AGING AND DISABILITY SERVICES ADMINISTRATION

 

December 17, 2001

 

AASA: BH #2001-027
Subject:??? OXYGEN USE AND SMOKING HAZARDS

 

Dear Boarding 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 danger 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 resident 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.

State regulations, at Washington Administrative Code (WAC) 388-78A-055(1)(w), require boarding homes to have policies and procedures related to smoking, including a means to protect nonsmokers.? An assessment of the resident?s abilities and needs must be done in order to determine his or her ability to smoke safely.

The policies and procedures must include safety issues related to resident smoking, and to residents who use oxygen and also smoke.? Enough details should be provided so that staff can ensure that residents who smoke are enabled to do so safely, and to protect nonsmokers.

Criteria under WAC 388-78A-240(1)(e) require the boarding home to evaluate the ability of staff to meet the resident?s needs based upon, among other things, his or her functional abilities including mental status and ability to perform activities of daily living.? This relates specifically to the resident?s cognitive and functional status, both of which influence the degree of risk associated with the task of smoking.? The resident?s ability to safely dispose of ashes and cigarette butts, and whether the resident uses oxygen, should also be assessed.

WAC 388-78A-260(1)(a) requires the boarding home to prepare an individual?s resident plan.? An individual?s resident plan is defined in WAC 388-78A-010 as a statement, written by the licensee and approved by the resident or the resident?s representative, of services to be provided based on an evaluation of the resident?s needs.

The facility must ensure that staff know, understand, and implement these policies and procedures.? This would include, at a minimum, the need for assessment, informing the resident of the safety risks related to smoking, the supervision required, and the individual?s resident 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