References
Home oxygen therapy in patients with COPD: safety issues for nurse prescribers
Abstract
Two landmark studies demonstrated survival benefit in chronic obstructive pulmonary disease (COPD) complicated by chronic hypoxaemia with the prescription of long-term oxygen therapy (LTOT). Best practice evidence therefore recommends that individuals with stable COPD and resting hypoxaemia (PaO2≤7.3kPa) should be assessed for long-term oxygen therapy. However, it is estimated that up to one-quarter of COPD patients prescribed LTOT continue to smoke. Oxygen therapy consequently presents an obvious fire hazard in the case of such patients, who are therefore at greater risk of death or sustaining devastating head and neck burns. This article critically analyses, through the context of a care study, the professional, ethical and legal issues involved in making a safe prescribing decision for LTOT in an individual with COPD who is a current smoker. Home oxygen prescription is a growing trend in the COPD population, and it is important for nurse prescribers to be aware of the issues highlighted in the article to ensure safe prescribing practices.
The author is a respiratory nurse specialist (RNS) practising as part of a community nurse-led respiratory assessment service. The RNS is responsible for ensuring that individuals with respiratory disease receive holistic care and is are empowered to develop expertise and advanced professional practice. The Department of Health (DH) (2008) advocated that such proficiency should be achieved through the appropriation of non-medical prescribing, which is now recognised as one of the most important developments in nursing since it became a profession in the early 20th century (Dowden, 2016).
The benefits of nurse prescribing are well documented, with qualitative evidence demonstrating positive outcomes in efficiency of care (Courtenay et al, 2011), increased nurse autonomy (Watterson et al, 2009) and greater patient satisfaction (Carey and Stenner, 2011). Therefore, with current governmental demands to ensure high-quality care provision regionally (Department of Health, Social Services and Public Safety (DHSSPS), 2012) and nationally (DH, 2009), independent and supplementary non-medical prescribing has been recognised as a valuable asset for advanced nursing practice.
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