To ensure widespread and accurate take-up of the Guideline for Emergency Oxygen Use in Adult Patients, BTS has established a network of ‘oxygen champions’ in hospitals across the UK. ‘Oxygen champions’ will facilitate training and will disseminate the supportive educational materials and new standardised documentation for the prescription and monitoring of emergency oxygen use. If you wish to find out more about oxygen champions in your hospital, or if you would like to become an oxygen champion, please contact: emergencyoxygen@brit-thoracic.org.uk
Chronology
December 2011
The results of the 2011 Emergency Oxygen Audit were presented at the BTS Winter Meeting on 7 December 2011. The presentation is available here.
28 April 2011
We are enormously grateful to all of the many Oxygen Champions throughout the UK who are working hard to improve the safety of oxygen use. The 2010 audit has shown that the number of patients with a valid prescription for oxygen in the UK has increased from 32% in 2008 to 56% in 2010 and the Oxygen Champions must take credit for most of this improvement. However, we still have a long way to go. You can access your hospital’s results compared with the National results via the BTS audit system (https://audits.brit-thoracic.org.uk/) and you will hopefully have a record of the results for individual wards available locally with ward data collection documents from your audit in October 2010.
We have prepared an audit powerpoint presentation that will allow you to compare your local results with the UK-wide results with minimal effort (download here ). All that is required is to enter your local data into the blank spaces marked with ***. Perhaps your Audit department can assist with this task. This will allow every doctor, nurse and physiotherapist in your Trust to see how their own unit is performing compared with the rest of the hospital and compared with similar units elsewhere in the UK. When the presentation is complete, we would suggest sending it to the Trust Directors of Audit and Quality control and to the Medical Director and Director of Nursing in the first instance with a request that the presentation should be circulated to every doctor, nurse and physiotherapist in your hospital and discussed at the Clinical Governance meetings of every Directorate in line with the advice from the National Patient Safety Agency and NCAAG (National Clinical Audit Advisory Group).
Finally, we would also like to draw your attention to the 2011 Emergency Oxygen audit which will run from 15 August to 1 November 2011. Full details are now available through the BTS audit system.
Thank you again for your assistance with implementation of the BTS Guideline and with previous audits and we look forward to further improvements in the 2011 BTS National Hospital Oxygen audit later this year.
March 2011
STOP PRESS: The British Thoracic Society, Salford Royal NHS Foundation Trust and Southend University Hospital NHS Foundation Trust: - winners of the 2011 Patient Safety in Clinical Practice Award.
More details here. The winning presentation made to the Award judges is available here.
24 February 2011
Emergency oxygen audit 2010: reports can now be generated from the BTS Audit System to show individual ward results compared to the national averages for each ward type. A template powerpoint presentation is available here for local use to allow oxygen champions to present the ward-based data in their hospital.
18 January 2011: BTS shortlisted for the Patient Safety Award 2011
The British Thoracic Society,Salford Royal NHS Foundation Trust and Southend University Hosptial NHS Foundation Trust application "Improving the safety of administration of emergency oxygen in adult patients" has been shortlisted for the 2011 Patient Safety Award. The presentation made to the Award judges is available here. The winners of the 2011 Patient Safety Awards will be announced in March 2011.
5 November 2010: Email to oxygen champions
We are writing to draw your attention to a very important paper which has been published in the BMJ (30 October 2010) and with an accompanying editorial written by Ronan O'Driscoll and Richard Beasley. The bottom line is the patients with COPD treated with high concentrations of oxygen have double the mortality of those treated with controlled oxygen. This provides fantastic evidence support for the BTS target saturations.
The paper can be found here:
http://www.bmj.com/content/341/bmj.c5462.abstract?ijkey=5a4fe4b4b07fe83bff938f80b40c1dd3e699100b&keytype2=tf_ipsecsha
Also the new European Resuscitation Guidelines state that after resuscitation patient's oxygen saturations should be maintained between 94-98%.
We would also like to remind you that that the 2010 Emergency Oxygen audit is now open for data entry (closing date 15 November). The data collection forms for the audit this year have been streamlined and we hope that you will add data on wards on your hospital to the audit system before the closing date - further details are available here:
https://audits.brit-thoracic.org.uk/
We would also like to invite you to complete this short survey about progress towards implementation of the Guideline recommendations in your hospital. The link to the online form which contains 12 short questions is here: http://www.btssurveys.com/TakeSurvey.aspx?SurveyID=n2KM385
You may recall that we last ran this survey in November 2009 and we would like to produce an updated snapshot (as of 1 November 2010) of progress towards implementing the introduction of an oxygen policy, a drug prescription chart and a monitoring chart, as well as the status of training across institutions. Please complete the survey by Friday 26 November if possible.
If you are planning to attend the BTS Winter Meeting next month, the Oxygen Champions meeting will take place at 12.30 - 1.15 pm on Friday 3 December (Elizabeth Windsor Room). The BTS Emergency Oxygen audit will also feature in the special session on "The Best of BTS Audit" to be held at 1.45 - 3.30pm on the Friday afternoon in the Churchill Auditorium.
Finally, we have had requests from respiratory leads in each region for the names of oxygen champions in their regions so that oxygen leads in each hospital can be kept informed about local developments. Until now, we have used the BTS network of oxygen champions for BTS communications only, and so we felt that we should write to let you know that we intend to pass on the names (and email addresses) of oxygen champions in each hospital to the regional respiratory lead following the BTS Winter Meeting in December. If you do not wish your name to be relayed to your regional respiratory lead - please let Sally know (sally.welham@brit-thoracic.org.uk ) by 30 November.
Thank you very much for your help with the audit and with the good work that everybody is doing. We are getting there!
4 June 2010: Email to oxygen champions:
Our national network of oxygen champions continues to expand and so this is a brief message to draw your attention to a number of issues that may be helpful to you:
2009 Emergency Oxygen Audit: Institutions that participated in the 2009 national audit can now generate individual reports that compare the institution’s data with that of the national dataset. Please log into the BTS audit system and follow the links to the Reports page: https://audits.brit-thoracic.org.uk/
The 2010 Emergency Oxygen Audit will take place in October/November 2010 and further details will be circulated in due course.
Emergency oxygen use and voluntary rescue organisations: Following a number of enquiries the authors of the Guideline have produced a statement on emergency oxygen use for organisations operating outside the NHS. This document can be found here:. http://www.brit-thoracic.org.uk/clinical-information/emergency-oxygen/emergency-oxygen-use-in-adult-patients.aspx
Copies of oxygen alert cards are still available – if you require further copies of the cards, please contact emergencyoxygen@brit-thoracic.org.uk
The recent NICE guideline: Chest pain of recent onset (http://guidance.nice.org.uk/CG95 ) includes a recommendation about the administration of oxygen which is in line with the recommendations of BTS Guideline: In patients presenting with acute chest pain (thought to be cardiac in origin):
1.2.3.3: Do not routinely administer oxygen, but monitor oxygen saturation using pulse oximetry as soon as possible, ideally before hospital admission. Only offer supplemental oxygen to:
• people with oxygen saturation (SpO2) of less than 94% who are not at risk of hypercapnic respiratory failure, aiming for SpO2 of 94–98%
• people with chronic obstructive pulmonary disease who are at risk of hypercapnic respiratory failure, to achieve a target SpO2 of 88–92% until blood gas analysis is available.
Finally, work is underway to produce an e-learning module on emergency oxygen. This will be aimed at those involved in the administration of oxygen and will be available through the BTS Learning Hub – further details will be provided in later in the year.
6 January 2010
NPSA Rapid Response Report ‘Oxygen safety in hospitals’: Frequently Asked Questions - can now be found on the NPSA website at http://www.nrls.npsa.nhs.uk/oxygen
Email: 16 October 2009
BTS Guideline on Emergency Oxygen Use in Adult Patients – Audit 2009
As you know, a baseline audit of emergency oxygen use in adult patients was undertaken in autumn 2008, prior to the publication of the BTS Guideline on Emergency Oxygen Use.
We would now like to invite your hospital to participate in the 2009 audit of emergency oxygen use.
As you may be aware, the BTS Audit Tool system was relaunched in the summer and so this year the emergency oxygen audit will use the new audit system to collect data online. This year we have added the facility for you to enter collated audit data for each ward in your hospital. A feature of the new system is that reports can be generated online to allow users to see a comparison of their hospital data against the national picture (please note that this feature will be available when data collection for the audit has closed in mid November).
The online audit will be available for entry of data from Friday 16 October until Monday 16 November 2009. Your audit can take place on any day during this period. It is intended that the preliminary results from this audit will be presented at the BTS Winter Meeting (further details about the Open Meeting to be held during the conference will be circulated to oxygen champions in due course).
Full information on the audit and copies of the paper data collection forms can be found here: www.brit-thoracic.org.uk/oxygenaudit
Please download the individual patient and ward record forms and distribute these to those who will be involved in the audit.
The online audit tool for collection of the aggregate ward data is available at: http://audits.brit-thoracic.org.uk/
If you have not already registered for the new audit tool system, please follow the instructions from this webpage to register for an account.
If you have any queries please contact audittools@brit-thoracic.org.uk
Dr Tony Davison
Dr Ronan O’Driscoll
Sally Welham
BTS Guideline for Emergency Oxygen Use in Adults
Email: 6 October 2009
Oxygen Alert Cards
We are pleased to say that the British Thoracic Society has produced copies of the Oxygen Alert Card to support the dissemination of the Guidelines for Emergency Oxygen Use in Adult Patients. We are delighted that the Intensive Care Society and College of Paramedics have endorsed the oxygen alert card, and College of Emergency Medicine have also now confirmed their support for this initiative. We have sent a small supply of the cards by mail to one oxygen champion in each hospital on our database (so if you receive these in the mail please pass these on to your fellow oxygen champions in your institution).
We currently have a limited stock of cards which will be sent out to those who request further copies on a first come, first served basis. We plan to monitor the demand for alert cards over the coming 2-3 months, and if there is sufficient demand, we hope to be able to offer to supply cards to those who wish to use them at a small charge. Further information is available on the BTS website at: www.brit-thoracic.org.uk/oxygenchampion
We hope that you will find the cards useful and if you require further copies of the cards at this point, please contact emergencyoxygen@brit-thoracic.org.uk
Emergency Oxygen Audit 2009
We plan to run the emergency oxygen audit later this month and further information will be sent to oxygen champions in the next couple of weeks.
Oxygen Safety in Hospitals: NPSA Rapid Response Report
A rapid Response Report on oxygen safety in hospitals was released by the NPSA on 29 September – further details available at:
http://www.nrls.npsa.nhs.uk/resources/?entryid45=62811
Lecture for Doctors - Web appendix 8 - updated
This powerpoint lecture has been updated and is now on the website at www.brit-thoracic.org.uk/emergencyoxygenguideline
Dr Tony Davison, Dr Ronan O’Driscoll
Co-Chairs Emergency Oxygen Guideline in Adults
28 September 2009: Oxygen Alert Cards
The British Thoracic Society has produced oxygen alert cards to support the dissemination of the Guidelines for Emergency Oxygen Use in Adult Patients. A small supply of the cards has been sent to an oxygen champion in each hospital on our database. Further copies of the cards will be sent out to those who request them on a first come, first served basis. We plan to monitor the demand for alert cards over the coming 2-3 months, and if there is sufficient demand, we hope to be able to offer to supply cards to those who wish to use them at a small charge. If you require further copies of the cards at this point, please contact emergencyoxygen@brit-thoracic.org.uk
28 July 2009: Example of Good Practice from South Tees NHS Trust:
South Tees NHS Trust will implement a local oxygen policy from 1 August 2009. A copy of the poster prepared for staff members is available here.
If you have examples of good practice from your Trust which you would like to share with other oxygen champions please contact: emergencyoxygen@brit-thoracic.org.uk
17 June 2009: Email to Oxygen Champions
Oxygen flow rates and Venturi masks: Please note that further additional information has been added to the website regarding Section 10.2 (flow rates from selected Venturi masks) and Paragraphs 11.1.2 and 11.1.3 regarding Patient Group Directions. This includes a revised Table 11 and revised Figure 11b which can now be downloaded from:
www.brit-thoracic.org.uk/emergencyoxygenguideline
Introducing a local emergency oxygen policy: Following the successful BTS short course on emergency oxygen, held in Manchester in April, we have placed a copy of the presentation from Lisa Ward on the website to assist oxygen champions in this important task. The presentation can be downloaded from: www.brit-thoracic.org.uk/oxygenchampion
Oxygen Alert Cards: A copy of an Oxygen Alert card (featuring the logos of the endorsing organisations: College of Paramedics, Intensive Care Society and BTS) is now available to download so that these can be printed and distributed as required in your institution. The card has been designed to fit into a “business card”-sized plastic wallet. The card can be downloaded here
JRCALC Guidelines: The Joint Royal Colleges Ambulance Liaison Committee have recently revised their guidelines in the light of the BTS Emergency Oxygen Guideline and a copy of the JRCALC guidance can be found on their website at: http://www.jrcalc.org.uk/latest_guidelines_updates0409.html
3 June 2009: Introducing a local emergency oxygen policy
A copy of the presentation given at the recent BTS short course on Emergency Oxygen which covers introduction of a local emergency oxygen policy (How it was done in Southend) is available here.
28 May 2009: Emergency Oxygen Alert Card
The Emergency Oxygen Alert Card is now available. This card can be printed, cut out and given to patients for them to keep in their wallet/purse. Click here to download.
30 March 2009: email to oxygen champions,
This is a brief note to highlight the following:
Survey of progress towards implementation: In relation to the implementation of the guideline, we would like to invite you to complete 6 short questions which are available here: http://www.btssurveys.com/TakeSurvey.aspx?SurveyID=72KIll2
Our aim is to produce a snapshot (as of 1 February 2009) of progress towards implementing the introduction of an oxygen policy, a drug prescription chart and a monitoring chart, as well as the status of training across institutions. Results of this survey will be made available on the BTS website in due course. So far we have 47 responses but would like to increase this number before we close the survey at Easter. There is no need to respond again if either you or someone else at your Trust has already responded in February or March.
Please note that some additional information has been added to the website regarding Section 10.2 (flow rates from selected Venturi masks) and Paragraphs 11.1.2 and 11.1.3 regarding Patient Group Directions. For full details please click here:
http://www.brit-thoracic.org.uk/ClinicalInformation/EmergencyOxygen/EmergencyOxygenuseinAdultPatients/tabid/327/Default.aspx
Finally I have been asked to pass on the following message from Dr Craig Davidson, Chair of the BTS Education and training Committee regarding the forthcoming short course on Emergency Oxygen Use in Adult Patients. (Further information on this course can be found here:
http://www.brit-thoracic.org.uk/EducationHub/ShortCourses/EmergencyOxygenUseinAdultsCourse/tabid/337/Default.aspx )
Dear Colleagues,
I am contacting you both as Chair of E & T committee and as a fellow O2 champion. Tony Davison recently circulated details of where we are nationally with implementation. I was relieved to see many others were still at the planning stage. It seems crucial to me to enlist some deputies in nursing and pharmacy.
This conference, to be held in Manchester on 24 April, is therefore an ideal way to encourage some more local O2 champions and, as it happens, has so far been under subscribed.
Could I suggest that your department offers to fund places for a couple of nurses to attend? I have and the offer to do so has been important.
I am sure it will make a difference down the line.
Best wishes
Craig
Dr Craig Davidson
27 February 2009: email to Oxygen Champions
We hope that all your hard work in introducing the Emergency Oxygen Guideline is going well. It takes quite a long time to introduce a new local policy and get the drug charts changed.
Some of you may have seen the Editorial in the BMJ this week on the use of emergency oxygen in adults. We think that this is a very good Editorial and will certainly help in promoting the guideline outside of the chest community.
The Editorial emphasises the importance of modifying the prescription charts and education of staff and change in the oxygen culture. Obviously these were all things that you are involved in at the sharp end. You may find this Editorial helpful in trying to convince management in your Trust if you are having problems. The Editorial can be found here on the BMJ website: http://www.bmj.com/cgi/content/extract/338/jan20_1/a2790?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=emergency+oxygen&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
We would also like to remind you of the following items:
Survey of progress towards implementation: In relation to the implementation of the guideline, we would like to invite you to complete 6 short questions which are available here: http://www.btssurveys.com/TakeSurvey.aspx?SurveyID=72KIll2
Our aim is to produce a snapshot (as of 1 February 2009) of progress towards implementing the introduction of an oxygen policy, a drug prescription chart and a monitoring chart, as well as the status of training across institutions. Results of this survey will be made available on the BTS website in due course.
Emergency Oxygen Use in Adults - a one day short course will be held on Friday 24 April, at the Staff House Conference Centre, Manchester. The course is organised by Dr Ronan O’Driscoll, and aims to provide an understanding of the principles of safe oxygen therapy and delegates will become familiar with the core content of the 2008 BTS Guideline for emergency oxygen use in adult patients. Further details are available at:
http://www.brit-thoracic.org.uk/EducationHub/ShortCourses/EmergencyOxygenUseinAdultsCourse/tabid/337/Default.aspx
Dr Tony Davison, Dr Ronan O’Driscoll
Co-Chairs Emergency Oxygen Guideline in Adults
9 February 2009: Email to Oxygen Champions
I am writing with further information about the Emergency Oxygen Guideline.
Local oxygen policy: The template document for a local oxygen policy (available on the website as Appendix 3 at http://www.brit-thoracic.org.uk/ClinicalInformation/EmergencyOxygen/EmergencyOxygenuseinAdultPatients/tabid/327/Default.aspx ) was updated at the end of November and is now available as a word document which can be easily amended to suit your local situation.
Survey of progress towards implementation: In relation to the implementation of the guideline, we would like to invite you to complete 6 short questions which are available here: http://www.btssurveys.com/TakeSurvey.aspx?SurveyID=72KIll2
Our aim is to produce a snapshot (as of 1 February 2009) of progress towards implementing the introduction of an oxygen policy, a drug prescription chart and a monitoring chart, as well as the status of training across institutions. Results of this survey will be made available on the BTS website in due course.
Emergency oxygen audit: as you know the preliminary results of the audit undertaken at the end of 2008 were presented at the BTS Winter Meeting in December 2008, and a copy of this presentation can be found on the BTS website at www.brit-thoracic.org.uk/oxygenaudit/
For those institutions that did not submit audit data in 2008, we have re-opened the audit data collection form to allow further responses to be made. This data collection form will be available until 27 February 2009. Full instructions for the audit including the link to the online data collection form can be found here: www.brit-thoracic.org.uk/oxygenaudit/
Please note that if your institution submitted data to this audit last year, then no further action is necessary – please do not submit your data again.
Emergency Oxygen Use in Adults - a one day short course will be held on Friday 24 April, at the Staff House Conference Centre, Manchester. The course is organised by Dr Ronan O’Driscoll, and aims to provide an understanding of the principles of safe oxygen therapy and delegates will become familiar with the core content of the 2008 BTS Guideline for emergency oxygen use in adult patients. Further details are available at:
http://www.brit-thoracic.org.uk/EducationHub/ShortCourses/EmergencyOxygenUseinAdultsCourse/tabid/337/Default.aspx
13 January 2009: Email to Oxygen Champions
Almost 100 institutions submitted data to the emergency oxygen audit in autumn 2008. The preliminary results of this audit were presented at the BTS Winter Meeting in December 2008, and a copy of this presentation can be found on the BTS website at www.brit-thoracic.org.uk/oxygenaudit/
We know that a number of institutions are now ready to provide their audit data and so we have re-opened the audit data collection form to allow further responses to be made. This data collection form will be available until 27 February 2009. Full instructions for the audit including the link to the online data collection form can be found here: www.brit-thoracic.org.uk/oxygenaudit/
Please note that if your institution submitted data to this audit last year, then no further action is necessary – please do not submit your data again.
If you did not participate in the autumn 2008 round of this audit – we hope very much that you will be able to contribute now. Only one submission per institution is required. We know that some institutions have more than one oxygen champion, and so you may wish to coordinate your response with your colleagues. If you wish to check who is listed as an oxygen champion on our database for your institution or if you have any other queries, please email bts@brit-thoracic.org.uk
We very much appreciate your help in the implementation of this important guideline.
December 2008: BTS Winter Meeting - Open Meeting for Oxygen Champions
The presentation given by Dr Ronan O'Driscoll and Dr Tony Davison on Wednesday 3 December 2008 is available here.
20 November 2008: email to all Oxygen Champions - oxygen policy
Dear Oxygen Champion
You will all be aware that the Guideline on Emergency Oxygen has now been in published in Thorax. One of the first things the oxygen champions need to do is to introduce the policy into their hospitals. An example of a local oxygen policy is available as appendix 3 on the BTS website - here.
This has been updated and is available as a Word document which is easily adaptable for your own institution.
29 September 2008: Guideline published. The full Guideline and associated Appendices can be found here.