Evaluation of an Assessment Tool for Equipment Management (ATEM) of Home Oxygen Concentrators

Abstract

BACKGROUND: We sought to assess clients’ or caregivers’ ability to accurately and safely manage home oxygen equipment and backup systems. Forms commonly used for client assessment by home oxygen equipment providers were compared to the Assessment Tool for Equipment Management (ATEM) of home oxygen concentrators (HOC). The ATEM addresses standards for knowledge assessment recommended by the Joint Commission on Accreditation of Healthcare Organizations including knowledge of liter flow, hours of daily use, oxygen safety and emergency procedures, equipment maintenance and storage, use of backup supplies, and response to equipment malfunction. METHODS: Five regional home care companies recruited 70 subjects who were first-time users of HOC; hospice clients were excluded. Participants were interviewed twice during in-home visits by a different employee each time. They were randomized to be assessed initially by either the ATEM or the company documentation form. The first interview was within 5 days of equipment setup and training. The second interview, using the remaining assessment tool, took place an average of 3.2 days later, with the interviewer blinded to the first assessment results. The company documentation forms were then independently scored using the ATEM format. RESULTS: Compared with the ATEM, company documentation forms provided less specific and complete information. Company forms were also more subjective in their assessment of knowledge of proper management of equipment. The ATEM identified high-risk knowledge deficits related to equipment management more than 16 times more often than standard instruments (67 deficits vs 4 deficits detected) (p <0.001). Three of 5 companies recorded no knowledge deficits or functional problems in 39 clients, while the ATEM found 36 deficits in the same population. CONCLUSIONS: The ATEM comprehensively assesses knowledge and functional ability of clients or caregivers to manage HOC safely and with greater sensitivity than other assessment forms. The ATEM facilitates documentation by providing both visual cuing and well-defined criteria for scoring and identifies potentially critical knowledge deficits far more often.