Home Fires and Oxygen

Home safety risk assessment

Q. NPSG.15.02.01 EP 1 appears to require our home care clinicians to conduct a task that they are neither trained for nor qualified to perform such as verifying the working order of smoke detectors and fire extinguishers.

A. The following plan for compliance with this requirement has been developed in collaboration with accredited home health services and home oxygen suppliers:
Objective:

The provider organization will assist its oxygen customers in minimizing the risk of an oxygen supported fire in their residence.
Expectations For Compliance:

1. Consistently inquire about the presence or absence of a functional smoke detector and fire extinguisher when oxygen is delivered, as well as with subsequent encounters. If needed: 
   • Encourage the patient to have a functional smoke detector 
   • Encourage the patient to have a functional fire extinguisher 
   • Provide the patient with information concerning where the absent items can be purchased
2.  When smoke detectors, fire extinguishers and fire safety plans are present: 
   •  Ask the patient during the initial set-up if they have tested their smoke detectors and checked the condition (charge level) of their fire extinguishers in the last 30 days 
   • Ask the patient during each service check visit if they have tested their smoke detectors and checked the condition (charge level) of their fire extinguishers in the last 30 days 
   • If not, document the deficiency in the home care record, notify supervisory personnel within 48 hours, and re-educate the patient or caregiver of the importance of fire safety when using oxygen 
   • Check all medical equipment provided to home oxygen patients on each service visit to ensure its fire safety. Document in the home care record that this check has occurred.
3. Identify as a sub-set of all oxygen customers serviced by the organization, those homes where the patient or others use smoking materials or there is a potential for open flames such as in heating devices, cooking surfaces, or fireplaces.
   1. Within these homes verify the following: 
      • That ‘no smoking’ signage is properly posted, 
      • That the caregiver has been encouraged to have a functional smoke detector 
      • That the caregiver has been encouraged to have a functional fire extinguisher 
      • Patient and/or caregiver understand and confirm understanding by verbalizing the dangers of smoking and open flames while using oxygen 
      • Patient and/or caregiver will avoid smoking or the presence of any open flames anywhere near oxygen 
      • Physician has been notified if patient/caregiver persists in smoking or using open flame devices in the vicinity of oxygen
   2.  Note in the home care record the occurrence of items i – vi.

Patient and family education

Q. NPSG.15.02.01 EPs 2 and 3 require home care organizations to provide education to the patient and family regarding causes of fire and fire prevention activities. What education are you looking for besides telling the patient not to smoke or be near an open fire when using their oxygen?

A. It is expected that education related to the common causes of household fires, how oxygen enhances fires, and a comprehensive list of what preventive actions need to be taken by the patient using oxygen. This education can be provided orally, or in writing (such as in a pamphlet), or preferably both.