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COVID Oximetry @home and COVID virtual wards

Detecting the early signs of deterioration in patients with confirmed or suspected COVID-19 is a significant challenge for health and social care teams. As patients at risk of poorer outcomes can be identified by reduced oxygen saturation levels, the ability to recognise early decreases in blood oxygen levels before the patient becomes symptomatic is vital. Here you will find key information about ‘COVID Oximetry @home’ and ‘COVID virtual wards’, including links to relevant resources and webinars.

The NHS have released a new video which explains why monitoring oxygen levels is important, how to use a pulse oximeter and take readings, and when to seek help. You can view the NHS video here.

What’s the difference between ‘COVID Oximetry @ home’ and ‘COVID virtual wards’?

The West of England Patient Safety Collaborative is supporting the use of pulse oximeters in our local health and care systems, both as part of the national COVID Oximetry @home and virtual ward models:

COVID @ table

What does this mean for patients?

By mid-February 2021 over 1600 patients in the West of England have been enrolled on either COVID Oximetry @home or COVID virtual wards. Read about our rapid and collaborative implementation of pulse oximetry services across the region, as well as a case study, here.

General advice for anyone experiencing the symptoms of COVID-19 is available on the NHS website. The NHS has also published a ‘safety netting’ leaflet for people with suspected coronavirus who are isolating at home.

Patients may use a remote monitoring COVID-19 diary to track their pulse oximeter readings. Translations of the COVID-19 diary are available here as well as an Easy Read version.

Health Education England has produced a short animation which explains how to use pulse oximeters at home and keep a COVID-19 diary.

 

Is there national guidance available? Where is the evidence?

Pulse oximetry and remote monitoring guidance has been published by NHS England and NHS Improvement along with standard operating procedures for COVID Oximetry @home and COVID virtual wards.

  • This case study from Salford Royal NHS Foundation Trust describes their rapid deployment of a COVID-19 virtual ward to improve patient experience, flow and the interface to Same Day Emergency Care.
  • This paper on Virtual Wards, Silent Hypoxia and improving COVID outcomes was published by the Royal College of General Practitioners in October 2020.
  • This paper on the Validation of home oxygen saturations as a marker of clinical deterioration in patients with suspected COVID-19 considers whether the early identification of deterioration in suspected COVID-19 patients managed at home enables a more timely clinical intervention.
  • HSJ has published this set of resources on pulse oximetry as a COVID early warning system.
  • The HSJ have produced a suite of short training/information videos. These explain the background information for COVID Oximetry @home models based on first wave pilots highlighting Oxygen levels as a key indicator for deterioration in COVID-19, and why patients need to be monitored for silent hypoxia. The videos describe to GPs, Nurses, Paramedics and Care home staff how this can be done across the system to safeguard patients at home in COVID Oximetry @home virtual wards. Watch the HSJ training videos here.
  • NIHR Applied Research Collaboration (ARC) Wessex and partners have compiled a report: An Evidence-Based Approach to Quality Improvement for COVID Oximetry @home. Read the NIHR report here.
  • Dr Matt Inada-Kim is one of the authors of a pre-print publication examining home saturation in COVID confirmed cases as a trigger for initial hospital assessment. Read the pre-print publication here. The early identification of deterioration in suspected COVID-19 patients managed at home enables a more timely clinical intervention, which is likely to translate into improved outcomes. The authors undertook an analysis of COVID-19 patients conveyed by ambulance to hospital to investigate how oxygen saturation and measurements of other vital signs correlate to patient outcomes, to ascertain if clinical deterioration can be predicted with simple community physiological monitoring.
  • Cecilia Vindrola-Padros, Naomi Fulop and Trish Greenhalgh describe the importance of oximeters and how they could save lives in Nuffield Trust article: ‘Virtual wards: caring for Covid-19 patients at home could save lives’. Read the Nuffield Trust article here.

Join the learning network

The AHSN Network have convened a rapid learning and sharing network to support the pilot sites, and the development of toolkits, on the FutureNHS collaboration platform.

If you currently have access to this platform, log on and click on ‘My Workspaces’, then ‘Find a Workspace’ and search for ‘National Patient Deterioration Forum’. Once access is granted, click on the ‘COVID 19 Virtual Ward Toolkit’.

For those not on FutureNHS, you can register if you have an NHS email address.  Register for a Future NHS account here (using your NHS email address) and request access to the National Patient Deterioration Forum.

These quick start guides cover how to access the COVID Oximetry @home toolkit and how to access the COVID virtual ward toolkit.

Get in touch

For more information, and to discuss the support available from the West of England AHSN, please email Nathalie Delaney at nathalie.delaney@nhs.net.

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