Abstract
Background: Personalized educational intervention in the management of chronic conditions has a strong evidence base1. Structured review by a respiratory specialist for all patients admitted with asthma exacerbation has become a NICE quality standard in February 20132.
Objectives: We aimed to assess the specialist referral rate and the impact of asthma specialist nurse review in decreasing the readmission rate of patients admitted to our hospital with acute asthma exacerbation
Methods: We included all patients admitted with asthma exacerbation at our DGH between August 2013 and December 2013. All patients who were referred were offered review within 2 weeks of presentation with our asthma specialist nurses. We then compared the number of admissions in 2013 with admissions in 2014.
Results: 29 patients with accurate diagnosis were identified. Only 58% of them were referred for respiratory review and they were seen within the 2 weeks target. The 29 patients had a total of 51 admissions in 2013, with 45% of them having 2 or more admissions. In 2014 the same group of patients had 15 admissionsin total , a 71% decrease compared to 2013 and only 20% of them had 2 or more admissions, equating to a 77% decrease over 2013
Conclusions: Our study has shown a substantial decrease in the total number of acute asthma admissions and in number of patients requiring more than 1 admission per year in our cohort of patients.
Education sessions are necessary to improve referral rate as well as active case identification by our asthma nurses. Larger cohort studies will be useful to prove statistical significance in the future.
1 Tapp S, Cochrane Airways Group, 2007
2 NICE guidelines, 2013.
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