Transcript Slide 1
COPD and Outreach Services
Mandy Dickson
Clinical Nurse Specialist
Respiratory Outreach Service
What’s New?
Clinical Strategy for COPD
My Role
Provide education and share knowledge
to staff, patients and carers
Act as a resource for other healthcare
professionals
Run nurse-led clinic for chronic disease
Respiratory Outreach Service manager
Respiratory Outreach Service
The Respiratory Outreach Service was
set up in 2002 to facilitate the early
supported discharge of respiratory
patients, mainly those with COPD.
The aim of the service was to discharge
patients within 3 days of admission and
continue their treatment at home.
How do we find our patients?
Admissions List
Referral from ANY team
A&E or Obs ward
Outpatients Clinic
Criteria
Oxygen saturations >90% on air or
LTOT
PH within normal limits
No acidosis
CXR – minimal consolidation, no
pneumothorax or pulmonary oedema
No worsening peripheral oedema
No acute confusion
No nocturnal dyspnoea
Able to transfer safely/independently
Self caring or home support available
Self medicating or support available
Access to telephone
Patient agreement
Our Role in Discharge
Respiratory assessment
Measure against the criteria for early
supported discharge.
Inform medical team patient meets our
criteria for discharge
TTA’s
Transport
Patients would need to meet a strict
criteria to ensure their safety
Discharged home on nebulizers, steroids
and +/- antibiotics
Loan of equipment
Daily visits from specialist trained nurses
to provide full respiratory assessment,
monitoring of condition, treatment
changes, and education
Although patients are discharged from
the hospital they remain under the care
of the Outreach Service and the
Respiratory Team have medical
responsibility until we discharge them.
Follow-up, if required, is with the
discharging team or Respiratory Nurse
Clinic.
Benefits of the Service
Length of stay in hospital down from 13.9 to
<2.9 days
Readmission rate <3%, and usually for
respiratory unrelated reason
Better education and development of self
management skills to prevent admissions in
the future
Breathlessness Clinic
The Breathlessness Clinic is a nonpharmacological intervention to help
patients with breathlessness linked to
moderate to severe COPD improve ways
of coping with their condition and
improve their quality of life.
People involved
Clinical Health Psychologist
Respiratory Nurse
Physiotherapist
Occupational Therapist
Criteria
Moderate /Severe COPD
Suffering from breathlessness and/or panic
attacks
Breathlessness of a chronic nature
Finding it hard to cope
No unstable cardiac conditions
Able to understand English
Suitable for group setting and would benefit
from self-management techniques
Would like to attend the Breathlessness Clinic
Course Content
Five week group clinic
Coping with anxiety and panic attacks
Education on lung disease/medication
Breathing control techniques
Planning and pacing activities
Relaxation/distraction techniques
Carers/partners encouraged to attend
Referral
Referrals should be directed to the Clinical
Health Psychology Department