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       #Post#: 33--------------------------------------------------
       Implementation details for 24 hours Asthma service for young
       people’s
   DIR By: admini5
       Date: April 16, 2015, 5:39 am
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       What are the implementation details for 24 hours Asthma service
       for young people’s?
       A project group including the paediatric community nursing
       manager, community pharmacist, paediatrician and project lead
       was formed. The benefits of moving from a 9am-5pm asthma service
       to a 24-hour service were discussed with the board of the
       primary care organisation and the local acute hospital.
       Agreement was reached over the service redesign which included
       integrating the existing paediatric asthma/allergy service with
       the 24 hour community children's nursing team.
       Progress with implementation was monitored through the business
       development committee. The majority of the work was undertaken
       by the project manager, supported by the service manager. All
       aspects of the work were discussed at the project group meetings
       with the community pharmacist, acute paediatrician and
       paediatric community nurse manager, with support from the
       business management and finance teams.
       Detailed algorithms linked to a PGD were developed, allowing
       nurses to supply and administer medicines. An additional
       paediatric nurse was recruited in order to manage the extra
       workload of moving to a 24-hour service.
       Initially 190 patients were recruited from the existing caseload
       of the asthma/allergy clinical nurse specialist; the number of
       patients has since increased to 200. Target groups were children
       and young people whose asthma was difficult to manage and who
       typically sought A&E hospital treatment.
       Patients were offered the chance to join the service after an
       exploratory home visit, which included recording baseline
       clinical observations by the paediatric community nurse. As the
       initiative progressed, some patients were able to leave the
       service and self-manage, which allowed other patients to join
       the service.
       Key features of the integrated service were a single point of
       access and a 24-hour service. Patients or their parents were
       given a dedicated pager number to call for urgent advice and
       treatment of acute asthma episodes. Following a set protocol,
       the duty nurse assessed the need for telephone triage, a home
       visit or an emergency ambulance.
       Each call results in 2 follow-up visits (at 24 hours and 2
       weeks). These visits involve reassessing the child’s
       condition and providing information and training to try and
       prevent future exacerbations. Written information is provided
       for the patient/carer/parent, which includes an individualised
       self-management plan in line with the SIGN-BTS guideline.
       Information produced by Asthma UK is also provided.
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