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Aims and Objectives This study was conducted to assess if doctors and nurses may be lacking in their understanding and application of oxygen therapy and if we can see the change by applying standard guidelines like those from British Thoracic society. Literature have shown that inconsistent and inappropriate oxygen therapy practices are associated with increased mortality and morbidity. The new aspect of the study was how internationally recognized guidelines can be applied to low middle income countries and the barriers and challenges in applications of the guidelines and how we can transform health practices in LMIC and bring uniformity.Method and Design This study is guided by the Plan–Do–Study–Act (PDSA) Cycle, a well-established model in quality improvement.Prospective interventional study design was used utilizing a pre-test/post-test approach.Plan: A baseline assessment identified gaps in knowledge, attitude, and practice (KAP) regarding oxygen therapy, informing the introduction of BTS guidelines and staff training.Do: Educational sessions were conducted to train doctors and nurses on oxygen therapy, focusing on BTS guideline principles, including indications, delivery methods, and target saturation monitoring.Study: Post-intervention KAP assessments evaluated the impact of training on clinical knowledge and practice.Act: Recommendations included ongoing training programs, policy updates, and regular audits to sustain improvementAbstract 3863 Figure 1Results and Conclusion Baseline assessments revealed substantial gaps: only 1.6% of participants had prior formal oxygen therapy training, and fewer than 8% reported using any guideline in practice.Post-training results demonstrated statistically and clinically significant improvements across all domains. Mean knowledge scores increased by over 20 percentage points (p < 0.001), attitudes shifted from variable or neutral to uniformly positive (effect size r = 0.83), and practice adherence to BTS standards improved by more than 70 points on a 200-point scale (p < 0.001). Gains were consistent across professional roles, confirming the intervention’s broad applicability and equity.