RefHazardsRisksPeople at riskCurrent Control MeasuresL x C=RIs further action required (Y/N)
Facial burns
Community Nursing Staff
Patients and carers
(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 fireCommunity 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, wheelsRestriction of or no Oxygen supplyPatient(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/gelsCombustionCommunity nursing staff Patients and carers(1) Ensure hands are adequately dried after the use of alcohol gels.
5Use of oil based emollientsLocal burning of affected areaPatient(1) Instruct patients (or carers) not to use oil based emollients on patients nostrils
6.Patient/Carers not aware on how to obtain replacement cylindersRunning out of oxygenPatient(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.TubingTrips and fallsCommunity 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 concentratorNo oxygen supplyPatient(1) Check patient has a back up cylinder
(2) Educate patient not to use back up cylinder unless there is power failure to concentrator
9Unauthorised adjustment of flow rate on oxygen equipmentWorsening respiratory failure in oxygen sensitive patientsPatient(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.
10Non compliance with assessment and/or review processRisks 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.
11Non compliance with oxygen prescriptionHypoxia remains untreatedPatient(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.