- Email: [email protected]
268 Short-term pulmonary rehabilitation program in children and adolescents with chronic respiratory disease
S126
11. Nursing/Psychosocial/Quality Improvement
265 Drug allergy documentation in the All Wales Adult CF Centre (AWACFC) S. Basrai1 , M. Young1 , M. Lea-Davies2 , L. Speight2 , D. Lau2 , R.I. Ketchell2 , J. Duckers2 . 1 Cardiff University, Cardiff, United Kingdom; 2 Cardiff & Vale University Health Board, All Wales Adult CF Centre, Cardiff, United Kingdom Aims: i. To examine the validity of drug allergy documentation in the AWACFC. ii. To explore how effective communication is between AWACFC and patients’ GPs regarding their drug allergies and whether patient knowledge of their own allergies matches AWACFC and GP records. Method: Allergy records from the patients’ latest annual reviews were reviewed retrospectively. Allergy records were requested from the patients’ GP and a questionnaire regarding drug allergies was given out to patients. The data was also used to identify if allergies were documented correctly. Allergy was defined as a usually harmless substance resulting in immunological activation (Robinson et al. 2002). Results: Of the 240 patients attending the AWACFC 106 (44%) patients had a complete dataset of allergy records from the GP, AWACFC annual review and patient questionnaire. Only 40 of the 106 patients (38%) had allergy documentation from AWACFC, GP and patient questionnaire that matched. A total of 164 drug allergies were documented with 67 patients (63%) having at least one drug allergy documented. 34 of these 67 patients (51%) had at least one drug allergy documented where the description did not meet the definition of a true allergy. Conclusion: Communication regarding drug allergies between the patient, GP and AWACFC was poor. It was difficult to characterise true allergies as many of the documented allergies lacked descriptions. Over half the patients had at least one drug allergy documented that was not an allergy. Misdiagnosing an adverse event as an allergy can result in patients needlessly missing out on optimal treatment.
Posters
267 Peripherally-inserted central catheters use and care in cystic fibrosis: A survey on the practice of free-lance home care nurses in France J. Chapron1 , V. Patalas2 , S. Surget3 , B.-L. Jaouani4 , F. Cases5 , C. Jaumain6 , C. Courtiol7 , R. Panzo1 , D. Hubert1 , E. Burnet1 , I. Honor´e1 , R. Kanaan1 , P.-R. Burgel1 , D. Dusser1 , C. Dupont1 . 1 Pulmonary Department and Adult Cystic Fibrosis Centre, Cochin Hospital, AP-HP, Paris, France; 2 Pulmonary Department, Cystic Fibrosis Centre, Nouvel Hˆopital Civil, Strasbourg, France; 3 Home Care Provider Network, Paris, France; 4 Free-lance Home Care Nurse, Paris, France; 5 Home Medical Equipment Provider, Marseille, France; 6 Home Medical Equipment Provider, Paris, France; 7 Cancer Institute of Lorraine, Nancy, France Background: A study conducted at Cochin Hospital in Paris showed that PICC lines were generally safe to infuse IV antibiotic courses at home for patients with Cystic Fibrosis (CF) and non-CF bronchiectasis (Burgel et al., 2014). However, in our CF centre, we have observed that dressing changes performed by free-lance nurses are oftentimes inadequate and inconsistent. In France, PICC lines have been used since 2005 and home care is provided by free-lance nurses who are responsible for their own training on PICC line care. Objectives: To evaluate the skills and practice of free-lance nurses relating to PICC line care, particularly to identify the variables leading to improper PICC line dressing change. Methods: A survey was conducted among free-lance nurses between March 2012 and January 2014. 296 self-administered questionnaires were filled by nurses at the beginning of IV therapy training sessions. Results: 56.4% had already used a PICC line. 91.6% of them had changed the dressing at least once, 74.4% of which had changed the sutureless securement device (SSD) at least once (41.2% of the overall population). 41% found the SSD difficult to remove and to set up. 43.4% had been trained by private medical supply providers and 39.7% by hospital personnel. Nurses who had been trained were four times more likely to answer questions correctly and three times more likely to have the skills to follow practice guidelines. Conclusion: This study enabled us to gain a better understanding of home care nursing practice, and to identify SSDs change as the main problem and therefore to tailor IV therapy training to the actual needs of free-lance nurses working in the home care setting.
266 Experience of Mycobacterium abscessus eradication therapy at Aberdeen Royal Infirmary
268 Short-term pulmonary rehabilitation program in children and adolescents with chronic respiratory disease
K.J. Griffiths1 . 1 Aberdeen Royal Infirmary, Respiratory Department, Aberdeen, United Kingdom
P. Van de Wijdeven1 , L. Govaerts1 , K. Spooren1 , K. Van Aerschot1 , M. Moens1 . 1 Respiratory Rehabilitation Centre for Children and Adolescents Pulderbos, Respiratory Department, Zandhoven, Belgium
Mycobacterium abscessus (MA) is emerging as a potential major pathogen in CF with potential implications for transplantation. Ongoing research shows that an aggressive attempt at eradication is the treatment choice. Three patients underwent eradication treatment at Aberdeen Royal Infirmary during 2014, following the Papworth eradication protocol. Patients underwent 4 weeks of multiple intravenous antibiotics followed by a long-term regime of nebulised and oral antibiotics. Close monitoring of sputum cultures was ongoing throughout this time. To date, all three patients have had 3 consecutive negative sputum cultures for MA following eradication therapy. The CF Foundation and ECFS draft guidelines state that eradication therapy should continue for one year after the first of 3 negative sputum cultures, thus within the next 3 months, all 3 patients will be able to discontinue their long-term eradication treatment and return to a routine CF clinic within the department. Patients A and B both dropped their FEV1 predicted values during eradication therapy (9.67% and 30.73% respectively) whilst Patient C experienced a slight increase in predicted FEV1 of 6.78%. Patient B has commenced anti-asthma therapy, which has led to an improvement in her most recent FEV1 recording. All 3 patients have gained weight, with Patient C gaining 13.8 kg over the last 8 months since commencing eradication treatment. Patients A and B have both gained just over 1 kg in weight in this time. Eradication treatment for MA is complex and difficult for some patients to tolerate. We believe that further research regarding treatment and cross infection is imperative.
Introduction and Aims: Inpatient rehabilitation programs for children and adolescents with chronic respiratory disease aim to improve health by optimizing treatment resulting in improved pulmonary function, physical strength and endurance, and weight. In order to achieve these aims a multidisciplinary approach is required during several weeks to months. After discharge patients might benefit from shortterm yearly follow-up rehabilitation therapy to maintain optimal care. We aimed to develop a short-term pulmonary rehabilitation program to improve pulmonary function, weight and quality of life. Methods: A short-term rehabilitation program was established from 2004–2014. Patients were admitted during a period of two weeks for a program of intensive respiratory physiotherapy and physical exercise. Patients received individual treatment and practical training in a group-based program in a multidisciplinary approach. Patient characteristics, lung function and questionnaires were recorded pre- and post-intervention. Results: We report the results of a retrospective cohort of ten patients with a total of 57 admissions. Average forced vital capacity improved modestly during the rehabilitation period: 3.5 versus 3.6 liter (p = 0.03). There was a modest average weight gain after two weeks of rehabilitation: 0.3 kg (−1.3, +3.1, p = 0.03). Qualityof-life as measured by the ‘Cystic Fibrosis Questionnaire-Revised’ improved. Conclusion: Short-term pulmonary rehabilitation for children and adolescents with chronic respiratory disease induces weight gain and improves lung function and quality of life. These short-term effects await replication in larger cohorts and studies on long-term effects.
11. Nursing/Psychosocial/Quality Improvement
265 Drug allergy documentation in the All Wales Adult CF Centre (AWACFC) S. Basrai1 , M. Young1 , M. Lea-Davies2 , L. Speight2 , D. Lau2 , R.I. Ketchell2 , J. Duckers2 . 1 Cardiff University, Cardiff, United Kingdom; 2 Cardiff & Vale University Health Board, All Wales Adult CF Centre, Cardiff, United Kingdom Aims: i. To examine the validity of drug allergy documentation in the AWACFC. ii. To explore how effective communication is between AWACFC and patients’ GPs regarding their drug allergies and whether patient knowledge of their own allergies matches AWACFC and GP records. Method: Allergy records from the patients’ latest annual reviews were reviewed retrospectively. Allergy records were requested from the patients’ GP and a questionnaire regarding drug allergies was given out to patients. The data was also used to identify if allergies were documented correctly. Allergy was defined as a usually harmless substance resulting in immunological activation (Robinson et al. 2002). Results: Of the 240 patients attending the AWACFC 106 (44%) patients had a complete dataset of allergy records from the GP, AWACFC annual review and patient questionnaire. Only 40 of the 106 patients (38%) had allergy documentation from AWACFC, GP and patient questionnaire that matched. A total of 164 drug allergies were documented with 67 patients (63%) having at least one drug allergy documented. 34 of these 67 patients (51%) had at least one drug allergy documented where the description did not meet the definition of a true allergy. Conclusion: Communication regarding drug allergies between the patient, GP and AWACFC was poor. It was difficult to characterise true allergies as many of the documented allergies lacked descriptions. Over half the patients had at least one drug allergy documented that was not an allergy. Misdiagnosing an adverse event as an allergy can result in patients needlessly missing out on optimal treatment.
Posters
267 Peripherally-inserted central catheters use and care in cystic fibrosis: A survey on the practice of free-lance home care nurses in France J. Chapron1 , V. Patalas2 , S. Surget3 , B.-L. Jaouani4 , F. Cases5 , C. Jaumain6 , C. Courtiol7 , R. Panzo1 , D. Hubert1 , E. Burnet1 , I. Honor´e1 , R. Kanaan1 , P.-R. Burgel1 , D. Dusser1 , C. Dupont1 . 1 Pulmonary Department and Adult Cystic Fibrosis Centre, Cochin Hospital, AP-HP, Paris, France; 2 Pulmonary Department, Cystic Fibrosis Centre, Nouvel Hˆopital Civil, Strasbourg, France; 3 Home Care Provider Network, Paris, France; 4 Free-lance Home Care Nurse, Paris, France; 5 Home Medical Equipment Provider, Marseille, France; 6 Home Medical Equipment Provider, Paris, France; 7 Cancer Institute of Lorraine, Nancy, France Background: A study conducted at Cochin Hospital in Paris showed that PICC lines were generally safe to infuse IV antibiotic courses at home for patients with Cystic Fibrosis (CF) and non-CF bronchiectasis (Burgel et al., 2014). However, in our CF centre, we have observed that dressing changes performed by free-lance nurses are oftentimes inadequate and inconsistent. In France, PICC lines have been used since 2005 and home care is provided by free-lance nurses who are responsible for their own training on PICC line care. Objectives: To evaluate the skills and practice of free-lance nurses relating to PICC line care, particularly to identify the variables leading to improper PICC line dressing change. Methods: A survey was conducted among free-lance nurses between March 2012 and January 2014. 296 self-administered questionnaires were filled by nurses at the beginning of IV therapy training sessions. Results: 56.4% had already used a PICC line. 91.6% of them had changed the dressing at least once, 74.4% of which had changed the sutureless securement device (SSD) at least once (41.2% of the overall population). 41% found the SSD difficult to remove and to set up. 43.4% had been trained by private medical supply providers and 39.7% by hospital personnel. Nurses who had been trained were four times more likely to answer questions correctly and three times more likely to have the skills to follow practice guidelines. Conclusion: This study enabled us to gain a better understanding of home care nursing practice, and to identify SSDs change as the main problem and therefore to tailor IV therapy training to the actual needs of free-lance nurses working in the home care setting.
266 Experience of Mycobacterium abscessus eradication therapy at Aberdeen Royal Infirmary
268 Short-term pulmonary rehabilitation program in children and adolescents with chronic respiratory disease
K.J. Griffiths1 . 1 Aberdeen Royal Infirmary, Respiratory Department, Aberdeen, United Kingdom
P. Van de Wijdeven1 , L. Govaerts1 , K. Spooren1 , K. Van Aerschot1 , M. Moens1 . 1 Respiratory Rehabilitation Centre for Children and Adolescents Pulderbos, Respiratory Department, Zandhoven, Belgium
Mycobacterium abscessus (MA) is emerging as a potential major pathogen in CF with potential implications for transplantation. Ongoing research shows that an aggressive attempt at eradication is the treatment choice. Three patients underwent eradication treatment at Aberdeen Royal Infirmary during 2014, following the Papworth eradication protocol. Patients underwent 4 weeks of multiple intravenous antibiotics followed by a long-term regime of nebulised and oral antibiotics. Close monitoring of sputum cultures was ongoing throughout this time. To date, all three patients have had 3 consecutive negative sputum cultures for MA following eradication therapy. The CF Foundation and ECFS draft guidelines state that eradication therapy should continue for one year after the first of 3 negative sputum cultures, thus within the next 3 months, all 3 patients will be able to discontinue their long-term eradication treatment and return to a routine CF clinic within the department. Patients A and B both dropped their FEV1 predicted values during eradication therapy (9.67% and 30.73% respectively) whilst Patient C experienced a slight increase in predicted FEV1 of 6.78%. Patient B has commenced anti-asthma therapy, which has led to an improvement in her most recent FEV1 recording. All 3 patients have gained weight, with Patient C gaining 13.8 kg over the last 8 months since commencing eradication treatment. Patients A and B have both gained just over 1 kg in weight in this time. Eradication treatment for MA is complex and difficult for some patients to tolerate. We believe that further research regarding treatment and cross infection is imperative.
Introduction and Aims: Inpatient rehabilitation programs for children and adolescents with chronic respiratory disease aim to improve health by optimizing treatment resulting in improved pulmonary function, physical strength and endurance, and weight. In order to achieve these aims a multidisciplinary approach is required during several weeks to months. After discharge patients might benefit from shortterm yearly follow-up rehabilitation therapy to maintain optimal care. We aimed to develop a short-term pulmonary rehabilitation program to improve pulmonary function, weight and quality of life. Methods: A short-term rehabilitation program was established from 2004–2014. Patients were admitted during a period of two weeks for a program of intensive respiratory physiotherapy and physical exercise. Patients received individual treatment and practical training in a group-based program in a multidisciplinary approach. Patient characteristics, lung function and questionnaires were recorded pre- and post-intervention. Results: We report the results of a retrospective cohort of ten patients with a total of 57 admissions. Average forced vital capacity improved modestly during the rehabilitation period: 3.5 versus 3.6 liter (p = 0.03). There was a modest average weight gain after two weeks of rehabilitation: 0.3 kg (−1.3, +3.1, p = 0.03). Qualityof-life as measured by the ‘Cystic Fibrosis Questionnaire-Revised’ improved. Conclusion: Short-term pulmonary rehabilitation for children and adolescents with chronic respiratory disease induces weight gain and improves lung function and quality of life. These short-term effects await replication in larger cohorts and studies on long-term effects.