Our respiratory nurses have won the Kent Surrey & Sussex Quality Improvement award in the Medicines Optimisation category of a competition run by Kent, Surrey, Sussex Academic Health Science Network.  Members of the team collected their award on the 14 May at the KSS Academic Health Science Respiratory Collaborative.

The team’s key driver was quality improvement in the prescribing of inhaled therapy for adults with Chronic Obstructive Pulmonary Disease (COPD), focusing on delivering safe, patient centred care.  In addition they have promoted self-management of their condition after the patient leaves hospital.  The team wanted to ensure that prescribed inhalers were clinically appropriate, cost effective and one the patient can use correctly. The new inhaler guides the team has developed have been shared with colleagues across Royal Surrey and with those providing primary care such as GPs.

Respiratory Lead Nurse, Sarah Pearce, said, “We are delighted to win this award. The team’s achievement will ensure that inhalers are prescribed appropriately and most importantly one which patients can demonstrate they can use effectively”.

The aim was to optimise licenced inhaled therapy for patients with COPD in line with local and national guidelines.  The team wanted to reduce variation in prescribing practices so they designed and developed a visual inhaler guide.

Inhaled therapy has become increasingly more complicated over recent years, with over 115 inhaler options in 17 different devices available in the UK.  This has made it difficult for both specialist and non-specialist in choosing the right inhaler.

Given the complexity of prescribing inhaled therapy and the large volume of devices available, the team wanted to develop an easy to use inhaler guide. The guides are regularly reviewed and updated in line with local and national guidelines.

The team met with Surrey prescribing clinical network and looked at the clinical pathways and all the devices licenced within Surrey for COPD.  The inhaler guide is used as a tool by healthcare professionals when choosing which device to prescribe, however it is also a useful visual resource for patients when reviewing their inhaled therapy.

The team also delivered a number of inhaler workshops within the trust for pharmacists, doctors and nursing staff. This has led to an increase in referrals to the respiratory nurse team for an inhaler review prior to commencing therapy.

The respiratory nurse provides a patient centred inhaler review, educating and coaching the patient on their inhaler technique.  Ensuring that the patient is able to demonstrate the correct technique and modifying any critical errors. Inhalers are prescribed once the patient has received training in the use of the device and has demonstrated a satisfactory technique.

In 2017 £987 million was spent on inhaled medicine in England 2017 (NHS Digital, 2017).

This project has contributed to a cost saving to the trust of £60,000 and reduced readmissions to hospital significantly.

The team’s future plans include delivering respiratory virtual clinics in primary care as part of an integrated respiratory service to bring hospital specialist and primary care clinicians together to improve the care of people with a chronic lung condition.

Chief Nurse, Jo Mountjoy said, “This is a significant piece of work by the Respiratory Team which will make a real difference to our COPD patients.  I am proud of the way our nurses constantly look for ways to improve patient care.”

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