PPT9 Staff perspectives on nasal high flow oxygen: assessing clinical practice and the need for standardised guidelines in a teaching hospital

<h3>Background</h3> Nasal High Flow Oxygen (NHFO) delivers heated, humidified oxygen at high flow rates and is increasingly used for respiratory support. However, concerns persist regarding its inappropriate use at end of life, potentially delaying discharge and prolonging hospital stays. Despite these issues, NHFO remains widely used, with inconsistent application of standard operating procedures (SOPs) and varied clinician perspectives. This study aimed to explore staff perspectives on NHFO at a single teaching hospital trust. Assessment focused on their knowledge of appropriate indications, decision-making around initiation and withdrawal, and experiences of suboptimal outcomes related to NHFO use in clinical practice. <h3>Methods</h3> To gather data, an online questionnaire was distributed for one month via hospital email lists and QR codes, targeting physicians and nurses in medical specialties and critical care. The survey comprised questions on participant demographics and NHFO-related practices. <h3>Results</h3> A total of 164 staff members (Consultants 15%, Staff Nurses 23%) from various specialties (Emergency Medicine 17%) responded. While 70% felt confident identifying appropriate clinical scenarios for NHFO, only 44% were confident about its withdrawal. Notably, 89% supported the development of a formal withdrawal plan. Among those involved in NHFO withdrawal, one-third believed NHFO should not have been initiated in the cases they had managed. <h3>Conclusions</h3> These results show a cohort of individuals who are confident in starting NHFO, but not in NHFO withdrawal. Additionally, it supports the mix of experiences amongst staff- a third of the participants had experienced caring for an individual where they believed NHFO had been started inappropriately. These findings support a need for further education and consistency in NHFO use through production of a SOP for NHFO administration and withdrawal, taking into account risks and benefits of starting NHFO. Next steps will be production of a SOP and then a re-audit of staff perspectives.