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Manaia PHO Respiratory Support Services Presented by Sue Armstrong

This service aims to up-skill primary healthcare nurses, improve links between secondary and primary services, and provide resources for more complex cases and diagnostic spirometry. The goal is for all PHC nurses in Northland to be competent in assessing and managing patients with respiratory conditions. Asthma/COPD Fundamentals Course and Asthma Patient Education are provided, along with GP referrals, spacer technique training, and nurse-led clinics.

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Manaia PHO Respiratory Support Services Presented by Sue Armstrong

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  1. Manaia PHO Respiratory Support Services Presented by Sue Armstrong Manaia PHO Clinical Nurse Specialist/Educator

  2. BackgroundAsthma Society & Manaia PHO

  3. 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

  4. Up-skilling PHC NursesGoal:For all PHC Nurses in Northlandto be competent in assessing and managing patients with respiratory conditions

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. Emergency Plan Use reliever with spacer (1 puff to 6 breaths ) & repeat this 6 times (The Asthma Foundation, 2012)

  12. Managing Exacerbationsof COPDLung function will never return to what it was prior to the exacerbation

  13. 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

  14. Acknowledgement of current PHC nursesbuilding on experiencesupporting new graduatesworking towards capacity, capability and confidence of PHC nurses in managing respiratory conditions

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