New safety measures for transporting patients on oxygen

JGH patients on oxygen can now breathe easier, thanks to new safety precautions that ensure they won’t run short of oxygen when they’re transported from their rooms to other hospital locations to undergo tests or healthcare procedures.

Now that implementation of the new policy has begun, transportation of a patient on oxygen—whether by wheelchair, stretcher or bed—will be possible only if an appropriate member of staff consults a special chart and confirms that the amount of oxygen in the cylinder is sufficient for the trip.

A new document, known as a passport, must also be signed by a member of staff when the patient leaves the unit, and again when the patient arrives at the destination, with the same measures taken for the return trip. The signature confirms that the oxygen-related aspects of the patient’s transfer have been reviewed and are confirmed to be safe.

To be extra-sure there are no doubts about the patient’s needs, the transport attendant must even speak an identifying sentence aloud—for example, “This patient is on oxygen”—to the nurse or other staffer who takes charge of the patient at the destination.

In a utility room in Pavilion K, Neil Michaels (Coordinator of Emergency Measures, and Civil and Global Security), Tracey Lang (centre, Clinical Nurse Specialist) and Lianne Dzygala (Chief of Quality and Risk Management – Acute Care Services) ensure that oxygen cylinders are correctly stored and signs are properly posted in the designated area.

In addition, the new policy tightens safety procedures regarding the storage of oxygen cylinders, as well as specifying that the hospital’s cylinders must not be sent home when the patient is discharged.

According to Lianne Dzygala, Chief of Quality and Risk Management – Acute Care Services, plans call for certain elements of the JGH policy to be applied, where appropriate, to other facilities in CIUSSS West-Central Montreal. Now that the network’s sites have been surveyed about their procedures, representatives will meet later this year to share information about the JGH policy and determine which portions of it can be implemented elsewhere.

“This is yet another example of our CIUSSS introducing measures to ensure the safety of healthcare users in a wide variety of circumstances,” says Dr. Anne Lemay, Assistant Executive Director for the Support, Administration and Performance Programs. Dr. Lemay, who chaired the committee that developed the policy, adds that CIUSSS staff “are continuously looking for ways to keep upgrading safety and the quality of care, in order to further enhance the user experience.”

Development of the JGH policy was undertaken as a result of a major incident in late 2014, when a patient experienced serious difficulty after oxygen ran short during transport within the hospital. Help arrived in time and the patient recovered.

Ms. Dzygala says this incident served as “a wake-up call” that a total review was needed. In early 2015, an examination of all aspects of the policy was launched by a special committee that included representatives from such areas as Nursing, medical staff, Quality and Risk Management, outpatient clinics, Emergency Measures, Logistics, Respiratory Therapy, Radiology, and Health and Safety.

Rosalie Johnson, Nursing Coordinator of the JGH Nursing Resource Centre, explains that patients are likeliest to run low on oxygen when they are taken somewhere for an appointment and have to wait much longer than expected.

Previously, since no member of staff was formally designated to verify how much oxygen remained in the cylinder, no one was aware whether the patient faced the risk of running low. In the overwhelming majority of cases, nothing untoward occurred, but in a small number of instances, those patients experienced difficulties.

As a result, Ms. Johnson says, a member of staff must now call ahead to the destination to ask whether and how long the patient will have to wait. If the receiving department can’t guarantee that the patient will be seen within a reasonable amount of time, the trip is postponed.

“As with so many other aspects of health care, clear communication among staff is of key importance,” adds Ms. Johnson. “It’s an essential way for us to safeguard the well-being of patients who rely on us to literally keep them breathing.”

More details about the new policy are available in a video.