How to reduce unnecessary hospital attendances for young people with asthma?
The service seeks to reduce unnecessary hospital attendance for urgent asthma treatment by providing personalised, 24-hour access to home nursing support for children and young people with asthma from birth to 16 years. The service was formed in response to increasing demand for urgent asthma treatment. It integrated the existing 9am-5pm paediatric asthma/allergy service into the 24-hour community children’s nursing team to provide a 24-hour service.
The 24-hour service allows patients to contact the on-call nurse. The nurse follows triage algorithms to determine if the condition can be managed by the patient with advice, if a visit from the nurse is required, or if an emergency ambulance if necessary.
The service is protocol-driven and emphasises patient safety. Adherence to protocols is monitored and there have been no ‘near misses’.
Setting up the service involved training the community children's nurses in assessing and treating asthma conditions, and producing a set of highly detailed algorithms and flow charts that the nurses must follow. These are linked to a Patient Group Direction (PGD), which permits nurses to supply and administer medication.
Each intervention incorporates education for the patient and their parents/carer and families about self-managing asthma.
An additional paediatric community nurse was appointed to help meet the overall extra workload.