The Newcastle upon Tyne Hospitals NHS Foundation Trust. Policy for the Transportation and Storage of Medical Gases

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1 The Newcastle upon Tyne Hospitals NHS Foundation Trust Policy for the Transportation and Storage of Medical Gases Version No: 1.0 Effective From: 23 January 2014 Expiry Date: 23 January 2016 Date Ratified: 7 November 2013 Ratified By: Trust Health and Safety Committee 1. Introduction The Newcastle upon Tyne Hospitals NHS Foundation Trust recognises that it has a responsibility to provide a safe environment for all patients, staff and visitors. It is important to remember that piped medical gasses should always be the preferred option of supplying medical gasses to patients and cylinder gasses should only be used when this is not possible. After interrogating accident data within the Trust associated with Medical Gas cylinders, it has been identified that specific guidance is needed to ensure the safe storage and transportation of Medical Gas Cylinders on wards, departments and throughout the Trust. 2. Policy Scope This Policy document is provided to ensure that all staff involved in the handling, transportation and storage of medical gases understand their individual responsibilities and the methods employed by the Trust to ensure safe practice. 3. Aims of Policy Failure to adhere to safe practice when transporting or storing medical gas cylinders can lead to serious injury or fatalities. 4. Duties Roles and Responsibilities 4.1 Chief Executive - The Chief Executive has overall responsibility to the Trust Board for ensuring that appropriate and effective health and safety management systems are in place. 4.2 Directorate Managers - The day-to-day activities of the Directorate/Department are conducted in as safe and suitable manner. 4.3 Medical Gas Committee Responsible for ensuring and monitoring compliance with the policy. Page 1 of 9

2 5. Strategy 5.1 Storage of Medical Gas Cylinders on Wards and Departments It is imperative to safety that Medical Gas Cylinders are stored correctly on Wards or in Departments to ensure that cylinders do not pose a risk to staff, patients or visitors. If cylinders are not stored in a correct manner they can pose a risk by falling onto people causing injury or as a significant tripping hazard Cylinders should be stored in a designated area and must be secured in place It is recommended that there is a designated area located as near to the exit/entry to the department as possible for easy access, but consideration must be given to ensure that safe access and egress is maintained Cylinders should never be left lying on floors unsecured or in areas where they can present a tripping hazard Cylinders must never be propped against walls as they can fall and injure passers by Cylinders must never be left on top of tables, chairs, beds or anywhere they can fall from height and injure people Cylinders must be placed in an appropriately designed holder. Cylinders should not be placed on patients beds, they must `be placed in specifically designed holders where they can be kept away from direct contact with combustible materials. Please be advised that the Trust does not have a suitable vehicle or drivers qualified in the (Transportation of Hazardous substances) to transport medical gasses between sites. If a patient requires medical gasses that are not available through a piped system, the relevant gas or gases must be ordered from the supplier via the Trust Pharmacy Department in advance of the patient attending. WALL BRACKET - CYLINDER Cylinders stored on Wards or Departments should be stored in these purpose built storage facilities. Cylinders should be stood in the upright position and secured in place with the chains provided. Any missing chains or damage to the storage facility must be reported to the Estates department for replacement or repair. Page 2 of 9

3 HOLDER/WALL BRACKET - CYLINDER This product is for securing 2 cylinders securely and safely. It should be positioned to the wall at approximately half of the cylinder height. The cylinder size is indicated on each bracket. This product can be obtained from Bristol Maid Hospital Metalcraft Limited. CYLINDER HOLDER This product allows for safe storage of D and E size cylinders at a bedside and features a carry handle and an extended hanging hook suitable for beds with 25mm thick side/end members, with a small gap between base and frame. The holder can be bolted to the bed for added security. WALL PLATE FOR CYLINDER HOLDER This product is a stainl ess steel wall plate to support and provide a permanent place for 1 cylinder holder. The cylinder holders slot into the flange at the top of the wall plate as shown. Page 3 of 9

4 5.2 Transportation of Medical Gas Cylinders - Clinical CLINICAL TROLLEY - CYLINDER, 'F/G' Cylinder trolley to hold popular 'F' or 'G' cylinders. Cylinder is retained by means of two drop over chains. Wheels are inoperative when trolley is in the upright position and stationary TROLLEY - CYLINDER, 'J' This trolley has been strengthened to transport a large 'J' cylinder. Wheels are inoperative when trolley is stationary and in the upright position. Cylinder is retained by 2 drop over chains. 5.3 Transportation of Medical Gas Cylinders Portering PORTERING TROLLEY - CYLINDER, 'F/G', STABILISERS Trolley fitted with 2 extra castors allowing transportation of cylinder stabilised, thus reducing likelihood of tipping. Page 4 of 9

5 TROLLEY - CYLINDER, DOUBLE 'F/G', STABILISERS Increased width trolley with rear stabilisers to support two F or G cylinders. Cylinders are supported by drop over chain linkages TROLLEY, CYLINDER - 12 'D' or 'E' Special trolley with 12 sections suitable for 'D' or 'E' cylinders, with non-slip rubber base board and push handle one end. Suitable for transporting and delivering or for areas requiring more than the average medical gas storage. TROLLEY - CYLINDER, 'J', STABILISED For transportation of a large 'J' cylinder, with 2 extra castors allowing transport of cylinder stabilised, reducing likelihood of tipping. Page 5 of 9

6 5.4 Transportation of Patients on Medical Gas Therapy G/200/RS PORTERING, REAR STEER, INTER-NESTING CHAIR This is the G/200/RS Portering, rear steer, inter-nesting chair. This chair is purchased from Bristol Maid, Hospital Metal Craft and is the preferred chair for the transportation of patients and medical gasses. As can be seen in this photograph the cylinder sits in the cylinder holder, which is secured to the back plate of the chair. This ensures that the cylinder is away from the patient and is secured in a safe po sition and d oes not present a hazard to passers by. The cylinder holder can b e removed from the chair and safely be secured to a wallmounted plate once you have reached the patients destination. (See wall m ounted plate pictured above). Or transferred to an upright cylinder holder. HOSPITAL WHEELCHAIR This is a sta ndard hospital wheelchair used throughout the trust. This chair must not be used to transport patients and medical gasses unless a third person can accompany the patient to carry the medical gas cylinder in a mobile oxygen trolley. THEATRE TROLLEY All patient trolleys us ed within the trust are equipped with specific medical gas cylinder storage areas as shown. These storage areas must always be used when transp orting patients and medical gas cylinders. Medical gas cylinders must never by transported on to p of the trolley beside the patient. Page 6 of 9

7 INFANT COT When transporting a patient in a paediatric cot the cylinder holder must be attached to the rail at the foot of the cot as shown. WARD BED When transporting patients in hospital beds the cylinder holder should be attached at the head or the foot of the bed as shown. WARD BED The cylinder holder must not be attached to the cot-side of the bed as this would present a hazard to passers by and could also cause the cot-side to collapse. Page 7 of 9

8 5.5 Guidance on Handling of Medical Gas Cylinders A full risk assessment must be completed for any task involving the transportation of medical gasses. All staff must be properly trained in manual handling and in the transportation of medical gasses. Always use the correct trolley for the size of the cylinder to be transported. Cylinder trolleys, transporters and holders should be regularly checked for defects by the user. All defects must be reported to the Estates Department for repair. Always ensure that the cylinder is secured in place when transporting. Only ever milk churn cylinders to manoeuvre cylinders over short distances e.g. trolley to bed. Never leave cylinders free standing, always ensure they are secured in an appropriate holder. Never roll cylinders along the ground as this can cause the valve to open accidentally which could cause an explosion or a fire and will also damage the cylinder paintwork and label. Never attempt to catch a falling cylinder. Only size D and E size cylinders should be used whilst transporting patients on oxygen therapy. Ensure cylinders are stored in a clean well ventilated room, free from dust and grease. Always use an appropriate cylinder carrier during transportation. These are available for beds and chairs. Never put a cylinder between a patient s legs. Never cover a cylinder with a blanket (the bedding will become saturated and pose an extreme fire hazard.) Avoid all grease and oil when handling or having medical gases administered (whether via a cylinder or via a pipeline). Do not use hand cream before handling a medical gas. Patients should not use oil / grease based lip lubrication whilst being treated with medical gases (i.e. Vaseline, Lipsyl, Chapstick, lip balms etc) Further information can be obtained from a Trust Health and Safety Advisor if required re cylinders carriers, and Pharmacy Medicines Information for issues related to gas administration. Large quantities of medical gasses stored internally should be stored on an external wall. Page 8 of 9

9 6. Training Training on the Handling, Transportation and Storage of Medical Gas Cylinders will be provided to all staff involved in their use. This training will be provided via E- Learning. 7. Equality & Diversity The Trust is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on any grounds. This document has been appropriately assessed. 8. Monitoring Compliance of this policy will b e monitored by the Medical Gas Committee who will monitor the policy by undertaking a review of medical gas incidents which hav e taken place in the interim period between meetings. Standard / process / issue Compliance with Trust procedural document Transportation and Storage of Medical Gases. Monitoring and audit Method By Committee Frequency Reviewing Clinical Medical Gas Quarterly medical gas Governance Committee incidents & Risk reported via Datix on a Quarterly basis 9. Consultation and Review This policy has been reviewed in consultation with the Medical Gases Committee and the Trust Health & Safety Committee. 10. References The British Compressed Gas Association Technical Information Sheet TIS 12 regarding handling gas cylinders safely. Page 9 of 9

10 THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST IMPACT ASSESSMENT SCREENING FORM A This form must be completed and attached to any procedural document when submitted to the appropriate committee for consideration and approval. Policy Title: Policy for the Transportation and Storage of Medical Gases Policy Author: Ian Gaffney Yes/No? 1. Does the policy/guidance affect one group less or more favourably than another on the basis of the following: (* denotes protected characteristics under the Equality No Act 2010) Race * No Ethnic origins (including gypsies and travellers) No Nationality No Gender * No Culture No Religion or belief * No Sexual orientation including lesbian, gay and bisexual people * No Age * No Disability learning difficulties, physical disability, sensory impairment and No mental health problems * Gender reassignment * No Marriage and civil partnership * No 2. Is there any evidence that some groups are affected differently? No 3. If you have identified potential discrimination which can include associative discrimination i.e. direct discrimination against someone because they associate with another person who possesses a protected characteristic, are any exceptions valid, legal and/or justifiable? 4(a). Is the impact of the policy/guidance likely to be negative? N/A (If yes, please answer sections 4(b) to 4(d)). 4(b). If so can the impact be avoided? N/A 4(c). What alternatives are there to achieving the policy/guidance without the impact? N/A 4(d) Can we reduce the impact by taking different action? N/A N/A You must provide evidence to support your response: Comments: Action Plan due (or Not Applicable): Name and Designation of Person responsible for completion of this form: Ian Gaffney Date: Names & Designations of those involved in the impact assessment screening process: Ian Gaffney Health and Safety Advisor (If any reader of this procedural document identifies a potential discriminatory impact that has not been identified on this form, please refer to the Policy Author identified above, together with any suggestions for the actions required to avoid/reduce this impact.) For advice on answering the above questions please contact Frances Blackburn, Head of Nursing, Freeman/Walkergate, or, Christine Holland, Senior HR Manager. On completion this form must be forwarded electronically to Steven Stoker, Clinical Effectiveness Manager, (Ext ) together with the procedural document. If you have identified a potential discriminatory impact of this procedural document, please ensure that you arrange for a full consultation, with relevant stakeholders, to complete a Full Impact Assessment (Form B) and to develop an Action Plan to avoid/reduce this impact; both Form B and the Action Plan should also be sent electronically to Steven Stoker within six weeks of the completion of this form. IMPACT ASSESSMENT FORM A October 2010

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