An oximetry at home service provided by Newcastle Hospitals’ Community Directorate has helped COVID-19 patients most at risk of becoming seriously unwell receive care at the right time and in the right place.
During the third wave of the pandemic from January to April 2021, the service cared for 57 patients across the City and identified 16 patients who needed further hospital treatment with few patient deaths.
The service cared for patients with confirmed COVID-19 and who were symptomatic over the age of 65 years, and those under 65 years identified as clinically extremely vulnerable to Covid-19.
Patients were monitored two-three times a day, patients were asked whether they had any new symptoms and their oxygen level and pulse readings were taken from the pulse oximetry machine.
Community Matron Katie Lynn, who set up the service at Newcastle Hospitals, said: “As part of the government initiative, we set up the oximetry at home service to provide a 7-day service for patients who were most vulnerable from getting seriously unwell from COVID-19.
“Pulse oximeters were provided to patients so they could record their oxygen levels and pulse reading and patients were monitored two-three times a day, with a full assessment of their symptoms.”
The team consisted of a community matron, community sister, four community staff nurses, three district nurse students and two health care assistants. The service was able to capture patients at the right time and it enabled them to receive treatment if needed. It has also helped to ease patient anxiety, reduce isolation and provide support to both patients, families, carers and GPs.
Patients who recorded an oxygen reading of 95% and above would be monitored two-three times a day.
Patients with an oxygen reading of 94/93% would be seen by the clinical team at home and referred for a medical review or to hospital as required.
If the patients oxygen levels were 92% or below this would trigger an urgent category 2 ambulance response to the assessment suite at the RVI or A&E. Assessment of symptoms and patients pulse could also trigger further assessment.
As Katie explains, the pulse oximetry machines and regular telephone assessments helped in capturing the deteriorating patient in a timely manner:
“We would usually see patients oxygen saturations deteriorate between days three and seven. The worry with COVID-19 is that sometimes patients feel well in themselves and have reduced oxygen levels without having any signs of respiratory distress.
“The late presentation can result in patients requiring intensive therapies. Without prompt emergency treatment, fewer patients may need escalation of care to intensive care and ventilation. It was vital that patients were monitored during the acute period so we could identify those who were deteriorating promptly.
“We absolutely saved the lives of those who went to hospital. We were able to refer patients at the right time and only a few who were admitted went to ITU or required non-invasive ventilation.
Michael Trotter, 68 from Newcastle, was one of the patients the team was able to identify deterioration and get urgent help. As Michael explains:
“When I tested positive for COVID-19, the GP rang me up to ask if I wanted to be cared for by the oximetry at home service. The team came out to see me and gave me a pulse rate monitor. I was called two to three times a day for assessment.
“About four or five days later, my oxygen readings were at 65% and 70%. I was so weak when I was trying to get upstairs to toilet – I could not be bothered to eat. An ambulance was called and I was blue-lighted to hospital.”
Michael was in hospital for eight days, he has oxygen through a facemask for a day or two before having CPAP for about four to five days.
“When you have been so ill, you don’t realise how bad you are. That must be the only time I did not know my body.” Michael said.
Five months on, Michael is still recovering from COVID-19, but is making progress:
He said: “I am about 96% recovered, but I am still struggling with shortness of breath. I have to stop every 500 yards when out for a walk and sit down, but at least I was able to walk out the hospital.
“Although there are so many different departments in the hospital, it all worked so perfectly together. If it were not for the staff, I would not still be here. If I could have hugged them all – I would have given everyone a hug.”
As the vaccination programme started to take effect and the waves of infection reduced, fewer referrals were received and the age-range for referral lowered.
Although the service is no longer running at the present time, it remains on standby if needed again.