HOME OXYGEN ORDER FORM (HOOF) USER GUIDE Prior to
Contents
1. HOME OXYGEN ORDER FORM HOOF USER GUIDE PATIENT NEEDS OXYGEN Ambulatory Ea Emergency Short Burst L T amp Ambulatory O2 should not 1 Call Air Products on normally be prescribed without a 0800 373580 to initiate specialist respiratory assessment supply unless for example for Palliative Care 2 Complete Patient Consent Form HOCF 3 Complete HOOF stating it is confirmation of the telephone order Complete Patient Consent 4 If oxygen is needed Form HOCF beyond 3 days complete a second Complete HOOF HOOF at the same time stating when the routine Fax HOOF to Air Products oxygen supply commences and the Fax HOOF to PCT Oxygen Lead emergency supply should cease Original HOOF and consent form stays on patient record Fax HOOF s to Air Products Send a copy to the patients GP practice if assessment made by Fax HOOF to PCT respiratory team Oxygen Lead Original HOOF and consent form stays on patient record 8 Send acopy to the patients GP practice if assessment made by respiratory team NB An emergency oxygen prescription supply 4 hour response costs 9 times more than routine supply and will continue fora minimum of three days and then until cancelled or a routine HOOF is received Prior to hospital discharge oxygen SHOULD BE requested direct from Air Products by the hospital 3 days in advance of discharge 1 When to use the HOOF The HOOF replaces the FP10 prescription for oxyg2. en and is required for all patients who use home oxygen cylinders from 1 February 2006 Concentrator patients who do not use cylinders do not need a HOOF Ambulatory or long term oxygen should not normally be ordered without prior specialist respiratory assessment Complete a Home Oxygen Consent Form HOCF at the same time as the HOOF for all new patients to obtain patient consent for sending the order to the supplier Air Products as they are outside the NHS 2 Completing the form The form must be completed in full omissions are likely to result either in delay in supply or a call from Air Products for clarification Please note You must confirm that patient consent has been obtained using the HOCF tick box Modality of supply boxes 7 9 on the HOOF sufficient information e g flow rate hours usage should be given to allow the supplier to provide the most appropriate modality for the patient In general for short burst oxygen therapy 2 litres min is an appropriate flow rate unless the patient has been assessed by a respiratory physician and an alternative flow rate suggested The tick box relating to an oxygen conserving device box 14 should be ticked only if a device is NOT wanted 3 Emergency oxygen and out of hours supply Call Air Products on 0800 373580 to initiate a supply within 4 hours Complete the HOOF and HOCF as above and fax the HOOF to Air Products as confirmation of the order as soon as possib
3. le If ongoing oxygen is needed beyond 3 days complete a second HOOF so that Air Products know when the emergency supply ceases and the ongoing supply begins NB An emergency oxygen prescription supply 4 hour response costs 9 times more than routine supply and will continue for a minimum of three days and then until cancelled or a routine HOOF is received 4 COMPLETING THE ORDER Fax the HOOF to Air Products on 0800 214709 They will inform the patient about installation gt Fax copy to the PCT Oxygen Lead Laraine Tuplin Sue Allen 01332 203046 gt File original in patient records 5 Holiday provision Patients should ask their GP to complete a HOOF for oxygen required while they are on holiday within the UK Include the duration of supply and oxygen delivery address in box 13 6 Where to obtain the forms GP practices Derwent Shared Services Outrams Wharf
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