Moore David
Respiratory Nurse Specialist and Independent Nurse Prescriber, Mater Hospital Belfast.
Br J Nurs. 2019 Jul 25;28(14):912-917. doi: 10.12968/bjon.2019.28.14.912.
Two landmark studies demonstrated survival benefit in chronic obstructive pulmonary disease (COPD) complicated by chronic hypoxaemia with the prescription of long-term oxygen therapy (LTOT). Best practice evidence therefore recommends that individuals with stable COPD and resting hypoxaemia (PaO≤7.3 kPa) should be assessed for long-term oxygen therapy. However, it is estimated that up to one-quarter of COPD patients prescribed LTOT continue to smoke. Oxygen therapy consequently presents an obvious fire hazard in the case of such patients, who are therefore at greater risk of death or sustaining devastating head and neck burns. This article critically analyses, through the context of a care study, the professional, ethical and legal issues involved in making a safe prescribing decision for LTOT in an individual with COPD who is a current smoker. Home oxygen prescription is a growing trend in the COPD population, and it is important for nurse prescribers to be aware of the issues highlighted in the article to ensure safe prescribing practices.
两项具有里程碑意义的研究表明，对于合并慢性低氧血症的慢性阻塞性肺疾病（COPD）患者，长期氧疗（LTOT）可带来生存获益。因此，最佳实践证据建议，对于稳定期COPD且静息时存在低氧血症（PaO≤7.3 kPa）的患者，应评估其是否适合长期氧疗。然而，据估计，在接受LTOT治疗的COPD患者中，高达四分之一的人仍在吸烟。因此，对于这些患者，氧疗存在明显的火灾隐患，他们因此面临更高的死亡风险或遭受严重的头颈部烧伤。本文通过一项护理研究的背景，批判性地分析了在为一名仍在吸烟的COPD患者做出安全的LTOT处方决策时所涉及的专业、伦理和法律问题。家庭氧疗处方在COPD患者群体中呈上升趋势，护士开处方者了解本文所强调的问题以确保安全的处方实践非常重要。
