Standard Operating Procedure – Oxygen Concentrator Home Loan

Western Division Consultations

Date: 1/6/23

Venue: Novotel Nadi

Notes

 Suggestion to change the title to: Oxygen Concentrator For Domiciliary Use - Floor Agreed
 Take out “plane” from SOP as they don’t use pure oxygen.
 If we have the bond for patients, nobody will be willing to loan, which means prolonged stay
in hospital.
 Should have a system of monitoring for the OC given for home loan- Checks by Biomeds etc
 Participants did not agree for putting a cost to oxygen use at home.
 Is there an opportunity where FPBS could step in to purchase OCs for pts on home loan with
the assistance from social welfare- (in terms of sustainability).
 Free medication scheme, General Practitioners scheme something similar could have been
applied looking at eligibility for patients, but there was abuse happening. In the future if we
seem to be adopting this then there should be some sort of revenue generation.
 We need a robust system in place in order to adopt free home loan.
 Sigatoka Subdivision shared their process for home loan of concentrators- keeping a register
where patient and staff sign. If patients come to hospital for review or are sick, they bring
along with them their OC concentrator.
 We might need a concentrator bank if word spreads on OC home loan.
 Consultant gives approval, but we have the HITH team which can also provide support in
terms of monitoring and visitations. Patients discharged on home loan might not survive for
long.
 Distributing the 5-liter concentrators can be given for home loan since we have a lot of it in
the clinical area.
 Maximum lifespan of OC filters in 7000 liters, but it all depends on the type of environment
it is placed in.
 Damages to OC can be divided into 2 parts: technical and physical. Suggest putting a cost to
physical damage if need be.
 Zone nurse might have to make a decision of home loan if no consultant is available,
however a phone consultation is preferred.
 VHW’s could also step in to do monitoring, regular checks. This is where scope of practice
comes in, a consultation has to be done with the Nursing Council (procedure manuals should
be in place)
 Draft a procedure manual for nurses and VHWs- to be discussed in the Central /Eastern
consultations. It might 2 -3 years, we can start with the ground, work now but this would
eventually lead to cabinet approvals, budget.
 Is there a SOP, that could be made for intentional damage to OC’s- a situation was shared
with the Sigatoka team.
 There has been mishandling of OC’s happening, eg. Broken nozzles, cracks, not only by
patients but clinical staffs as well. It is very important to have proper trainings on the care of
equipment.
 Minimum Standards of Equipment at Different Level Health Facilities

 We have to consider the total number of beds in the hospital, population, gradings of the
facilities.
 It should be in the SOP that the health center will cater for the oxygen for the nursing
station.
 Another thing to look at is the oxygen accessories.
 Minimum equipment standard list was done by FPBS. It is currently under review.
 Oxygen should be added to the minimum drug requirement.
 Minimum oxygen standard for oxygen should be presented at the Central/Eastern oxygen
delivery.
 Sometimes other factors need to be looked into when we think of oxygen consumption,
population could be more but they could have no or less patients requiring oxygen.
 Proper transportation is required for the delivery of Oxygen Cylinders including sea passage
transfer. This is currently in the tender process.
 Purchasing the vehicle is one issue, but maintaining the vehicle is another issue, highlighted
by Head of FPBS.
 Head of FPBS raised a query on storage space, also for oxygen banks.
 What happens to vacant nursing stations, will the oxygen equipment still be stored in the
nursing station?
 Tagging of cylinders will be an important thing. Other avenues are being looked at to tag
equipment’s, such as barcoding equipment.
 Recommendations came to use oxygen equipment/cylinders similar to a DD concept. This
will also add extra duties to the nursing cadre.