Oxygen audit
Survey of professionals
1. What is your role?
o Consultant
o SpR
o SHO
o Specialty Doctor
o CNS
o Other …………..
2. Which ICN do you currently work in?
o Liverpool
o St Helens and Knowsley
o Don’t know
3. Which clinical area do you mainly work in?
o Hospital Acute
o Hospital Specialist Palliative Care
o Hospice
o Community SPCT
4. Do you provide oxygen based on any clinical guidelines?
o Yes
o No
o N/A Do not provide
o If yes which guidelines do you use? Please state…………………..
5. In your main setting, if you were to provide oxygen for a patient, how would it be prescribed?
o Prescribed on drug chart
o Prescribed on another written order
o A verbal order
o Prescribed electronically
o Not prescribed
o N/A - Do not provide
o Other (please state)………………
6. Do you feel confident in providing oxygen?
o Yes
o No
o N/A Do not provide oxygen
7. Have you received training in relation to completion of the following HOOF forms and equipment available?
o HOOF Part A
o HOOF Part B
o Both HOOF Part A and B
o Neither HOOF Part A nor B
o N/A Do not order oxygen
8. Have you filled out the following HOOF forms to supply patients with oxygen?
o HOOF Part A
o HOOF Part B
o Both HOOF Parts A and B
o Neither HOOF Part A nor B
o N/A Do not order oxygen
9. When a patient is newly commenced on oxygen therapy, do you reassess 72 hours post commencement?
o All of the time
o Most of the time
o Occasionally
o Never
10. For in-patients, do you routinely monitor daily oxygen saturations of patients on oxygen?
o All of the time
o Most of the time
o Occasionally
o Never
11. Which disease groups of patients do you currently order oxygen for? Tick all that apply
o Cancer
o Heart failure
o Respiratory
o Neurological
o Any progressive illness
o Other please state
o N/A Do not order oxygen
12. For which reasons/conditions would you suggest or prescribe oxygen (in your setting)? Tick as many as appropriate
o Hypoxia
o Breathlessness
o Terminal breathlessness
o Cough
o Cluster headaches
o Panic/anxiety
o Comfort
o Patient request
o Family request
o Pre-existing medical condition eg COPD /HF
o For use of nebuliser
o Fatigue
o Other (please state)……………………………….
13. What clinical benefit would you expect for the patient when you arrange oxygen therapy?
o Symptom control
o Improve hypoxia
o Increase activity
o Improve QOL
o Improve prognosis
14. For patients in the last 2-3 months of life, are there any circumstances where you would suggest or prescribe oxygen before all reversible causes for breathlessness had been managed?
o Yes (please comment) ……………………………
o Only if hypoxic
o Would always manage reversible causes first
o Would use non pharmacological therapies first
o Would use non pharmacological therapies as an adjunct to oxygen therapy
o Don’t know
15. Are there any circumstances when you would not prescribe/order oxygen for a patient?
o Yes
o No
o Unsure
16. In what circumstances would you not order oxygen? (Tick all that apply)
o Fire risk
o Smoker
o CO2 retention
o Not hypoxic
o Lack of space in the area
o When concentration of oxygen required is > 60%
o When advice is needed
o Trip hazard
o None of the above
17. What practice do you follow for patients who are a known smoker and who require home oxygen? Tick all that apply
o Alert PCT
o Contact Fire Brigade
o Inform GP
o Inform Oxygen supplier
o Inform local assessment service
o Undertake a risk assessment
o Other……………………………..
18.What problems do you regularly see in patients using oxygen ? Tick as many as apply
o None
o Dry nose
o Dry eyes
o Pressure sore to ears
o Pressure sore nose
o Dry mouth
o Claustrophobia
o Social isolation
o Dependence on oxygen
o Nausea
o Drowsiness
o Fire risk
o Increase in trips or falls
o Loss of independence
o Reduced prognosis
19.What checks/ assessment would you undertake prior to considering prescribing/ ordering oxygen? Tick as many as apply
o Arterial blood gas
o Shuttle test/ 6 minute walk test
o Breathlessness assessment tool
o Oxygen saturations
o Smoking risk assessment
o Past medical history
o Whether the patient has an alert card
o Positioning of patient
o Trip hazard
o Would not consider any
o Other (please state)………………….
20. Based on your experience, overall how often do you find oxygen therapy helpful in relieving breathlessness in patients at the end of life?
o All the time
o Most of the time
o Occasionally
o Never
21. Are you aware of how to order specialist oxygen equipment? Eg ambulatory oxygen
o Yes
o No
o Not sure
22. Can you access a home oxygen assessment for your patients if needed?
o Yes
o No
o Not sure
o Was not aware such a service existed in my area