Lightbulb innovation: home pulse oximetry service

Image of a lightbulb with the words lightbulb innovations

Putting patients first - easy to say, harder to do. Not for Anne Harvey and her team, who have put patients, in this case children, right at the heart of a redesigned service in a busy Ear, Nose and Throat department.

Tonsillectomies (an operation to remove the tonsils) and adenotonsillectomies (removing both the adenoids and tonsils) are performed on children for a number of reasons, but a very common one is due to obstructive sleep apnoea (OSA), a condition where your breathing stops for short spells when you are asleep. OSA, in children at least, is often caused by enlarged tonsils and adenoids.

Measuring the relative severity of obstructive sleep apnoea is often done by a respiratory team, involving an overnight stay in hospital. This is known as polysomnography. Due to the strange environment, the child's sleep is often broken and fitful, making it difficult to accurately measure the severity of OSA in the child. It's also disruptive to the family, as a parent has to stay overnight in hospital too.

As is often the case, the innovation turned out to be a simple one. Anne recognised that there is another very common way to determine OSA in children, which is using a pulse oximeter. Pulse oximetry measures oxygenation, and if used continuously, it can accurately measure the number of times a child stops breathing overnight, enough to result in a desaturation on pulse oximetery  thus measuring the severity of the OSA. The great advantage to this method is its ease of use, and certainly something that the parent could do at home.

"It's about putting patients at the heart of their treatment" says Anne. Instead of an overnight stay in hospital, the ENT team teach the parents how to set up the pulse oximeter at home, and perform the test. It reduces disruption to the family routine, reduces the added stress of being in a strange environment for the child, and removes the need of an overnight stay in hospital, and High Dependency Unit (HDU) admissions in particular. The service has been audited, and parents are extremely pleased.

"The service has really taken off" says Anne, "and we have increased the clinical sessions to cope with demand." Not only is this a great example of putting patients first, but the reduction in overnight stays saves the hospital money. There's no reason why this innovative service redesign cannot be spread to other children's, and adults services.

If you'd like to know more about this innovation, please contact Anne Harvey, email: Anne.Harvey@alderhey.nhs.uk.

Website: RCN Frontline First

 

If you liked that, you might like this