Inhaler Use in Care Homesprompts for educational session to care home staff. Community Pharmacy Enhanced Service to Care Homes

Transcription

1 Inhaler Use in Care Homesprompts for educational session to care home staff Community Pharmacy Enhanced Service to Care Homes

2 Objective To improve the outcomes for patients in care homes with respiratory needs through the introduction of collaborative working between the care home, dispensing pharmacy, medicines management team and the patient s general practice.

3 Achieved through.. Engagement with staff (and resident if possible) about understanding, beliefs and concerns about inhaler use Knowing what the treatment is to achieve Inhaled drug is clinically appropriate Inhaler regime is clinically effective Inhaler device is appropriate Supporting residents to use inhaler Effective collaborative working

4 Points to cover in the educational session Short acting reliever Preventer inhaler Long acting relievers Combination inhalers Cleaning of inhalers and spacers Use of spacer devices Oxygen management Anticipatory medication management Smoking status Flu jab Other services pulmonary re-hab

5 Types of Inhaler device Pressurised Metered Dose Inhaler Dry powder inhaler Spring Loaded Pressurised Metered Dose Inhaler Fine Mist Pressurised Metered Dose Inhaler

6 Identify the reliever Explain what the active drug does Advised to use as soon as resident is feeling short of breath Shake the MDI prior to each dose used Is spacer device used? Duration of action Reliever

7 Preventer Identify the preventer Explain what the active drug does Advise needs to be taken regularly ( as prescribed) Shake MDI prior to each dose used If MDI is spacer device used Onset of action / duration of action Rinsing mouth after use

8 Long acting reliever Identify the long acting reliever Explain what the active drug does Advise needs to be taken regularly ( as prescribed) Shake MDI prior to each dose used If MDI is spacer device used Duration of action Difference between long acting and short acting

9 Combination inhalers Identify the combination Explain what the active drugs do Advise needs to be taken regularly ( as prescribed) Shake MDI prior to each dose used If MDI is spacer device used Onset of action/ duration of action Rinsing mouth out after use

10 Spacer devices Routinely used with MDI Cleaning and replacement One per resident / labelled Mask attachment

11 Asthma Control Test Five questions - ( on a scale of 1 5) During the past 4 weeks, how often did your asthma prevent you from doing your normal routine? During the past 4 weeks, how often have you had shortness of breath? During the past 4 weeks, how often did your asthma symptoms wake you up at night or earlier than usual? During the past 4 weeks, how often have you used your reliever inhaler? How would you rate your asthma control during the past 4 weeks?

12 COPD checklist Any changes to cough Any changes to phlegm colour / amount, consistency Any changes to breathing Any worsening of COPD symptoms Any changes to sleep pattern / tiredness Requirement of antibiotics/ steroids Had severe cold or flu Hospital admission due to breathing Need to use rescue meds more frequently Smoking status Five questions that best describe your breathing

13 Smoking cessation and flu immunisation Smoking cessation is a treatment for COPD ( NICE) different types a smoking cessation to offer Extra support available Influenza vaccination

14 Anticipatory medication What are the symptoms of exacerbation? Respond quickly Detailed instruction from prescriber in the care paln Increased breathlessness oral corticosteroid Sputum is purulent antibiotics Adjust bronchodilator therapy Just in case - course of antibiotics / steroids

15 Oxygen management Stored appropriately with hazard signs Awareness of hourly rate Annual review Tubing clear in colour not green Filter is clean Back-up cylinder

16 Pulse oximeter Non invasive monitoring of oxygen saturation

17 Pulmonary rehabilitation Telephone number ; Contact the Physiotherapy Service on Active Programmes