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Oxygen Policy 2018 Oxygen Policy Document Control Title Oxygen Policy (Prescribing & Administration of Oxygen to Adults in Hospital Policy) Author Author’s job title Consultant Physician, Respiratory Medicine Clinical Development Facilitator Directorate Department Division of Medicine, A&E and Comm. Respiratory Hospitals Date Version Status Comment / Changes / Approval Issued June 0.1 Draft Draft presented to Medical Gases Committee. 2010 1.0 Jun Final Approved at Clinical Services Executive Committee 2010 (CSEC) in 14th June 2010. Approved by Drugs and Therapeutics Committee on July 1st 2010. 1.1 Dec Revision Minor amendments by Corporate Affairs to document 2010 control report, filename, header and footer, formatting for document map navigation. Hyperlinks to appendices and Trust procedural documents. Update to document control report. Amendments to section 8 and 24.1. 1.2 Dec Revision Appendix F added 2017 Re wording/re-ordering of most sections Minor alteration to section 5.2 Sepsis 6 added to section 5.2 Addition of endoscopy and ED to 5.8 1.3 June Revision Appendix G added 2018 Minor alteration to section 5.4 2.0 June Final Approved by all members of the Medical Gas Committee 2018 Main Contact Consultant Physician Tel: Direct Dial – 01271 349589 Level 5 Tel: Internal – Ext No. 3375 North Devon District Hospital Raleigh Park Barnstaple, EX31 4JB Lead Director Medical Director Superseded Documents Issue Date Review Date Review Cycle June 2018 June 2021 3 years Respiratory Team Oxygen Policy Page 1 of 39 Oxygen Policy Consulted with the following stakeholders: (list all) Medical Gas Committee Ward Manager MAU Consultant Physicians Quality Improvement Team Approval and Review Process Medical Gas Committee Local Archive Reference G:\LEARNING DEVELOPMENT Local Path Learning Development\Policies and procedures Filename Oxygen Policy v2.0 June 2018 Policy categories for Trust’s internal Tags for Trust’s internal website (Bob) website (Bob) Gases, Oxygen Respiratory Page 2 of 39 Respiratory Team Oxygen Policy Oxygen Policy CONTENTS Document Control ............................................................................................................... 1 1. Introduction .................................................................................................................. 4 2. Purpose ........................................................................................................................ 4 3. Definitions .................................................................................................................... 5 4. Responsibilities ........................................................................................................... 5 5. Oxygen Prescribing, Administration and Monitoring ................................................ 6 6. Cautions when Considering Oxygen Therapy ......................................................... 10 7. Transfer and Transportation of Patients Receiving Oxygen ................................... 11 8. Peri-operative and Immediately Post Operatively ................................................... 12 9. Nebulised Therapy / Medicines and Oxygen ............................................................ 12 10. Humidification ............................................................................................................ 12 11. Tracheotomy and Tracheostomy Patients ............................................................... 13 12. Duration of Treatment / Continuing Oxygen on Discharge ..................................... 13 13. Weaning off Oxygen .................................................................................................. 13 14. The Use and Storage of Oxygen Cylinders in the Hospital Setting ........................ 14 15. Training of Staff in the Safe Handling and Use of Oxygen Cylinders in Hospital .. 14 16. Training of Staff in the Administration of Oxygen ................................................... 15 17. Health and Safety ....................................................................................................... 15 18. The Development of the Policy ................................................................................. 15 19. Consultation, Approval and Ratification Process.................................................... 16 20. Review and Revision Arrangements including Document Control ........................ 16 21. Dissemination and Implementation .......................................................................... 17 22. Document Control including Archiving Arrangements ........................................... 18 23. Monitoring Compliance With and the Effectiveness of the Policy ......................... 18 24. Equality Impact Assessment ..................................................................................... 19 25. References ................................................................................................................. 20 26. Associated Documentation ....................................................................................... 21 Appendix A: Glossary of Terms ....................................................................................... 22 Appendix B: Oxygen Prescription Chart (example) ........................................................ 24 Appendix C: Guideline for Oxygen Administration in Acutely Unwell Patients ........... 25 Appendix D: Oxygen Alert Card ....................................................................................... 26 Appendix E: How long will an Oxygen Cylinder Last? ................................................... 27 Appendix F: The Storage & Transportation of Medical Gases within a Clinical Area .. 28 Appendix G: BOC Oxygen Cylinder Leaflet .................................................................... 37 Page 3 of 39 Respiratory Team Oxygen Policy Oxygen Policy 1. Introduction Hypoxaemia (reduced oxygen concentration of arterial blood), may cause serious or irreparable damage to vital organs and tissues. All patients who are hypoxaemic should receive oxygen therapy which is an essential element of appropriate management for a wide range of clinical conditions. However oxygen is a drug and therefore requires prescribing in all but emergency situations. Failure to administer oxygen appropriately can result in serious harm to the patient. Therefore, the safe implementation of oxygen therapy with appropriate monitoring is an integral component of the Healthcare Professional’s role. This document sets out Northern Devon Healthcare NHS Trust’s (NDHT) system for the administration of oxygen therapy in hospital. It provides a robust framework to ensure a consistent approach across the whole organisation. Implementation of this policy will ensure that: The Trust is compliant with National Guidance. Staff are given clear guidance about the administration of oxygen to enable them to achieve competency in this skill. This policy applies to all Trust clinical staff, including Midwifery Care Assistants and Health Care Assistants. 2. Purpose The purpose of this document is to define safe and standardised methods for the administration of oxygen in hospital. Implementation of this policy will ensure that: All patients who require supplementary oxygen therapy receive oxygen appropriate to their clinical condition and in line with national guidance (BTS Guideline; Thorax, 2008). Oxygen will be prescribed with a target oxygen saturation range which aims to achieve a specific outcome, rather than specifying the oxygen delivery method alone. Those who administer oxygen therapy will select the appropriate oxygen delivery device, monitor the patient and keep within the target oxygen saturation range. Risks related to the administration of oxygen are minimised The use of oxygen cylinders is minimised Pulse oximetry is available in all locations where oxygen is used Page 4 of 39 Respiratory Team Oxygen Policy Oxygen Policy A multidisciplinary group (Medical Gas Committee) will review oxygen related incidents and develop an oxygen administration training programme for clinical staff 3. Definitions 3.1 Nurse The use of the term Nurse in this policy refers to a registered nurse and is intended to include registered midwives. 3.2 Allied Health Care Professionals (AHPs) The use of the term AHP refers to Registered Physiotherapists, Registered Operating Department Practitioners and Registered Radiographers. 3.3 Support Workers The use of the term Support Workers refers to Midwifery Care Assistants, Health Care Assistants and Assistants to Allied Health Care Professionals. A glossary of additional terms is attached (see Appendix A). 4. Responsibilities 4.1 Role of Chief Executive The Chief Executive is responsible for: Ensuring that oxygen is prescribed and handled safely and that all staff involved in prescribing, administering and monitoring oxygen therapy are competent to do so. 4.2 Role of Trust Board The Trust Board is responsible for: Ensuring the implementation of this policy and that adequate resources are available to adhere to this policy guidance. The Drug and Therapeutics Committee is responsible for writing and regularly reviewing the Trust’s Medicines Policy and ensuring that it is up to date and its guidance implemented and audited. 4.3 Role of Prescribers The following staff can write prescriptions for the treatment of patients for whose care the Trust is responsible: Medical staff Non-medical prescribers Page 5 of 39 Respiratory Team Oxygen Policy Oxygen Policy 4.4
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