Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1273
M. Marathe, K. Leech, H. Stone, I. Hussain
Introduction: Reducing the number of readmissions after an acute exacerbation of COPD (AECOPD) remains a challenge. A number of strategies have been shown to reduce early readmission including early outpatient follow up and the use of validated scoring systems to highlight patients at high risk of readmission. The aim of our ongoing project is to reduce the readmission rate of above 40% to the National COPD audit average of 23%. Our initial intervention was to increasing the number of patients seen by the community respiratory team (CRT). Methods: From April 2018 we referred an increasing number of patients admitted with AECOPD to the CRT upon discharge. Our efforts were initially aimed at patients with PEARL scores above 5. We used pre-existing data sheets, already utilised for the national audit, to record referral data. The patients’ electronic records were then analysed 90 days after discharge to determine time to re-admission. Two cycles of analysis were completed 90 days after the April and May discharges. Results: The 90 day readmission rate owing to COPD for patients admitted in March 2018 fell from 46% to 35% and 40% for patients admitted in April and May respectively. The number of referrals for high risk patients (PEARL above 5) increased every month but in May, lower risk (PEARL less than 5) had a higher rate of referrals as well. Conclusion: Our QIP has shown promising results with some reduction in readmission rates after higher referral rates to the CRT. This is likely due to early management of unstable symptoms and exacerbations. More work is required in developing a fully integrated approach and analysing the effectiveness of different community therapies.
{"title":"Reducing COPD related readmission rates at Royal Stoke University Hospital (RSUH), UK: a Quality Improvement Project","authors":"M. Marathe, K. Leech, H. Stone, I. Hussain","doi":"10.1183/13993003.congress-2019.pa1273","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1273","url":null,"abstract":"Introduction: Reducing the number of readmissions after an acute exacerbation of COPD (AECOPD) remains a challenge. A number of strategies have been shown to reduce early readmission including early outpatient follow up and the use of validated scoring systems to highlight patients at high risk of readmission. The aim of our ongoing project is to reduce the readmission rate of above 40% to the National COPD audit average of 23%. Our initial intervention was to increasing the number of patients seen by the community respiratory team (CRT). Methods: From April 2018 we referred an increasing number of patients admitted with AECOPD to the CRT upon discharge. Our efforts were initially aimed at patients with PEARL scores above 5. We used pre-existing data sheets, already utilised for the national audit, to record referral data. The patients’ electronic records were then analysed 90 days after discharge to determine time to re-admission. Two cycles of analysis were completed 90 days after the April and May discharges. Results: The 90 day readmission rate owing to COPD for patients admitted in March 2018 fell from 46% to 35% and 40% for patients admitted in April and May respectively. The number of referrals for high risk patients (PEARL above 5) increased every month but in May, lower risk (PEARL less than 5) had a higher rate of referrals as well. Conclusion: Our QIP has shown promising results with some reduction in readmission rates after higher referral rates to the CRT. This is likely due to early management of unstable symptoms and exacerbations. More work is required in developing a fully integrated approach and analysing the effectiveness of different community therapies.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88096532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1269
Lynsey J. Brown, Victoria Worrall, A. Lilley, R. Thursfield, C. Grime, C. Hepworth, Lucy Gait, C. Semple, Christine B. Doyle, N. Mingaud, I. Sinha
Introduction: There is interest in new therapies for severe asthma, and how network clinics can facilitate this. Aims and Objectives: We aimed to: 1) explore comorbidities and adherence issues in children referred to our regional multidisciplinary (MDT) asthma clinic 2) describe the interventions utilised by the specialist medical, psychology, nursing, pharmacy, and physiotherapy teams. Method: Retrospective casenote review of referrals into the clinic since July 2018. We extracted data on demographics, co-morbidities, and issues with inhaler technique and adherence. We summarised medical and non-medical interventions used in the clinic. Results: 52 patients were referred (Median age 13 years [IQR 10-15], 37/52 male; 17/52 (32%) demonstrated persistently low FEV1, and 29/52 (55%) had persistently high FeNO. 45/52 (86%) had suboptimal inhaler technique and/or adherence issues. 31/52 (60%) had concurrent medical issues such as allergy, obesity and adrenal insufficiency. 44/52 (85%) had dysfunctional breathing or low fitness on formal step testing. 40/52 (77%) had psychological comorbidities such as anxiety, depression, and low self-esteem. We changed inhalers in 14 patients and utilised methylprednisolone in 1 patient. Due to these interventions we have not needed to start any patient on biologic therapies, immunomodulators or maintenance oral steroids for asthma, and we successfully stopped these in 4 patients. Conclusion: Inhaler competency and adherence, breathing technique, fitness, and psychological problems are common in children with poor asthma control. Addressing these fundamental issues using an MDT specialist clinic can usually negate the need to step up medical treatment, even in children with severe asthma.
{"title":"A new regional multidisciplinary clinic for children with difficult asthma","authors":"Lynsey J. Brown, Victoria Worrall, A. Lilley, R. Thursfield, C. Grime, C. Hepworth, Lucy Gait, C. Semple, Christine B. Doyle, N. Mingaud, I. Sinha","doi":"10.1183/13993003.congress-2019.pa1269","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1269","url":null,"abstract":"Introduction: There is interest in new therapies for severe asthma, and how network clinics can facilitate this. Aims and Objectives: We aimed to:\u0000 1) explore comorbidities and adherence issues in children referred to our regional multidisciplinary (MDT) asthma clinic 2) describe the interventions utilised by the specialist medical, psychology, nursing, pharmacy, and physiotherapy teams. Method: Retrospective casenote review of referrals into the clinic since July 2018. We extracted data on demographics, co-morbidities, and issues with inhaler technique and adherence. We summarised medical and non-medical interventions used in the clinic. Results: 52 patients were referred (Median age 13 years [IQR 10-15], 37/52 male; 17/52 (32%) demonstrated persistently low FEV1, and 29/52 (55%) had persistently high FeNO. 45/52 (86%) had suboptimal inhaler technique and/or adherence issues. 31/52 (60%) had concurrent medical issues such as allergy, obesity and adrenal insufficiency. 44/52 (85%) had dysfunctional breathing or low fitness on formal step testing. 40/52 (77%) had psychological comorbidities such as anxiety, depression, and low self-esteem. We changed inhalers in 14 patients and utilised methylprednisolone in 1 patient. Due to these interventions we have not needed to start any patient on biologic therapies, immunomodulators or maintenance oral steroids for asthma, and we successfully stopped these in 4 patients. Conclusion: Inhaler competency and adherence, breathing technique, fitness, and psychological problems are common in children with poor asthma control. Addressing these fundamental issues using an MDT specialist clinic can usually negate the need to step up medical treatment, even in children with severe asthma.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74872033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1276
A. Armstrong
Professional networking provides invaluable support for those working in the healthcare setting. In the United Kingdom (UK), there is an established Home Mechanical Ventilation (HMV) network, but this is not designed to address the challenges facing members of the nursing and allied health professional (AHP) teams working in the actual delivery of this treatment. Objective: To provide and co-ordinate a supportive network for nurses and AHPs who work in the delivery of long term ventilation (LTV) in the community setting. Method: The Specialists in Long-term Ventilation at Home (SiLVaH) group currently has over 120 nurses and AHP members. Many of the LTV services around the UK, and some world-wide, are represented. A conference is held annually, and a very well utilised email forum allows for regular discussion and problem solving about issues pertinent to the speciality of long-term ventilation. The focus of SiLVaH is around practise development, standardisation and service improvement. The conference allows networking opportunities, and the forum facilitates protocol and guideline development, which subsequently receive national endorsement. Results: The SiLVaH network is very highly praised by the group members, reporting benefits in terms of support, being able to discuss operational issues with other teams, as well as have the opportunity to be part of larger audits, practice development projects and research. Conclusion: It is clear from the feedback that this group is found by its members to be of both personal and professional benefit. Home ventilation is a relatively small specialist area, but being part of a larger netowrk provides a benchmark for practice standards, which ultimately improves patient care.
{"title":"A home ventilation nursing and allied health professional network","authors":"A. Armstrong","doi":"10.1183/13993003.congress-2019.pa1276","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1276","url":null,"abstract":"Professional networking provides invaluable support for those working in the healthcare setting. In the United Kingdom (UK), there is an established Home Mechanical Ventilation (HMV) network, but this is not designed to address the challenges facing members of the nursing and allied health professional (AHP) teams working in the actual delivery of this treatment. Objective: To provide and co-ordinate a supportive network for nurses and AHPs who work in the delivery of long term ventilation (LTV) in the community setting. Method: The Specialists in Long-term Ventilation at Home (SiLVaH) group currently has over 120 nurses and AHP members. Many of the LTV services around the UK, and some world-wide, are represented. A conference is held annually, and a very well utilised email forum allows for regular discussion and problem solving about issues pertinent to the speciality of long-term ventilation. The focus of SiLVaH is around practise development, standardisation and service improvement. The conference allows networking opportunities, and the forum facilitates protocol and guideline development, which subsequently receive national endorsement. Results: The SiLVaH network is very highly praised by the group members, reporting benefits in terms of support, being able to discuss operational issues with other teams, as well as have the opportunity to be part of larger audits, practice development projects and research. Conclusion: It is clear from the feedback that this group is found by its members to be of both personal and professional benefit. Home ventilation is a relatively small specialist area, but being part of a larger netowrk provides a benchmark for practice standards, which ultimately improves patient care.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80438781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1261
S. Alonso, Sonia Parra Cordero
{"title":"A qualitative hermeneutic phenomenological research among respiratory nurses (Rsn) in Spain to understand the lived experience of their profession","authors":"S. Alonso, Sonia Parra Cordero","doi":"10.1183/13993003.congress-2019.pa1261","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1261","url":null,"abstract":"","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81707832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1268
Bettina Nissen Pedersen, K. Nielsen, G. Bøgesvang, Helle Struwe Bødker, Britta Aaes, Hanne Svenningsen, A. Sorknæs
Background: Patients with COPD are susceptible to acute exacerbation of COPD (AECOPD), with poor outcomes in term of mortality and recurrence of AECOPD. In addition, AECOPD have impaired quality of life (QoL). Therefore, it would be a great advantage to detect early signs of AECOPD Purpose:To detect early signs of AECOPD in patients with COPD and home noninvasive ventilation (LT-NIV) Method:Patients referred to the respiratory department, M/FAM, OUH, Svendborg Hospital, Denmark,> 40 years, with COPD and LT-NIV, who gave written informed consent were provided with a standardized NIV-device (Lumis) with an associated online software program AirView. Daily the patients NIV-device send data of use, leak, tidal volume and breathing frequency. The Patients reported daily increased shortness of breath and mucus, need for acute medication, and the color of the mucus via an app. Data were checked weekdays by a nurse specialist. Patients could use a telephone hotline during workdays or send messages via the app. Controls were performed at the outpatient clinic Results:It´s a small study. Ten patients were included at the pulmonary department at OUH, Svendborg Hospital, Denmark from 01.03.17-28.02.18. Seven out of ten patients completed the one-year study period. Two patients died, and one patient decided to stop. The preliminary results seem to indicate that breathing frequency is the earliest predictor of an AECOPD. The total results will not be available before April 2019Conclusion:The preliminary results seem to that breathing frequency is the earliest predictor of an AECOPD, but the final result is not yet available, so it is too early to conclude on the result
{"title":"Is it possible to find a predictor for detecting early signs of an COPD-exacerbation with LT-NIVpatients?","authors":"Bettina Nissen Pedersen, K. Nielsen, G. Bøgesvang, Helle Struwe Bødker, Britta Aaes, Hanne Svenningsen, A. Sorknæs","doi":"10.1183/13993003.congress-2019.pa1268","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1268","url":null,"abstract":"Background: Patients with COPD are susceptible to acute exacerbation of COPD (AECOPD), with poor outcomes in term of mortality and recurrence of AECOPD. In addition, AECOPD have impaired quality of life (QoL). Therefore, it would be a great advantage to detect early signs of AECOPD Purpose:To detect early signs of AECOPD in patients with COPD and home noninvasive ventilation (LT-NIV) Method:Patients referred to the respiratory department, M/FAM, OUH, Svendborg Hospital, Denmark,> 40 years, with COPD and LT-NIV, who gave written informed consent were provided with a standardized NIV-device (Lumis) with an associated online software program AirView. Daily the patients NIV-device send data of use, leak, tidal volume and breathing frequency. The Patients reported daily increased shortness of breath and mucus, need for acute medication, and the color of the mucus via an app. Data were checked weekdays by a nurse specialist. Patients could use a telephone hotline during workdays or send messages via the app. Controls were performed at the outpatient clinic Results:It´s a small study. Ten patients were included at the pulmonary department at OUH, Svendborg Hospital, Denmark from 01.03.17-28.02.18. Seven out of ten patients completed the one-year study period. Two patients died, and one patient decided to stop. The preliminary results seem to indicate that breathing frequency is the earliest predictor of an AECOPD. The total results will not be available before April 2019Conclusion:The preliminary results seem to that breathing frequency is the earliest predictor of an AECOPD, but the final result is not yet available, so it is too early to conclude on the result","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83044404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa266
N. Tavares, K. Hunt, T. Wilkinson
{"title":"COPD patients’ preferences for palliative conversations with clinicians","authors":"N. Tavares, K. Hunt, T. Wilkinson","doi":"10.1183/13993003.congress-2019.oa266","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa266","url":null,"abstract":"","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83290783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa269
Dorthe Sørensen, Anna Rottensten Wieghorst, Johanne Andersen Elbek, C. A. Mousing
Introduction: As nutritional status is an indicator of both prognosis and outcome in relation to COPD, it is relevant to investigate how to improve nutritional intake through a knowledge of meal-related challenges. Aim: To investigate the behaviour and experiences of individuals diagnosed with COPD when faced with challenges in meal-related situations. Methods: This study used a phenomenological hermeneutic approach based on participant observations and informal conversations in both secondary and primary health care settings. From August 2018 until February 2019, 34 hours of meal-related observations and informal conversations with 14 patients were completed at a Danish Department of Respiratory Medicine and in patients’ private homes. The empirical data was collected and analysed using Spradley and Ricoeur. Results: This study reveals a lack of respect for the meal situation and shows that the professional responsibility in the face of meal-related challenges is unclear. Patients select dishes based on the texture of the food instead of on their taste preferences, which may limit their nutritional intake. The study shows that patients are hesitant to communicate their needs about nutrition and meal-related situations, which leaves a number of non-verbalised challenges unattended. Conclusion: The overall burden of meal-related challenges poses a risk of decreasing nutritional intake, thereby increasing the risk of undernutrition. Further research is needed to measure the prevalence of the meal-related challenges identified, and to develop interventions that can accommodate these.
{"title":"The burden of meal-related challenges in patients with COPD: Who cares?","authors":"Dorthe Sørensen, Anna Rottensten Wieghorst, Johanne Andersen Elbek, C. A. Mousing","doi":"10.1183/13993003.congress-2019.oa269","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa269","url":null,"abstract":"Introduction: As nutritional status is an indicator of both prognosis and outcome in relation to COPD, it is relevant to investigate how to improve nutritional intake through a knowledge of meal-related challenges. Aim: To investigate the behaviour and experiences of individuals diagnosed with COPD when faced with challenges in meal-related situations. Methods: This study used a phenomenological hermeneutic approach based on participant observations and informal conversations in both secondary and primary health care settings. From August 2018 until February 2019, 34 hours of meal-related observations and informal conversations with 14 patients were completed at a Danish Department of Respiratory Medicine and in patients’ private homes. The empirical data was collected and analysed using Spradley and Ricoeur. Results: This study reveals a lack of respect for the meal situation and shows that the professional responsibility in the face of meal-related challenges is unclear. Patients select dishes based on the texture of the food instead of on their taste preferences, which may limit their nutritional intake. The study shows that patients are hesitant to communicate their needs about nutrition and meal-related situations, which leaves a number of non-verbalised challenges unattended. Conclusion: The overall burden of meal-related challenges poses a risk of decreasing nutritional intake, thereby increasing the risk of undernutrition. Further research is needed to measure the prevalence of the meal-related challenges identified, and to develop interventions that can accommodate these.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82566059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1279
Carina Grespi Bueno, Danilo Augusto Ferrari Dias, Nicole Maria Miyamoto Bettini, Daniela De Lira Eiras Domene, L. Machado, E. Franco, I. Godoy
Introduction: Prolonged Homeopathic Oxygenation improves quality and prolongs the life expectancy of patients with Chronic Obstructive Pulmonary Disease(COPD)with chronic hypoxemia. The most common symptom is cough, associated or not with another respiratory change for a few weeks. Taking into account the European statistics that indicate an approximate prevalence of 40 patients/100,000 inhabitants as Chronic O2 users, it can be assumed that in Brazil we would have approximately 65,000 patients in this condition. Objectives: To know the profile and clinical characteristics of patients with ODP. Method: A quantitative, observational, transversal and analytical approach. Patients taking ODP with a diagnosis of COPD undergoing follow-up at the Prolonged Homeopathic Oxygen Outpatient Clinic in the period from July to October, 2017, were in the municipality of Botucatu. Results: There were 57 patients, mean age of 73(SD)years, most of them female. With regard to schooling, the vast majority had incomplete elementary education (61.4%). None of the patients smoked, of whom 79% were former smokers and 21% were non-smokers. The former smokers smoked on average 41 years(± 14.4). It should be noted that. 52.6% of patients did not make the correct use of therapy. The symptoms presented were: cough(33.3%), sputum (7%)and wheezing (5.3%)The majority (%) did not need hospitalization and had no exacerbation in the last 12 months;73.7% patients received the Influenza vaccine and 53% received the Pneumococcal vaccine in the last 5 years. Conclusion: The mean age of patients was high, low schooling, and no correct use of therapy. It requires continued education to improve care delivery and adherence to treatment.
{"title":"Sociodemographic and clinical characterization of patients users of prolonged domestic oxygen therapy","authors":"Carina Grespi Bueno, Danilo Augusto Ferrari Dias, Nicole Maria Miyamoto Bettini, Daniela De Lira Eiras Domene, L. Machado, E. Franco, I. Godoy","doi":"10.1183/13993003.congress-2019.pa1279","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1279","url":null,"abstract":"Introduction: Prolonged Homeopathic Oxygenation improves quality and prolongs the life expectancy of patients with Chronic Obstructive Pulmonary Disease(COPD)with chronic hypoxemia. The most common symptom is cough, associated or not with another respiratory change for a few weeks. Taking into account the European statistics that indicate an approximate prevalence of 40 patients/100,000 inhabitants as Chronic O2 users, it can be assumed that in Brazil we would have approximately 65,000 patients in this condition. Objectives: To know the profile and clinical characteristics of patients with ODP. Method: A quantitative, observational, transversal and analytical approach. Patients taking ODP with a diagnosis of COPD undergoing follow-up at the Prolonged Homeopathic Oxygen Outpatient Clinic in the period from July to October, 2017, were in the municipality of Botucatu. Results: There were 57 patients, mean age of 73(SD)years, most of them female. With regard to schooling, the vast majority had incomplete elementary education (61.4%). None of the patients smoked, of whom 79% were former smokers and 21% were non-smokers. The former smokers smoked on average 41 years(± 14.4). It should be noted that. 52.6% of patients did not make the correct use of therapy. The symptoms presented were: cough(33.3%), sputum (7%)and wheezing (5.3%)The majority (%) did not need hospitalization and had no exacerbation in the last 12 months;73.7% patients received the Influenza vaccine and 53% received the Pneumococcal vaccine in the last 5 years. Conclusion: The mean age of patients was high, low schooling, and no correct use of therapy. It requires continued education to improve care delivery and adherence to treatment.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80907629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa268
G. Schmid-Mohler, C. Clarenbach, Gabi Brenner, M. Kohler, É. Horváth, H. Petry
{"title":"Evaluation of the need for an Advanced Practice Nurse for COPD patients with a pulmonary exacerbation in Switzerland","authors":"G. Schmid-Mohler, C. Clarenbach, Gabi Brenner, M. Kohler, É. Horváth, H. Petry","doi":"10.1183/13993003.congress-2019.oa268","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa268","url":null,"abstract":"","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"53 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72447722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1274
S. Mongodi, S. Bonaiti, Erminio Santangelo, A. Stella, R. Vaschetto, P. Borrelli, Attilio Quaini, G. Grugnetti, A. Massara, A. Grugnetti, F. Mojoli
Background: Lung ultrasound significantly improves the differential diagnosis of acute respiratory failure and in particular allows ruling in or out pneumothorax by the analysis of lung sliding with high accuracy[1]. Nurses frequently assess patients with respiratory distress independently; this happens in case of trauma patients assisted by nurse-only emergency teams in pre-hospital field. So far nurses only used auscultation but may improve their assessment accuracy using ultrasound, after having received a proper training [2]. Aims and Objectives: to test the possibility to improve lung sliding interpretation by nurses with a short focused theoretical training. Methods: Interpretation of a slot of 25 clips (presence of lung sliding, lung pulse, lung point or no pleural movement) before and after a 3-hour focused training for nurses attending a first level university master in critical care. Results: 22 nurse trainees were involved (males 4, age 26.0 [24.0-28.0] year-old, previous ultrasound training 1, previous lung ultrasound training 0). From before to after the training, the median number of correct answers changed from 0.5 [0.0-2.0] to 8.5 [6.0-12.0] (p Conclusions: A short theoretical training significantly improved lung sliding interpretation by nurses; however, the percentage of exact answers after the training remained too low to allow clinical use, suggesting a longer training may be useful. The study only focused on image interpretation; the training required for image acquisition was not tested. References: 1. Laursen CB et al. Lancet Respir Med 2014;2:638-46; 2. Noble VE et al. BMC Medical Education 2009;9:3
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