AGING AND DISABILITY SERVICES ADMINISTRATION
December 17, 2001
Subject: OXYGEN USE AND SMOKING HAZARDS
Dear Adult Family Home Provider:
In the past year, a number of long-term care residents have been observed smoking while using oxygen.? I am taking this opportunity to remind you of the general hazards associated with smoking and of the dangers of using oxygen at the same time.
The department was informed, this past year, of three incidents where residents had sustained facial burns while smoking and using oxygen at the same time.? Other injuries from residents smoking, but without oxygen use, have resulted in burns on resident hands, holes burned in resident clothing, and residents? hair being singed.
The department consulted with the State Fire Marshal?s office, which provided the following information regarding smoking and oxygen:
- No smoking should take place in any area where liquid oxygen tanks are filled.
- No oxygen container should be in use within 10 feet of residents who are smoking.
- At minimum, if residents who use oxygen wish to smoke, the oxygen supply must be turned off and the nasal cannula removed from the resident?s face while smoking.? This applies to all types of oxygen supply or container.
The following areas of chapter 388-76 Washington Administrative Code (WAC) spell out some state requirements that apply to smoking, to smoking and oxygen use and to related safety issues:
WAC 388-76-60050(1)(b)&(f)? Requires the adult family home (AFH) to have house rules and policies governing resident conduct and responsibilities during the resident?s stay in the AFH, and to provide them to the resident prior to admission.
If smoking is allowed in the AFH, house rules and policies must include safety issues related to resident smoking, and to residents who use oxygen and also smoke.? The rules and policies should provide enough detail so that staff can ensure that residents who smoke are enabled to do so safely, and to protect non-smokers.
WAC 388-76-61020? Requires that specific information be contained in the current written assessment.? The following required areas of assessment provide important information for residents who smoke.
(1) Significant known behaviors or symptoms
that may cause concern or require special care;
(5) Evaluation of cognitive status in order
to determine the individual?s functioning, including an evaluation of disorientation,
and impaired judgement; and
(10) Preferences and choices regarding daily life that are important
to the person.
In order for the provider to determine the resident?s ability to smoke safely, the resident?s abilities and needs must be identified.? Both cognitive and functional status influence the degree of risk associated with the task of smoking.? The provider should also consider the resident?s ability to safely dispose of ashes and cigarette butts, and whether he or she uses oxygen.
WAC 388-76-61500(5)? A negotiated care plan ? identifies:? Other preferences and choices regarding issues important to the resident ? and what efforts will be made to accommodate those preferences and choices.
WAC 388-76-620(4)(b)? The provider shall ensure that resident services are delivered in a manner and in an environment:? ? Promotes the safety of all residents ?
The provider must ensure that staff know, understand, and implement smoking rules and policies.? This includes, at a minimum, the need for assessment, informing the resident of the safety risks related to smoking, the supervision required, and the resident?s negotiated care plan around the issues of safety related to smoking, and oxygen use if any.
If you have any questions please contact your local Residential Care Services (RCS) Field Manager.
Sincerely,
Patricia K. Lashway, Director
Residential Care Services
cc:????? RCS Regional Administrators
