Transcript Be Inspired – a non pharmacological breathlessness

Be Inspired – a non
pharmacological
breathlessness
management pathway
Sue Acreman
April 2010
The 8 domains of care
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Physical
Practical
Nutritional
Psychological
Informational
Spiritual
Financial
Social
Background
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Evidence review 2008
Service provision survey
Audit
Local demographics/ stats
Aims
Develop a sound, evidence based
pathway
Equity of access to care
Empowerment and independence
Widen knowledge and skills in
managing breathlessness
Resources/outputs
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Pathway
Assessment measures
Handbook
Calming hand
Systematic focussing
Relaxation technique
Education programme
Step 1
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:Triage
Meets criteria
No
Yes
Step 2
EXIT pathway
: Refer for BeInspired
Intervention
Step 3: Arrange Appointment
send self assessment form & daily activity
impact diary
Step 4: Assessment and Intervention – still meets criteria
Iniatiate Supported self management
-Triggers
-Beinspired handbook
-Signpost
Step 5: Review
Are BeInspired interventions adequate for patients
needs?
Yes
No
Step 6: Initiate referral for complex case
management
-Goal setting
-Outcome measures
-Self management plan
Results – 1
(February 2010)
Referrals to BeINSPIRED
Number of patients
40
35
31
30
25
18
20
15
10
5
0
Referrals received
Referrals seen
Number of patients (referred)
12
8
4
2
2
1
NH
L
Ca
pr o
st a
te
Ca
rec
um
Me
lan
om
a
Ca
ov
ary
Pa
nc
rea
s
Un
kn
ow
n
Ca
br e
ast
Ca
cer
v ix
Ca
ton
sil
Ca
lun
g
Interim Results – 2
(February 2010)
Tumour type (Primary)
10
10
6
6
1
2
2
3
1
1
0
2
Interim Results – 3
(February 2010)
Type of Intervention
17%
Complex case
management
Self
management
83%
Interim results (4)
It is nice to have all the necessary information in
one place to hand
If only I had known all this before
All useful-good simple basic details that have
helped my breathing
I couldn’t believe I had been struggling so long
with my breathing and the answer was so simple
once explained
Conclusions
Dyspnoea is not routinely assessed and
is an expected burden for many
people with cancer
Dyspnoea can affect all patients with
cancer, irrespective of tumour site
Early evaluation suggests that
appropriate patients are being
identified and the pathway and other
resources are fit for purpose
Contact details
[email protected]
Work mobile: 07837163930