[AtlantaRN]

Do you order the gambit of everything available when you start services? For instance, I have a patient who didn't need oxygen until today...It took 2 hours to get the 02 out there (she had been satting in the high 90's until today)...

I HATE waiting for the things I need (finding it hard to adjust from the hospitall setting because everything was just so handy)...

Any input is greatly appreciated.

[RN4ustat]

Yes, we tend to order things like O2 concentrators/portable tanks, nebulizers, etc if there is a potential that the patient will need it. Its better to have it on hand and not use it than need it in a crisis and not have it available.

[aimeee]

I will usually order an oxygen concentrator for anybody with cardiac dx or lung ca at the get go. They can change in a twinkling and even a short while when you are short of breath can seem like an eternity.

[Mel in MO]

I work as a Healthcare Specialist for a DME right now, and we can't do that. Medicare has specific criteria for 02 and other equipment, and they require a desat of < 89% for 5 mins or more, or the following criteria for portability: Sats resting, Sats w/ 3 mins exercise (ambulation preferred, although not always an option), and exercise ON 02, showing improvement. If they desat w/ sleep, it does not qualify them for portable oxygen during the day. They can have HS 02, but still need to qualify for portability.
If we don't have the qualifying testing, and the patient is set up anyway, they will have a 'heart condition' when they get the first bill.

Of course, that's here, in the heartland of the US. I realize this is an international board, so it may be different in your area.
Smiles,
Mel

[aimeee]

Ah, but that's one of the advantages of hospice....we don't have to worry (at least for now) about meeting those criteria for Medicare payment because the DME are paid for out of OUR reimbursement per diem. We don't have to wait for the patient to have an exacerbation and be in crisis...we can actually be prepared.

[NDN RN]

The Noc Triage nurse will thank you if you have O2 available at 2 am when the family calls, panicked, because the Pt is suddenly SOB or actively dying & looks dyspneic. Better to have the concentrator sitting in the closet or a corner than, as you found, try to get it quickly when its needed. Thankfully, O2 is part of our DME package, so unless the Pt or family adamantly refuses it, it is normally ordered on admission.

[PeacePisceRN]

I have to agree with the last post...as a night on-call nurse...please have the equipment available for the patient if there is even the possibility of a need for oxygen. In my opinion, there is a possibility with every hospice patient. O2 is something that will be necessary (if only for the comfort of the family) for any change in breathing. Thanks to all the nurses who make it better for us at night!