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COPD -Review of ‘At Risk Patient’ Mary Twitchett RGN MSc MSt (Cantab) Advanced Nurse Practitioner Dr Gant and Partners 114 Arbury Rd Cambridge

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Presentation on theme: "COPD -Review of ‘At Risk Patient’ Mary Twitchett RGN MSc MSt (Cantab) Advanced Nurse Practitioner Dr Gant and Partners 114 Arbury Rd Cambridge"— Presentation transcript:

1 COPD -Review of ‘At Risk Patient’ Mary Twitchett RGN MSc MSt (Cantab) Advanced Nurse Practitioner Dr Gant and Partners 114 Arbury Rd Cambridge

2 COPD ‘At Risk’ Patients Who Are They ? Hospital admission for COPD > 2 Exacerbations per year > 2 courses of steroids a year Severe COPD MRC score 4-5 ( ? 3) CAT Score > 20 Mild COPD patient COPD patient with low psychological profile Housebound

3 Key Factors of Review COPD review : usual review of patient as done at annual review Assessment tools –MRC/ DOSE/ CAT score Smoking / Inhaler technique/ Pulmonary rehabilitation Oxygen sats when well Self Management Plan Exacerbation Pack Advise out of hours DOCUMENTATION

4 Patient with COPD Palliative care Smokin g Breathlessness & exercise limitation Frequent exacerbatio ns Respirator y failure Cor pulmonal e Abnor mal BMI Chronic producti ve cough Anxiety & depressi on Managing stable COPD Assess symptoms/problems Manage those that are present as below Patients with COPD should have access to the wide range of skills available from a multidisciplinary team

5 “ Patient Myths” “My shortness of breath is just old age.” “There’s nothing my doctor can do except tell me to quit smoking.” “If I rest more, it will get better.” “It’s my own fault – I don’t want to bother them “

6 Practitioners challenges Build a relationship/ partnership Empathy Role with ambivalence Challenge Thoughts Goal set Follow up

7 What are the questions? Reproduced from: COPD Assessment Test Healthcare Professional User Guide

8 Multidisciplinary working – COPD care should be delivered by a multidisciplinary team that includes respiratory nurse specialists – Consider referral to specialist departments (not just respiratory physicians) [2004] Specialist department Who might benefit? PhysiotherapyAdvice about excessive sputum Dietetic advicePeople with BMI that is high, low or changing over time Occupational therapy People needing help with daily living activities Social servicesPeople disabled by COPD Multidisciplinary palliative care teams People with end-stage COPD (and their families and carers)


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