The Role of The Specialist Nurse In Respiratory Care Barbara Hanna Respiratory Specialist Nurse South Eastern Trust

Background The social, economic and health costs of respiratory disease are high. In Northern Ireland in 2002/2003 respiratory disease accounted for 28,241 hospital admissions, with an average length of stay of 6.5 days at an estimated cost of £47 million. By 2020, COPD is projected to increase and become the third leading cause of death and the fifth leading cause of morbidity, whereas other chronic diseases are likely to decrease over this period. According to NICE guidelines for COPD 20% of pts who are admitted to hospital do not need to be there but require a respiratory team to attend at home to ensure recovery from the exacerbation.

Episodes of Care Referrals to service (Lisburn Locality) 514 ( length of time on service varies) Staff – 1 Fulltime Resp. Nurse Band 7, 0.5 Band 5, 1.5 physiotherapist All Respiratory conditions  Active case-load approx 60-80pts (at any one time)  Respiratory Enhanced Discharge Scheme(REDS) : 8pts  Pulmonary Rehabilitation :129 pts referred  Telehealth Monitoring : 81 episodes of care(13 weeks)  Prevention of hospital Admission (96 occasions but very subjective)  Palliative Care

Quality of Life Patients deal with symptoms of breathlessness, cough, production of sputum, and frequent exacerbations. Lead to decreased exercise tolerance, poor self esteem, anxiety, depression, social isolation. Pulmonary rehabilitation Breathe Easy Support Group (Chest Heart Stroke) Self Management Education Expert Patient programmes Telehealth

Improved Patient Experience Satisfaction survey conducted twice yearly Results show 100% satisfaction with Staff Attitude Communication Skills Privacy and Dignity Treatment and Care Patient experience

Improved Patient Safety Respiratory Nurse/Physiotherapist assessment at home. Pts self refer to team to prevent hospital admission Northern Ireland Single Assessment Tool ISO procedures for patient journey Access to local pulmonary rehabilitation Self management education Liaison with GP`s for holistic approach to care

Access to Services Pulmonary rehab - held in variety of community settings-times are usually late am/pm to suit client needs Domiciliary visits Rapid access to hospital clinic as required Local Respiratory support groups Telehealth On discharge patients given contact number for on-going support with option of self referral if required in the future

Achievement of Service Objectives To continue to manage patients in the Community setting liaising with colleagues in the acute sector as required. Involve patients in their plan of care and treat with respect and dignity. Ongoing delivery of pulmonary rehabilitation in Community settings as need arises Implementation of new Telehealth service

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