Patent foramen ovale causing breathlessness and platypnoea-orthodeoxia syndrome in an older patient (2018)

Type of publication:
Journal article

Author(s):
*Madden, Katy; *MacKintosh, Abigail; *Mike, Nigel

Citation:
Age and ageing; Oct 2018

Abstract:
An 82-year-old male presented with a week’s history of shortness of breath on exertion, particularly when bending to tie his shoe laces. The breathlessness worsened on standing and was relieved by lying. His oxygen saturations were noted to fluctuate based on position dropping to 82% on standing. This was suggestive of platypnoea-orthodeoxia syndrome (POS), an uncommon but potentially reversible diagnosis. As the population ages we may be more likely to see patients with persisting patent foramen ovale decompensate and develop POS.

Quality improvement project for emergency oxygen delivery on a respiratory ward (2016)

Type of publication:
Conference abstract

Author(s):
*Hutchinson K.E.; *Craik S.; *Srinivasan K.; *Moudgil H.; *Ahmad N.

Citation:
Thorax; Dec 2016; vol. 71, Supplement 3

Abstract:
Background British Thoracic Society (BTS) guidelines state that oxygen should be used to treat hypoxaemia and prescribed to a target saturation range.1 Patients at risk of type 2 respiratory failure should target 88-92%, with the rest 94-98%. In the BTS national audit in 2013, out of 6214 patients, 55% had oxygen prescribed and 52% were prescribed and delivered to within a target saturation range.2 Methods We ran a Quality Improvement Project (QIP) involving three PDSA cycles to improve the delivery of oxygen to patients on the Respiratory Ward at the Princess Royal Hospital, Telford. We set our standards as: 1. 90% of patients receiving oxygen have it prescribed on a drug chart 2. 100% of patients prescribed oxygen have a documented target saturation range 3. 100% of patients have oxygen delivered appropriately to target The QIP process
commenced in Autumn 2015. After the first cycle we used bedside prompt cards and delivered teaching sessions with doctors, nurses and healthcare assistants (HCAs). After the second cycle we appointed a nurse, HCA and two FY1 doctors as ‘O2 Ninjas’. Data were collected at three points after each cycle from drug charts and VitalPaC. Results See Table (Table Presented) Conclusions Our QIP shows that education and¬†empowerment of ‘grass root’ healthcare workers can improve oxygen prescription on a Respiratory ward. We suggest this QIP is replicated in other trusts and specialties to improve safe oxygen delivery.

Consultant-led, collaborative service for people suffering from respiratory conditions (2016)

Type of publication:
Post on the Academy of Fab NHS Stuff website

Author(s):
Nawaid Ahmad

Citation:
Academy of Fab NHS Stuff (www.fabnhsstuff.net/), January 2016

Abstract:
This Future Hospital Programme case study from The Shrewsbury and Telford Hospital NHS Trust outlines the benefits of having a consultant- led service for respiratory medicine.

Key recommendations:

Establish a series of multidisciplinary team (MDT) meetings to discuss the needs of patients with long-term conditions. The MDT should incorporate primary care physicians, mental health, social services and palliative care services to provide a collaborative and exceptional level of care.
Run community-based clinics to reduce hospital admissions as well as help with accurate diagnosis
Propose a long-term management plan for more patients with more complicated health needs and to help with advanced care planning for those patients who are especially ill.

Link to more details or full-text: http://www.fabnhsstuff.net/2016/01/25/your-story-consultant-led-collaborative-service-for-people-suffering-from-respiratory-conditions/