Living with less oxygen

Steve Connew

Steve Connew

Captions: 1. Steve Connew checks an oxygen flowmeter at the head of a bed on Mersea Ward, Colchester General Hospital.In his left hand, he is carrying an oxygen mask.

2. In 2007 the Trust was wasting the equivalent of 319 cylinders of oxygen every day. The most recent audit shows this had fallen to just six cylinders.

20 December 2013

Hospitals in Colchester are developing a national reputation for the way they use their most commonly prescribed medicine - oxygen.

The Medical Gas Association invited Steve Connew from Colchester Hospital University NHS Foundation Trust to speak at a recent conference in Newcastle-upon-Tyne attended by NHS staff including nurses, pharmacists and managers.

Mr Connew, a biomedical engineer, told delegates that medical gas wastage was a problem for hospitals nationally but the amount of oxygen wasted at Colchester General Hospital and Essex County Hospital had been slashed, therefore saving money while improving patient and staff safety.

The National Patient Safety Agency recognised Colchester as an exemplar site for its management of medical gases and the Trust is one of only a handful of centres in the country to have a formal medical gases training programme.Little to no medical gas training is made available during student years, making workplace training very important.

The Trust trains about 2,500 of its 4,300 staff, including nursing staff, pharmacy staff, midwifery staff, physiotherapists, portering staff (who are involved in delivering medical gases to wards and departments) and many other allied professionals. Training and supportare also offeredto patients going home with oxygen.

In addition, it trains people from other organisations such as army medical personnel, staff from other NHS and private hospitals and from North Essex Partnership NHS Foundation Trust.

Mr Connew said: "Oxygen is something that the majority of our patients are given but many people are still surprised to learn it is regarded as a medicine.

"This initiative was never about being a quick fix but a longer term change of culture.

"We use about 1,000,000 litres every single day, making it the Trust's most commonly administered medicine.

"The Department of Health recognises our work in this area and I think our success is down to the fact that we have had buy-in and support from staff at all levels."

He said that in 2007 the Trust was wasting the equivalent of 319 cylinders of oxygen every day but the most recent audit shows this had fallen to just six cylinders.

In 2010, the Trust spent a total of £272,600 on medical gases - most of which was spent on oxygen - whereas the figure this year (calendar year 2013) is projected to be £190,000. This represents a saving of £82,600a year (30%), even though the Trust is now larger, treating more patients than in 2010 and the cost of medical gases has risen.

According to figures from BOC, the Trust's supplier of medical gases, it is today using 20% less oxygen than two years ago, which is bucking the trend being set by other acute hospital trusts in the East of England.

Ward sisters' twice daily checklists now include checking the flowmeters at the head of beds to make sure they are turned off when not in use.

An oxygen-enriched atmosphere has an increased risk of being a fire hazard and too much oxygen can also result in clinical harm -the primary cause of US singer-songwriter Stevie Wonder's blindness was the high levels of oxygen in the incubator he was put in after he was born.

Quarterly unannounced audits are carried out at Colchester General Hospital and Essex County Hospital to ensure that medical gases are not being wasted and that safe working practices are being adhered to. These audits involve matrons, ward sisters, nurses, health and safety staff and other staff groups.

Mr Connew has also given his "Living with less Oxygen" presentation recently at the University of Leeds and at an Institute of Healthcare Engineering & Estate Management conference in Manchester. He has been invited next year to give a presentation in Scotland.

In addition, he has received numerous requests for support and information from hospitals from Dunfermline to Belfast to Truro, from the British Medical Journal and organisations such as the Health Estates Facilities Management Association.

Oxygen is by far the most common medical gas. Others include entonox ("gas and air") and nitrous oxide ("laughing gas") which is used in anaesthesia.