More than 100 incidents of patients or visitors lighting cigarettes while close to oxygen were reported in a five-year period, according to HSE data for acute hospitals.
Overall, approximately 3,700 incidents relating to smoking in acute services were reported to the national incident management system (NIMS) from 2018 to 2022.
Over 180 incidents resulted in harm to either patients, visitors or staff. Four serious incidents associated with smoking in the five-year period led to severe harm or death of patients.
More than 2,000 incidents of indoor smoking were reported. A HSE patient safety supplement, produced in 2023, noted it was “especially concerning” that over 100 of these reports related to patients or visitors lighting cigarettes while using, or being close to, oxygen.
Smoking beside oxygen, which accelerates combustion, had led to a number of fires “resulting in burns (some significant), and smoke inhalation injuries to the patient, other patients and staff. Unfortunately, in more serious incidents patient deaths have occurred”, according to the patient safety supplement.
The data also found that verbal and physical abuse of staff and patients – by patients requesting to smoke – was a recurring theme.
Incidents of patient harm due to smoking following application of alcohol gel were also highlighted.
“Ongoing challenges are encountered when patients leave health services to have a cigarette. Predominantly these were incidents where patients did not return or fell resulting sometimes in serious injuries including fractures.”
Recommendations included working with patients to support the treatment and management of tobacco addiction and recording the smoking status of all patients routinely on admission.
A HSE spokesperson told the Medical Independent that ‘stop smoking’ clinical guidelines were published by the Department of Health’s national clinical effectiveness committee in January 2022. The guidelines recommend that healthcare professionals ask about smoking status at every consultation and act by recommending or prescribing stop smoking medication and referring to stop smoking (QUIT) services.
The HSE’s Tobacco Free Ireland Programme has produced an e-learning module for healthcare professionals called ‘Stop smoking medicines and how to use them’.
The Executive’s spokesperson further noted that its Tobacco Free Campus Policy was launched in 2012.
“Successful implementation of the policy requires leadership and a systematic approach,” they said. “The HSE Tobacco Free Ireland Programme is committed through its implementation plan (2022-2025) to supporting health services nationally to achieve the highest level of tobacco free policy implementation and are consistently employing new and creative supportive strategies.”
In 2019, the programme introduced a Tobacco Free Campus Quality Improvement Bursary. Three individual bursary cycles have been completed to date, with over 150 services awarded funding to invest in tobacco control initiatives.
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