71 High flow nasal oxygen (HFNO) use in palliative and end of life patients: effect on care in an acute hospital

<h3>Background</h3> HFNO is used in the management of hypoxic patients. For palliative care patients, HFNO can increase symptom burden, cause distress and prevent preferred place of death. A literature search returned limited relevant results; mostly comparing HFNO, non-invasive ventilation and continuous positive airway pressure in the management of breathlessness, oral intake and tolerance of oxygen delivery. The literature recommends considering patients goals, values and preferences before commencing HFNO for palliative care patients. This survey seeks to add to the literature. <h3>Methodology</h3> Single hospital, retrospective audit of consecutive patients‘ electronic notes (n = 15). Patients known to the Hospital Palliative Care Team (HPCT) and used HFNO (April-July 2023). A subsample of notes double checked for consistency and bias. Ethical permission was not necessary as survey assessed routine practice. Project was registered with governance team. Data was anonymised and stored securely in hospital. <h3>Results</h3> <h3>Conclusion</h3> This shows the adverse outcomes of HFNO are not routinely considered prior to commencement. The hospital’s oxygen policy was reviewed and updated based on these findings and an education program is in development. Reaudit planned to assess effect of interventions.