|A Different Approach to the Delivery of a Respiratory Integrated Care Service.
|P. O'Toole J. O'Hara S. O Beirne
|St. Michaels Hospital
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|The Respiratory Integrated Care Service aims to provide expert diagnosis and care for patients with COPD and Asthma. Mentorship between the integrated clinical nurse specialist (CNS) and advanced nurse practitioner (ANP) within secondary care was created. It was envisioned that the ANP would supervise and sign off the majority of the clinical patient caseload for the CNS, with overall clinical governance by the respiratory consultant. Inclusion and exclusion criteria would be applied to referrals and complex cases would be discussed with the respiratory consultant.
Monthly statistics were gathered and patient files were reviewed retrospectively. Data was collected from the commencement of the service in April 2021 to end of July.
In total 55 patients have been assessed. Of these, 12% (n=7) had no previous diagnosis of pulmonary disease. To clarify a diagnosis, 43% (n=24) were sent for additional testing (PFTs). 5.5% (n=3) had change in their diagnosis from Asthma to COPD. Overall, 27% (n=15) were referred to the consultant for further discussion/assessment.
This project shows that integrated care services can be supervised safely and effectively by a registered ANP once sufficient medical supports are in place. This in turn will lead to a time saving benefit for the consultant.