Introduction: Oxygen is a therapeutic agent that requires a formal prescription. It is frequently administered to paediatric patients in clinical settings. However, observations indicate inconsistencies in prescribing practices, documentation, and adherence to established standard protocols. Methodology: The study employed a prospective before-and-after observational design, comparing data collected prior to and following the implementation of quality improvement (QI) interventions. A baseline prospective audit was conducted in June 2025. Baseline data were obtained through a review of 20 randomly selected paediatric patients admitted to thepaediatric ward who were receiving oxygen therapy . The project was conducted in three sequential phases: (1) formation of the Quality Improvement (QI) team and baseline data collection; (2) root cause analysis to identify gaps in prescribing practices; and (3) implementation of weekly Plan–Do–Study–Act (PDSA) cycles to address identified deficiencies and monitor improvement. Results: At baseline, a formal oxygen prescription was documented in 35% of cases. The prescribed flow rate, target oxygen saturation, and method of oxygen delivery were recorded in 40%, 45%, and 30% of patients, respectively . Additionally , 10% of patients receiving oxygen therapy did not have appropriate monitoring equipment connected. Following the implementation of quality improvement interventions, the rate of valid oxygen prescriptions increased substantially , reaching the recommended standard. Conclusion: Standardized prescription and monitoring charts improved documentation and increased valid oxygen prescriptions; ongoing audits are needed to sustain compliance.