KSS Oxygen Wristband Project
A new initiative across Kent, Surrey and Sussex aims to increase correct oxygen prescribing and thereby reduce avoidable deaths as a result of incorrect use of oxygen.
Medical oxygen is a drug which, although life prolonging or enhancing when used appropriately, without a correct prescription or with inappropriate provision, carries a potentially fatal risk.
Today, oxygen should be prescribed to a target oxygen saturation range to maximise benefit and avoid possible harm. Incorrect use of oxygen by over-oxygenation (hyperoxia) can cause avoidable deaths in those at risk of hypercapnic respiratory failure, for example those with Chronic Obstructive Pulmonary Disease (COPD) or a progressive neuromuscular condition such as Motor Neurone Disease.
It is also linked to increased risk of death in stroke, ICU patients and survivors of cardiac arrest. Sometimes, however, a patient with other chronic respiratory conditions, such as asthma or pulmonary fibrosis, may inadvertently be given too little, because of a misplaced fear of the above.
The KSS Oxygen Wristband project has been launched to improve the safety of care for patients at risk of oxygen toxicity as a result of an incorrect target oxygen saturation. Community and Acute respiratory teams will categorise patients into one of three groups, and give them a colour-coded band which highlights their personal needs.
The initiative's launch coincides with changes to the National Early Warning Score 2 (NEWS2) system, which all Trusts will need to have implemented by March 2019. A key part of NEWS2 is the correct scoring of recommended oxygen saturation in patients at risk of hypercapnic respiratory failure.
The Oxygen wristbands offer a simple, effective solution for hospitals as they implement NEWS2 to ensure patients are put on the correct scale, potentially reducing harm and ensuring deterioration isn't missed.
Commenting on the initiative, Julia Bott, Consultant Physiotherapist, Clinical Co-lead and Oxygen Clinical Lead, KSS Respiratory Programme, said:
"The British Thoracic Society audit has shown that current oxygen prescribing and monitoring are suboptimal. The beauty of the oxygen wristband system is that it acts as a simple, visual alert to everyone involved in a patient's care.
"We've had great support for the project, from across acute and community respiratory services, and it's especially rewarding to have had the South East Coast Ambulance Service (SECAmb) involved in its roll-out, as crews will be made aware of the significance of a patient wearing an oxygen wristband."
The KSS Oxygen Saturation Wristband Project is based on a successful pilot study carried out at Ashford & St Peter's Hospital NHSFT and a trial in the East Midlands, which showed:
- Improved prescription of target saturations from 85% in 2012 to 95% in 2013, with 86% of patients within the target range, compared to 78% in 2012
- 81% of patients with wristbands felt 'reassured'about appropriate use of oxygen
- 87% of patients found the wristbands comfortable with 71% intending to continue wristband wear at home
- Relatives felt more aware of the use of oxygen and 92% of relatives felt more reassured about the care the patient was receiving.
Find out more: www.kssahsn.net/respiratory