CategoriesOxygen,  Services

Six Tips for Selecting the Right Cannula

cannula

Not all oxygen nasal cannulas are alike

For your patients with chronic obstructive pulmonary disease (COPD), where long-term oxygen therapy is required, a nasal cannula is used to administer oxygen flow. These devices are simple to use and install but not all are created equal.

Following are some helpful tips for selecting the best nasal cannula for each individual patient in order to achieve maximum results.

Know the Basics

No matter which type of cannula you choose, the most important thing is that it works. Make sure the oxygen flow is uninterrupted by selecting a kink-free tube. Some are reinforced with multiple internal channels (3-channel, 5-channel or 6-channel tubing) to make the whole tube sturdier. Others are referred to as “smooth bore,” meaning the inside is smooth. In some cases, smooth bore tubes are sufficient if the tube is narrow and the walls are thicker; however, when the tubes are wider, as with a high-flow cannula, multiple channels are recommended for extra support.
The second important factor is patient comfort. To achieve a comfortable fit, the tube should feel soft against the skin and be memory-free. To test this, request samples from your manufacturer and lay them out on a flat surface. If the tube lays flat instead of coiling back up, it is memory-free, which will increase comfort for the patient by securely fitting against his or her face and reducing friction against the skin.

Purchase from a Reputable Dealer

With Medicare’s cuts on oxygen reimbursement, it can be tempting to purchase your cannulas based on price. However, if your patients are not satisfied with the equipment you provide, you will incur the extra cost of either shipping them a new cannula or sending a technician to check on them. Even if you successfully replace faulty equipment, your reputation for providing quality products may suffer, making it well worth the effort to do some additional up-front research.

A qualified distributor will have a rigid set of quality control tests that their products must pass before they can sell them to you, so you can be confident that you will receive a reliable product the first time, every time. Ask your current manufacturer what quality control measures they have in place and if you are not satisfied with the results, look elsewhere.

Make Sure It Fits

Most cannulas come in three basic sizes: adult, pediatric or infant, which can work for the majority of patients.

The shape of the nasal prong can also vary from curved to straight and tapered to flare. This is based on patient preference and nose shape. Most patients prefer a curved shape as it matches the natural curvature of the nasal canal. When placing a cannula with a curved nasal prong on a patient, the curve should face downward. The prongs can also be trimmed slightly for added comfort.

Check the Flow as Prescribed by the Patient’s Doctor

A standard cannula can effectively deliver between 1-6 liters/minute of oxygen. Where higher rates are required (6–15 liters/minute), a high flow cannula is a good way to provide adequate saturation without using a mask. High flow cannulas have a larger bore (wider tube opening compared to standard tubing) to allow for effective delivery of oxygen flows up to 15 LPM.

Check the Oxygen Device

For most oxygen devices, a standard tube — sometimes called “single-lumen” — is used. With regard to oxygen tubing, the description single-lumen means there is one tube carrying the oxygen from the concentrator to the patient. For dual-port oxygen-conserving devices that only deliver oxygen when the patient inhales, a demand cannula should be used. A demand cannula has a split dual-lumen tube with two airways, one that delivers the oxygen and another that senses the breathing pattern of the patient to tell the device when to expel air.
Another factor to check on the device is the maximum tube length that the concentrator allows. Normally, length of oxygen tubing is determined by patient use and preference; however, some concentrators have limits for how long the tube can be before the pressure level will be affected. This information can typically be found in the device instruction guide.

The final thing to note when checking the device is the connection port. Most major manufacturers, including SeQual, Respironics, Invacare and Covidien Nellcor Puritan Bennett, use standard connectors. For non-standard or specialty connections, some manufacturers offer Fits-All connectors that are wider and can be adjusted to fit or separate adaptors that allow a standard tube to be used with a specialty connection.

Replace the Cannula Regularly to Avoid Infection

There is a lot of debate about how often to change a nasal cannula. We recommend homecare companies change their patients’ cannulas once per week to avoid infection and other complications. In addition, the cannula should be changed after the patient has been sick to avoid contact with the bacteria and mucus.

With Medicare’s recent changes in reimbursement, homecare companies have a limit to the amount they receive for oxygen patients. As a result, some manufacturers have established programs to make regular replacement easier and more affordable for their HME/DME customers.

Sunset Healthcare Solutions offers the ability to kit cannulas so DMEs can purchase a 3-month supply for each patient packed in one easy-to-use kit. All of the kits are customizable, so the DME can pick the quantities they are comfortable sending, and Sunset will assemble them at no additional charge.

With this unique approach, the DME can teach their patients how to replace their own cannulas and ship all the supplies they will need at once to save on shipping costs. Some fulfillment companies like our partners PPM, VGM and Jaysec offer drop shipping, so DMEs can have their supplies shipped directly to their patients without having to house inventory.

CategoriesServices

Product Instructions for Health Literacy

health-literacy

Studies show that almost 90 percent of adults struggle to understand health information readily available in hospitals, clinics, stores and the media. Meanwhile, the government is cutting reimbursement to the HME industry, which is pressuring providers to reduce the one-on-one care and training they now give to patients.

It’s a recipe for confusing older and ill patients who must use HME products for the first time. But there are steps you can take to ease their stress. HME providers can give patients simple instructions through a variety of mediums to increase health literacy—the degree to which patients understand medical information and use it to make good decisions about their health and medical care.

Placement With Packaging

The easiest place to teach patients how to use your products is on the packaging or on inserts you include with products. Many manufacturers cover this step with instructions that you can pass along to your patients. However, if your products do not come with instructions or you think they could use further explanation, add a supplemental flyer, booklet or instruction sheet. Here are tips for making instructions simple to understand:

  • Put the most important information first—many people with limited health literacy read only the first few words of a page.
  • Use simple language, short sentences and define technical terms.
  • Do research—chances are, somebody has already written instructions on how to use a product similar to yours. So check to see what other people have done and pick the most clear example to use as a guide.
  • Make the instructions easy to read and understand for all patients. This includes printing them large enough to read for people with poor vision, as well as making them bilingual if you serve a high percentage of non-English speakers.
  • A picture may be worth 1,000 words, but it’s worth 2,000 words if you count writing the instructions in two languages. Photos or diagrams can help patients no matter what language they speak.
  • Test instructions by having someone who has never used the product try to follow them. This can uncover gaps that are not obvious to you.
  • Ask patients for feedback on instructions and continually improve them if you hear the same questions multiple times. For example, if you receive phone calls from patients asking which side of their CPAP filter should be facing in toward the machine, then add a photo and description of the correct placement onto the packaging.

CPAP Filter insertion instructions

New Patient Set-up Kits

Another helpful piece of marketing that some providers have adapted is a new patient set-up kit. It can include everything from instructions, forms and manuals, to any replacement parts or tools they might need.

For example, many HME companies provide their new oxygen patients with a new-patient set-up kit that the manufacturer or distributor helps them to assemble. The kit includes all of the supplies that should be regularly replaced such as oxygen tubing and cannulas, as well as an accessory kit that includes every tool new patients might need to use with their oxygen device, such as a wrench for adjusting the cylinder pressure, a replacement washer and various connectors.

sunset-kit_chart

In addition to the supplies, many customers include their own instructions on best practices for handling the device, frequently asked questions, what to expect and other supplemental instructional materials that can make the transition onto oxygen therapy easier.

Instructional Videos

At a time when 16 million people per month visit WebMD to diagnose their own ailments, why not use YouTube videos to instruct patients on the correct way to use your products before they get incorrect information somewhere else?

Making a video is now surprisingly easy with the help of many digital cameras, smart phones and webcams. And YouTube now has free video editing tools available online so you can edit and add captions to your video at no cost. For information on tools to help you create your videos visit www.youtube.com/create.

Videos can be a great way to explain how to select, use, clean or fix one of your products without having to send a technician to a patient’s home. They provide the information impossible to convey through printed packaging.

Once your video is complete, post it on no fewer than these two locations:

1) Create a YouTube channel for your company—make it searchable by your company name and place all of your videos in one place for your customers and the general public to search. You can even customize your channel background to include your logo and color format. Be sure to tag the videos on YouTube once they are posted so people can easily search for them by subject, item or issue. As an added bonus, if you include your company’s web address at the end of your video, this could increase traffic to your website.

2) Embed the YouTube videos directly onto the corresponding product’s page on your website. That way if your patients are visiting your website to purchase your products, they can see the video and refer back to it if they have questions later.

Additional ways to get your video out there: Google Video, industry or company blogs, social networking and sites such as Facebook. You can even embed it in an e-mail and use it as a response to questions you receive from customers.

While the best solution is to send a trained technician to teach patients how to use new equipment and troubleshoot problems, with declines in reimbursement, the costs are not always feasible. When personalized attention isn’t an option, make sure you find other ways to educate your patients.

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