The use of pulse oximetry in care homes to manage residents with COVID-19 and long-term health conditions in England: a rapid evaluation

Manni Sidhu, Ian Litchfield, Robin Miller, Naomi Fulop, Barbara Janta, Jamie-Rae Tanner, Giulia Maistrello , Jenny Bousfield, Cecilia Vindrola-Padros, Jon Sussex

Research output: Book/ReportCommissioned report


Background: There are over 15,000 care homes in England, with a total of approximately 450,000
beds. Most residents are older adults, some with dementia, but others are people of any age with
physical or learning disabilities. Using pulse oximetry in care homes can help the monitoring and care of residents with COVID-19 and other conditions.

Objectives: To explore the views of care home staff, and NHS staff they interact with, about using
pulse oximetry with residents and NHS support for that.

Design: Rapid, mixed methods evaluation of care homes in England, comprising: 1) scoping
interviews with NHS leaders, care association directors and care home managers, engaging with
relevant literature, co-designing with a user involvement group; 2) online survey of care homes; 3)
interviews with care home managers and staff, and with NHS staff who support care homes, at six
purposively selected sites; and 4) synthesis, reporting and dissemination. The study team undertook online meetings and a workshop to thematically synthesise findings, guided by a theoretical framework.

Results: We obtained 232 survey responses from the 15,362 care homes: a low (1.5%) response rate but expected given exceptional pressures on care home managers and staff at the time of the survey We conducted 31 interviews at the six case study sites. Pulse oximeters were used in many
responding care homes before the pandemic and their use widened during the pandemic. Pulse
oximeters are reported by care home managers and staff to provide reassurance to residents and
their families, and to staff. Using pulse oximeters was usually not challenging for staff and did not
add to staff workload or stress levels. Additional support provided through the NHS COVID Oximetry at Home programme was welcomed at the care homes receiving it, but over half of survey respondents were unaware of the programme. In some cases, support from the NHS, including training, was sought but was not always available.

Limitations: The survey response rate was low (1.5%) so findings must be treated with caution.
Fewer than the intended number of interviews were completed due to participant unavailability.
Throughout the pandemic, care homes may have been asked to complete numerous other surveys
etc., which may have contributed to these limitations. Due to anonymity, the research team was
unable to determine the range survey respondents across location, financial budget or quality of

Conclusions: Using pulse oximeters in care homes is considered by managers and staff to have been beneficial to care home residents. On-going training opportunities for care homes’ staff in use of 4 pulse oximeters would be beneficial. , Escalation processes to and responses from NHS services could be more consistent alongside promoting t the NHS COVID Oximetry at Home programme to care homes.
Original languageEnglish
Commissioning bodyNIHR HS&DR Programme
Publication statusAccepted/In press - 2022

Bibliographical note

Not yet published 06/05/2022


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