| Title: | Impact of Direct Access to a Respiratory Advanced Nurse Practitioner Service in the Emergency Department |
|---|---|
| Author(s): | B. Magimairaj, P. O’Toole, M. Ward, A. Deegan, S.L. O’Beirne. |
| Institution: | Department of Respiratory Medicine, St. Michael’s Hospital, Dun Laoghaire, Co. Dublin. |
| Poster: | Click to view poster |
| Category: | Asthma and COPD |
| Abstract: | A direct access respiratory advanced nurse practitioner (ANP) service was developed in 2018 to support St. Michael’s Hospital Emergency Department (ED) by providing evidenced-based care and timely access to patients presenting with symptoms related to asthma and/or chronic obstructive pulmonary disease (COPD). A retrospective review of 50 care episodes between October-December 2019 was performed to evaluate interventions provided by ANPs related to care delivery and patient follow-up, with questionnaires prepared using national guidelines for asthma1 and COPD management2. All patients received standardised, evidence-based assessment and treatment. Additional ANP initiated interventions included: respiratory inhaler management (58%), treatment of upper respiratory (36%) and gastrointestinal (6%) symptoms and smoking cessation (36%). Non-pharmacological management included: initiation of high flow oxygen (4%) and provision of health-related education e.g. trigger avoidance, peak flow diary and vaccinations. Disposition decisions included: medical referral (34%), ED review for non-respiratory symptoms (10%) and discharge (56%). Discharge follow-up included: COPD outreach service (48%), ANP-led review (16%), respiratory clinic (34%) and GP (32%). Consultation referrals included cardiology, palliative care, orthopaedics and physiotherapy. A direct access ANP service in the ED for asthma and COPD assists evidence-based evaluation and treatment, supplements standard care by promoting patient-centred management and links patients to specialist services. |
