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
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Respiratory Outreach Service
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The Respiratory Outreach Service was
set up in 2002 to facilitate the early
supported discharge of respiratory
patients, mainly those with COPD.
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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?
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Admissions List
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Referral from ANY team
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A&E or Obs ward
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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
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Able to transfer safely/independently
 Self caring or home support available
 Self medicating or support available
 Access to telephone
 Patient agreement
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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
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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
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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.
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Follow-up, if required, is with the
discharging team or Respiratory Nurse
Clinic.
Benefits of the Service
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Length of stay in hospital down from 13.9 to
<2.9 days
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Readmission rate <3%, and usually for
respiratory unrelated reason
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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
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Clinical Health Psychologist

Respiratory Nurse
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Physiotherapist
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Occupational Therapist
Criteria
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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
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Referral
Referrals should be directed to the Clinical
Health Psychology Department