Using new technology to support patients with Covid-19 to remain safe at home
How did we do it?
In the first wave of the pandemic, many clinicians found that using pulse oximetry helped with earlier detection of ‘silent hypoxia’ in people with coronavirus, where a patient’s oxygen levels are dangerously low, but without any symptoms such as shortness of breath.
A pulse oximeter is a small medical device that is put on the tip of the finger, to check someone’s oxygen levels. Pulse oximeters measure blood oxygen levels by transmitting light through a finger – they are more accurate than smart watches or phones which make less accurate readings by reflecting light off the skin. By regularly monitoring oxygen levels with a pulse oximeter, it can be easier to spot if coronavirus symptoms are getting worse and identify if someone needs treatment or support.
To help support patients to remain in their own homes safely wherever possible, the Partnership set up The ‘Covid Oximetry at Home Service’, a collaboration between University Hospital Coventry & Warwickshire (UHCW), South Warwickshire Foundation Trust (SWFT), George Eliot, GPs and the NHS Volunteer bank, all of whom have worked together to design and deliver the service. Through this service, people who were diagnosed with coronavirus were provided with a pulse oximeter to use at home, to check their oxygen saturation levels for a set period of time and help spot signs of deterioration as early as possible so they could access help as soon as it was needed. The pulse oximeters which are self-monitoring devices, are offered to people who have been diagnosed with coronavirus, are symptomatic, and either extremely vulnerable to coronavirus or aged 65 or older, including people in care homes.
The services is GP led, and delivered by South Warwickshire Federation and GP Alliance across Coventry and Warwickshire. It provides that extra, vital layer of support that enables more intense monitoring of vulnerable patients with COVID within their homes and empowering them either to feel confident at home or seek that emergency help if needed in a timely and appropriate way.
Patients are offered regular prompts or check-ins to ensure they are confident in using the oximeter and that they know what to do if oxygen levels fall below normal levels. This may require assistance from carers and/or family members. A patient diary and instructional video are also made available. NHS Volunteer Responders are on hand to support the service by delivering oximeters to people’s homes where needed.
By regularly monitoring oxygen levels with the oximeter, it can be easier to spot if coronavirus symptoms are getting worse. If the readings show oxygen levels are starting to fall, the patient can be referred by the GP to the hospital to get the treatment they need early. Patients receive two phone calls a day; one to collect all the readings and another from a doctor to advise on next steps based on the data.
If, after 14 days of the onset of symptoms, patients show no signs of deterioration with coronavirus, they will be appropriately discharged from the service and given advice on returning the oximeter safely, and how to continue supporting themselves at home.
The service is also suitable for those patients who are well enough to be discharged from hospital, but still need close monitoring. This means patients can return to their own homes whilst still under the watchful eyes of clinicians during the later stages of their recovery from COVID and ensures continuity of care for the patients with ongoing needs and health issues, as well as freeing up resources for the acute trusts for other patients.
For more information about looking after yourself at home visit the NHS website.
“The gratitude and appreciation we are receiving from patients in this service speaks of the vulnerability these patients feel during this time and the comfort knowing they have access to this service, gives them. It is heartfelt.” Dr Hannah Tomes, GP/Clinical Lead for the service
“It has been extremely valuable to work on a project with healthcare stakeholders across the partnership. Aligning the services available in the footprint to match the requirement of the patient is exactly the kind of collaborative working that we need to foster in the future.
“Whilst COVID has been the most challenging event of most of our careers, it has presented opportunities such as this service, that we absolutely need to capitalise on in the future. I am particularly glad to have met and worked with the acute care providers in the partnership and look forward to working together on subsequent projects.” Dr Ben Attwood, consultant at SWFT