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Does having specialist asthma nurses improve adherence to national asthma guidelines? A comparison between two UK district general hospitals

Adam Ainley, Nadia Gildeh, Anna Seeley, Kirsty Lewis, Tara Maisel, Rebecca Jayasinghe, Jagan Muthurajah
European Respiratory Journal 2015 46: PA644; DOI: 10.1183/13993003.congress-2015.PA644
Adam Ainley
1Department of Respiratory Medicine, North Middlesex University Hospital NHS Trust, London, United Kingdom
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Nadia Gildeh
2Department of Respiratory Medicine, Darent Valley Hospital, Dartford, United Kingdom
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Anna Seeley
1Department of Respiratory Medicine, North Middlesex University Hospital NHS Trust, London, United Kingdom
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Kirsty Lewis
2Department of Respiratory Medicine, Darent Valley Hospital, Dartford, United Kingdom
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Tara Maisel
1Department of Respiratory Medicine, North Middlesex University Hospital NHS Trust, London, United Kingdom
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Rebecca Jayasinghe
2Department of Respiratory Medicine, Darent Valley Hospital, Dartford, United Kingdom
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Jagan Muthurajah
2Department of Respiratory Medicine, Darent Valley Hospital, Dartford, United Kingdom
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Abstract

Background: National guidelines advocate use of specialist nurses in managing patients with asthma. However, there is uncertainty about overall impact upon improving patient care[1]. We compared acute management of patients with asthma exacerbations in 2 district general hospitals, 1 with (H1) and 1 without (H2) asthma nurses to see if there were differences in adherence to national guidelines.

Methods: We retrospectively reviewed case notes of patients admitted/seen in A&E in 2 hospital trusts with an acute asthma exacerbation over 4 weeks (September 2014). Data collected included asthma nurse/respiratory team reviews and if recommended interventions (inhaler technique, appropriate discharge advice and action plan) were undertaken.

Results: In H1 25 patients were seen, 9 admitted (36%). In H2, 87 patients were seen, 22 admitted (25%). In both hospitals no patients were reviewed by asthma nurses in A&E. Of admissions, 44% of admissions were reviewed by asthma nurses in H1 (all on respiratory wards). 55% had specialist respiratory input in H1 vs 23% (H2). 77% of H1 patients had asthma plans documented vs 45% (H2). GPs were informed within 24hrs of discharge in 66% (H1) vs 13.6% (H2) and 55% were advised to see their GP within 48hrs (H1) vs 36% (H2).

Conclusion: Asthma specialist nurses do improve adherence to asthma guidelines compared to a trust without this service. However, adherence is still not 100%, likely due to patients not being referred for specialist input as per national guidance. More work needs to be done to improve pathways so all asthma patients are captured.

[1] Griffiths C et al BMJ 2004;328:144-147.

  • Asthma - management
  • Exacerbation
  • Nursing care
  • Copyright ©ERS 2015
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Does having specialist asthma nurses improve adherence to national asthma guidelines? A comparison between two UK district general hospitals
Adam Ainley, Nadia Gildeh, Anna Seeley, Kirsty Lewis, Tara Maisel, Rebecca Jayasinghe, Jagan Muthurajah
European Respiratory Journal Sep 2015, 46 (suppl 59) PA644; DOI: 10.1183/13993003.congress-2015.PA644

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Does having specialist asthma nurses improve adherence to national asthma guidelines? A comparison between two UK district general hospitals
Adam Ainley, Nadia Gildeh, Anna Seeley, Kirsty Lewis, Tara Maisel, Rebecca Jayasinghe, Jagan Muthurajah
European Respiratory Journal Sep 2015, 46 (suppl 59) PA644; DOI: 10.1183/13993003.congress-2015.PA644
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