Study shows benefits of a specialist nurse-led service in the community for people living with COPD

A new article published online in British Journal of Nursing, ‘Avoiding hospital admission in COPD: impact of a specialist nursing team’, shows that a community specialist nurse-led admission-avoidance service can be a safe and cost-effective model of care for managing patients experiencing acute exacerbations of COPD. The study was led by Karen Cox, a Senior Respiratory Nurse Specialist, with support from colleagues (respiratory nurse specialists and a complex case manager) at Lincolnshire Community Health Services NHS trust and Dr Arwel Jones from the Lincoln Institute for Health.

This study looked at notes of patients referred to the Lincolnshire Acute Respiratory Assessment Service over a 12 month period. The Acute Respiratory Assessment Service is commissioned to provide a hospital-at home/admission service for patients with COPD, which is delivered by the Lincolnshire Countywide Respiratory Team. Results of the case-note review demonstrated that the specialist skills of all respiratory nurse specialists are key factor in the success of the scheme, particularly the ability to interpret blood gases within the patient’s home and initiate emergency oxygen where required. Without management by a respiratory nurse specialist, results showed a number of patients would have been admitted to hospital for further assessment of the acute exacerbation of their COPD.

Respiratory Specialist nurses have an important role in supporting admission avoidance and have the ability to care for COPD patients safely and effectively and prescribe treatment that would otherwise necessitate hospital admission. These findings can be used to support planning and delivery of hospital-at-home schemes in the UK and internationally.

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