Transcript Inhaler Use in Care Homes

Inhaler Use in Care Homesprompts for educational session
to care home staff
Community Pharmacy
Enhanced Service
to Care Homes
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.
Achieved through……..
• Engagement with staff (and resident if
possible) about understanding, beliefs and
concerns about inhaler use
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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
Points to cover in the educational session
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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
Types of Inhaler device
• Pressurised Metered Dose Inhaler
• Dry powder inhaler
• Spring Loaded Pressurised Metered Dose
Inhaler
• Fine Mist Pressurised Metered Dose Inhaler
Reliever
• 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
Preventer
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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
Long acting reliever
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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
Combination inhalers
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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
Spacer devices
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Routinely used with MDI
Cleaning and replacement
One per resident / labelled
Mask attachment
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?
COPD checklist
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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
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
Anticipatory medication
• What are the symptoms of exacerbation?
• Respond quickly
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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
Oxygen management
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Stored appropriately with hazard signs
Awareness of hourly rate
Annual review
Tubing clear in colour – not green
Filter is clean
Back-up cylinder
Pulse oximeter
• Non – invasive monitoring
of oxygen saturation
Pulmonary rehabilitation
• Telephone number ;
Contact the Physiotherapy Service on 0114 231 9821
Active Programmes 0114 305 4200