Survey of acute hospital resources for patients with COPD T McCarthy, M O’Connor, on behalf of the National COPD (Respiratory) Strategy Group Population Health, HSE, Dr Steevens Hospital, Dublin Introduction COPD (chronic obstructive pulmonary disease) is a chronic condition where the majority of patient care takes place in the primary care setting. However it is still necessary for secondary/tertiary services to provide specialist care and expertise when required. In fact, in 2006, 29% of respiratory inpatient hospitalisations related to COPD. 1 The aim of this survey was to inform the development of a national COPD strategy, by describing the current resources available within acute HSE hospitals, for the care of patients with COPD. Results Pulmonary Rehabilitation Ten locations (38%) have a formal programme in place. Five (31%) do not but have onward referral mechanisms. Four (25%) are planning a rehabilitation programme. For those with a programme, direct referrals are accepted from: Respiratory team/nurse specialist – 100% Non respiratory hospital consultant – 90% Medical Assessment Unit – 20% Emergency Department – 50% GP – 20% All programmes are currently delivered on a hospital site, with two planning a move to a community location. The main components of programmes are as follows: Outreach Programmes Three respondents (11.5%) have an outreach programme in place, the purposes of which include: Admission prevention Rapid discharge within 48 hours Early discharge but >48 hours Support for patients newly diagnosed with COPD Support for those new to home O2 and NIV Conclusion This survey details the variation in hospital based services for COPD patients in terms of staffing and models of care delivery. Opportunities for service development include extension of pulmonary rehabilitation and outreach programmes, improved access to respiratory expertise and specialist services and development of local protocols. Results Guidelines and protocols in place Management of COPD - 12 (46%) Non invasive ventilation - 19 (73.1%) Long Term Oxygen Therapy- 15 (57.7%) Availability of Non Invasive Ventilation Access to specialist services Methods A survey on relevant staffing, wards and diagnostic units, policies and practice and access to specialist services was distributed to acute HSE hospitals via hospital network managers. Twenty-six hospitals responded (72%). Results – Staff 14 locations (54%) have respiratory consultants on staff (0.2-5WTE) 19 (73%) have respiratory nurse specialists. One site has a 0.5WTE nurse specialist working solely with COPD patients, funded by industry 16 sites (62%) have ward nurses with respiratory training 18 (69%) have smoking cessation officers 21(81%) have palliative care nurse specialists Details of locations with staff available, weekdays 9-5, to treat acute COPD patients are summarised below: References 1. National COPD (Respiratory) Strategy Group. National COPD (Respiratory) Strategy Health Service Executive, Irish Thoracic Society, Irish College of General Practitioners. September 2008.