Beverley Bostock
Asthma Lead, The Association of Respiratory Nurse Specialists (ARNS)
Emma Rickards
Acute Care Lead, The Association of Respiratory Nurse Specialists (ARNS)
With the winter pressures looming on the NHS, new innovations are helping to ensure continuity of care, finding new ways to avoid unnecessary hospital admissions and supporting patients back into the community.
In a normal year, respiratory disease is a major factor in ‘winter pressures’ within the NHS, with twice as many respiratory admissions usually occurring in December compared to August. This winter will be difficult with the continuing impact of COVID. New innovations are being developed to help support all areas of primary care.
Improving self-management for respiratory conditions
In general practice, the pressure has been on to get people living with respiratory conditions seen and supported. This is achieved by assessing their current control, symptoms and fine-tuning their treatment (best drug through the best inhaler device). In addition, it is important to ensure they have a self-management plan, so they know how to recognise if their symptoms increase and, importantly, what to do about it.
In general practice, the pressure has been on to get people living with respiratory conditions seen and supported.
Many respiratory reviews have taken place remotely. It is perfectly possible to do this with the right approach – a questionnaire sent out first, a telephone review to discuss the results and a video consultation (where possible) to check inhaler technique. These are usually followed up with a message sent to a mobile phone with the updated action plan and a video of the correct inhaler technique.
Many people have found this ‘remote’ option very useful, although for those who don’t have access to technology or who prefer a face-to-face appointment, general practice is well and truly open!
Avoiding unnecessary admissions
Due to the increasing volume of patients attending emergency departments, innovative ideas, such as having a respiratory nurse specialist within an emergency department (ED) for those turning up with a respiratory complaint, have prevented people being admitted unnecessarily (preventing 220 admissions).1
Similarly, an admission avoidance respiratory car working with ambulance services provided ‘hospital expertise’ at home which has avoided 231 admissions.2 Partnership working can provide improved services for patients with respiratory disease and prevent unnecessary hospital admissions.
The COVID pandemic has encouraged nurses and other healthcare professionals to adapt and improve the way that care is being delivered. Many of these innovations will continue to improve care in the future.
[1] Rickards, E, et al (2021). The SWISS Nurse; respiratory nursing care without any borders. An admission avoidance winter pressure initiative. European Respiratory Society Abstract.
[2] Rickards, E, et al (2021). The impact of an admission avoidance rapid response respiratory car in collaboration with the Northwest Ambulance Service. European Respiratory Society Abstract
