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Manaia PHO Respiratory Support Services Presented by Sue Armstrong Manaia PHO Clinical Nurse Specialist/Educator. Background Asthma Society & Manaia PHO. Respiratory Support Services. CNS / Educator role Aims of service Up-skilling PHCN’s Improving links between secondary
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Manaia PHO Respiratory Support Services Presented by Sue Armstrong Manaia PHO Clinical Nurse Specialist/Educator
Respiratory Support Services CNS / Educator role Aims of service • Up-skilling PHCN’s • Improving links between secondary & primary services • Linking people back into general practices • Resource Nurse • Clinic for more complex cases & diagnostic spirometry – GP referrals • Formation of Spirometry Hubs
Up-skilling PHC NursesGoal:For all PHC Nurses in Northlandto be competent in assessing and managing patients with respiratory conditions
Asthma/COPD Fundamentals Course(12 hrs professional development)A comprehensive resource manual is provided for each nurseRespiratory CNS to support nurse back in Practice by being present in 2 consultations; implementing assessment and management skills taught on courseNext course:7 & 8th November
Resource NurseFor GP’s & PHC NursesAsthma Patient EducationStandardised / same info across secondary servicesSpacer techniqueEmergency PlanPrimary Health Care NursesProgress to date: √ 48 nurses have completed this course
Secondary Care NursesAsthma Patient EducationStandardised / same info across secondary servicesSpacer techniqueEmergency PlanProgress to date: √ NDHB Paediatric ward√ Medical Outreach √ NDHB NETP nurses √ Public Health Nurses √ Invited to teach at ED Nurses Study dayA proposal to NDHB for delivering Fundamentals training
Weekly ClinicsGP referralsDiagnostic spirometry testingAsthma assessments & recommendations for managementComplex COPD patientsProgress to date: 72 patients seen in past 4 monthsMore of these patients will be directed back into GP for assessment & managementEncourage Nurse-led clinics – latest researchNurses provide 80% of patients care
Spirometry HubsGoal:To provide accessible , timely & accurate spirometry to all patients requiring testing Progress to date:√ 3 PHC nurses completed course(1 certified & 2 pending)√ Another 4 PHC nurses attending October training
Spacer Technique for MDI’s • Shake • Place in spacer end (making a good seal) • 1 puff & 6 normal breathes • Wait 10 – 20 secs • Repeat • ALL MDI’s to be used with a spacer. • 80% more effective
Emergency Plan Use reliever with spacer (1 puff to 6 breaths ) & repeat this 6 times (The Asthma Foundation, 2012)
Managing Exacerbationsof COPDLung function will never return to what it was prior to the exacerbation
Blue Card on Discharge from HospitalBack pocket AbxPrednisone 30mg 10/7Education on sxof exacerbationMore coughing, wheezing or breathlessness than usualNeeding to use inhalers more than usualA fever or feeling tires and unwellChanges in the amount or colour of your sputum/phlegmCheck spacer techniqueHealthy Homes ReferralPulmonary rehab / self management course referralBooklet on ‘Managing COPD
Acknowledgement of current PHC nursesbuilding on experiencesupporting new graduatesworking towards capacity, capability and confidence of PHC nurses in managing respiratory conditions