive Care Trial on Health Practitioners\u0026rsquo; Knowledge of the Results-A Self‐Reported Survey. J Adv Nurs. 2025;81(11):7480-7488. doi:10.1111/jan.16641\u003c/li\u003e\n \u003cli\u003eOza V, Kanabar B, Parmar V, Piparva K, Patel D, Chauhan J. Impact of Oxygen Stewardship Training on Knowledge and Practice for Oxygen Administration Among Healthcare Professionals Working in the Rajkot District. Cureus. Published online May 15, 2025. doi:10.7759/cureus.84152\u003c/li\u003e\n \u003cli\u003eFederal Ministry of Health (Ethiopia). Ethiopian Medical Oxygen Roadmap II (2022\u0026ndash;2027). Federal Ministry of Health; 2023\u003c/li\u003e\n \u003cli\u003eBelete AB, Kristinawati B. Medical Oxygen Service Delivery and Utilization in Ethiopian Healthcare Facilities: Assessment of hospitals in Ethiopia. J Ber Ilmu Keperawatan. 2025;18(1):69-76. doi:10.23917/bik.v18i1.8351\u003c/li\u003e\n \u003cli\u003eDean JB, Mulkey DK, Henderson RA, Potter SJ, Putnam RW. Hyperoxia, reactive oxygen species, and hyperventilation: oxygen sensitivity of brain stem neurons. J Appl Physiol. 2004;96(2):784-791. doi:10.1152/japplphysiol.00892.2003\u003c/li\u003e\n \u003cli\u003eLius EE, Syafaah I. Hyperoxia in the management of respiratory failure: A literature review. Ann Med Surg. 2022;81. doi:10.1016/j.amsu.2022.104393\u003c/li\u003e\n \u003cli\u003eColoretti I, Tosi M, Biagioni E, Girardis M. Oxygen: a powerful drug to handle with care. J Thorac Dis. 2019;11(S3):S226-S229. doi:10.21037/jtd.2019.01.84\u003c/li\u003e\n \u003cli\u003eAbhilash K, Acharya H, Dua J, Kumar S, Selvaraj B, Priya G. Impact of oxygen therapy algorithm on oxygen usage in the emergency department. J Postgrad Med. 2020;66(3):128-132. doi:10.4103/jpgm.JPGM_637_19\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Oxygen therapy, knowledge, emergency medicine, residents, nurses, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-9136633/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9136633/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Oxygen therapy is life-saving, but inappropriate administration causes morbidity and mortality. Knowledge gaps among emergency clinicians in resource-limited, high-acuity settings may compromise patient safety. This study aimed to assess the level of knowledge and associated factors regarding oxygen therapy among clinicians at the adult Emergency Department of Tikur Anbessa Specialized Hospital, the largest tertiary referral center in Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e We conducted an institution-based cross-sectional study from June to November 2025. A stratified random sample of 108 clinicians (51 residents, 57 nurses) completed a validated, pretested 15-domain self-administered questionnaire. Satisfactory knowledge was defined as a score above or equal to 60 %, based on the modified Bloom's cut-off point. Bivariate and multivariable logistic regression identified independent predictors, with statistical significance established at p \u0026lt;= 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003eOverall, 60.2% (65/108) achieved satisfactory knowledge. Residents outperformed nurses (70.6% vs 50.9%). In adjusted analysis, prior formal training showed the strongest association with satisfactory knowledge (AOR 37.04, 95% CI 10.16–134.98, p=0.001). Availability of oxygen therapy guidelines in the working area increased odds nearly fivefold (AOR 4.94, 95% CI 1.57–15.59, p=0.006). Professional role (resident versus nurse) remained significant (AOR 3.65, 95% CI 1.16–11.43, p=0.027). Notable gaps included humidification indications (17.6% correct) and recognition of risks from prolonged low-dose oxygen (43.5% correct).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eSatisfactory knowledge regarding oxygen therapy was observed in only three out of five emergency department clinicians, with significant professional disparities. Training and guideline availability emerged as modifiable factors strongly associated with knowledge. Mandatory in-service simulation-based training programs and the implementation of accessible oxygen therapy protocols are required to optimize patient safety in this and similar high-acuity settings.\u003c/p\u003e","manuscriptTitle":"Knowledge and Associated Factors Regarding Oxygen Therapy among Emergency Department Clinicians at a Tertiary Referral Hospital in Ethiopia: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-23 09:25:06","doi":"10.21203/rs.3.rs-9136633/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c1619abc-f6e5-4672-855d-9eb5b3bc18fc","owner":[],"postedDate":"April 23rd, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Rejected","date":"2026-05-04T10:59:14+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-04T07:26:34+00:00","index":65,"fulltext":""},{"type":"reviewerAgreed","content":"216280374120663211896880250179315099220","date":"2026-04-30T06:44:17+00:00","index":64,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-04T11:09:42+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-23 09:25:06","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9136633","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9136633","identity":"rs-9136633","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}