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       #Post#: 13--------------------------------------------------
       Impact on quality of care by 24 hours Asthma service for young p
       eople
       By: admini5 Date: April 15, 2015, 11:26 am
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       What is the impact on quality of care by 24 hours Asthma service
       for young people?
       Before the 24 hour home nursing service was established 45% of
       the 200 children and young people registered had attended A&E at
       least once in the previous year. Since the service was
       established the proportion of those attending A&E has reduced
       significantly, as many patients are able to manage their
       symptoms at home with the help of telephone advice and an
       on-call nurse.
       The most recent results show that during 2011–2012:
       • 17% (34) attended A&E, compared with 45% (90) before
       implementation. This is very similar to the results from
       2009-2010 and 2010-2011.
       • 14% (28) were discharged from the outreach service as a result
       of fewer asthma exacerbations and increased parental confidence
       to manage their child’s condition. This is an increase compared
       to 2010-2011 when 7% were discharged.
       Protocols were revised following the update of the joint -
       British Thoracic Society (BTS) - Scottish Intercollegiate
       Guidelines Network (SIGN) Guidelines on the management of asthma
       (BTS-SIGN 2012). This ensures the delivery of safe, effective
       personalised services. Protocols and PGD have been reviewed
       annually by both a consultant paediatrician in secondary care
       and a community pharmacist. The protocols support early
       treatment and monitoring of children in their own homes, helping
       to prevent the need for hospital attendance.
       At initial assessment a self-management plan is discussed and
       agreed between the patient/parent and nurse. This is recommended
       in the NICE quality standard QS25 for asthma (NICE 2013). The
       plan is reviewed following an acute attack and at the child’s
       annual review. Asthma UK self-management plans are used. Each
       patient contact provides the opportunity for education about
       asthma management and avoidance of subsequent exacerbations.
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