Ref	Hazards	Risks	People at risk	Current Control Measures
1.	Smoking	Fire Facial burns	Community Nursing Staff Patients and carers Patients	(1) Instruct patients, carers and visitors not to smoke in any part of the house where oxygen is used (2) Patient/carer to sign “smoking and oxygen” advice form (3) Arrange for removal of any oxygen equipment not in regular use (4) Fire breaks never to be removed from tubing supplied by oxygen provider (5) Ensure smoke detectors are fitted and in working order
2.	Exposure to naked flames from open/gas fires/candles and cooking appliances.	Explosion and fire	Community Nursing Staff Patients and carers	(1) Advise patient to maintain a safe distance from fires and naked flame appliances as instructed by oxygen provider (2) Oxygen must be positioned and stored as directed by oxygen provider
3.	Kinking or entrapment of tubing in/under furniture, doors, wheels	Restriction of or no Oxygen supply	Patient	(1) Check there are no kinks in the tubing (2) Check that the tubing is not trapped between furniture or trapped e.g. under bed wheels (3) Only tubing supplied by the oxygen provider is to be used on cylinders and concentrators (4) Encourage piped oxygen if there is excessive tubing
4.	Alcohol hand rubs/gels	Combustion	Community nursing staff Patients and carers	(1) Ensure hands are adequately dried after the use of alcohol gels.
5	Use of oil based emollients	Local burning of affected area	Patient	(1) Instruct patients (or carers) not to use oil based emollients on patients nostrils
6.	Patient/Carers not aware on how to obtain replacement cylinders	Running out of oxygen	Patient	(1) Ensure patient has information leaflet from company supplying oxygen (2) Check patient/carer has contact details on how to obtain/replace oxygen cylinder.
7.	Tubing	Trips and falls	Community Nursing Staff Patients and carers	(1) Advise patients and carers to check position of tubing daily to minimise risks of falls (2) Advise patients and carers to check position of tubing, particularly if patient using a walking frame etc (3) Current oxygen tubing must be of an appropriate length to meet the needs of the patient.
8.	Power supply cut off to concentrator	No oxygen supply	Patient	(1) Check patient has a back up cylinder (2) Educate patient not to use back up cylinder unless there is power failure to concentrator
9	Unauthorised adjustment of flow rate on oxygen equipment	Worsening respiratory failure in oxygen sensitive patients	Patient	(1) Educate patient on the reason for oxygen (2) Inform patient/carer of the prescribed flow rate and hours of use (3) Ensure patient/carer understands how to operate equipment safely (4) Inform patient/carer on the importance of not adjusting oxygen flow rate without seeking appropriate clinical advice and assessment (5) Very oxygen sensitive patients will be issued with an alert card and appropriate oxygen mask and tubing for use in ambulance transfers.
10	Non compliance with assessment and/or review process	Risks will not be identified or managed. Oxygen prescription may not be appropriate for the patient's clinical need.	Patient	(1) All except terminally ill patients should be formally assessed prior to commencing oxygen therapy. (2) Patients will be recalled for review according to national guidance (3) Assessment and review will be undertaken at a mutually convenient time and place.
11	Non compliance with oxygen prescription	Hypoxia remains untreated	Patient	(1) Patients will be educated on when and how to use oxygen at the time of prescribing. (2) Reason for oxygen will be discussed at each review. (3) Significant carers, family and other HP's involved with the patient to be educated on why oxygen has been prescribed.