A new, nurse-led ‘Respiratory Infections Team’ is delivering targeted and effective diagnosis and treatment for patients with community-acquired pneumonia leading to reduced hospital stays for the condition, according to a new study presented at the British Thoracic Society (BTS) Winter Meeting today, Thursday 7th December 2017.
Researchers will reveal data showing that the new team has helped improve antibiotic stewardship and reduced the median (a form of average) length of stay by two days for patients admitted to hospital with community-acquired pneumonia (CAP).
One year on, the full review of data from 301 patients is encouraging:
- Identification of the organism causing pneumonia increased from 4.9% the year prior, to 22.9%, leading to many more patients having targeted antibiotic strategies.
- Early supported discharge was appropriate for 30% of patients with low severity pneumonia, with no increase in hospital readmissions or mortality.
Considering all forms of pneumonia account for 29,000 deaths a year in the UK and the condition is the sixth biggest cause of death in UK, experts at Derby Teaching Hospitals NHS Foundation Trust were surprised at the lack of specialist teams around the UK. BTS audit standards such as adherence to local antibiotic guidance and early antibiotic administration were only achieved in just over half of NHS Trusts.
Despite evidence that targeted narrow spectrum antibiotics are safe, it is still routine practice to use broad spectrum antibiotics for patients with CAP, which can lead to resistance to antibiotics and healthcare-associated infections.
In an attempt to tackle this and improve care, a new Respiratory Infections Team was established by respiratory consultant Dr Tom Bewick.
Consisting of one consultant, one specialist nurse and one antimicrobial pharmacist, the team focused on three core areas with all patients admitted to hospital with CAP:
1. For those patients with low severity pneumonia, the team facilitated outpatient management with telephone support and follow up, providing many patients with the comfort of being at home, whilst reducing length of stay in hospital, and freeing up hospital beds.
2. Performing point-of-care tests to identify as early as possible the infecting organism the patient is suffering from, enabling the provision of the correct targeted antibiotic, rather than providing broad spectrum antibiotics empirically, as previously carried out
3. Promoting adherence to the BTS CAP ‘care bundle’ (a limited series of evidence-based actions to improve outcomes), such as patients receiving an X-ray within four hours and increasing diagnostic accuracy
Dr Tom Bewick, Consultant Respiratory Physician at Derby Teaching Hospitals NHS Foundation Trust and member of the British Thoracic Society, said:
“This new team has helped deliver better care for patients by reducing the amount of time spent in hospital, reducing unnecessary antibiotic use and improving diagnostic accuracy.
This is a totally new service which improves care, is cost-effective and helps with the fight against antibiotic resistance. We hope other NHS trusts will pick it up and introduce similar versions. As we continue to face severe pressures on finding beds during winter, this is one way to free up NHS resources for those in most need.”
Derby Teaching Hospitals have also now received a grant from NHS England to expand this service, so the team now boasts three nurses for cover 365 days a year, offers follow-up clinics, and supports education and good practice across the Trust.
For more information prior to the British Thoracic Society Winter Meeting (that is, before Wednesday 6thDecember 2017), please contact:
Rosie Strachan: t: 020 7831 8778 or 07566 223644
Charlotte Sutton: t: 07958 279240
Ed Gyde t: 020 7831 8778 or 07809 574801
During the British Thoracic Society meeting (from Wednesday 6th to Friday 8th December 2017):
Please contact the BTS news media office on t: 020 7798 4801/ 020 7798 4541 or the mobile numbers above.
Note to Editors:
The British Thoracic Society is the UK’s professional body of respiratory specialists. The Society seeks to improve standards of care for people who have respiratory diseases and to support and develop those who provide that care. A registered charity, it has over 3,400 members including doctors, nurses, respiratory physiotherapists, scientists and other professionals with a respiratory interest. For more information, go to www.brit-thoracic.org.uk
The British Thoracic Society Winter Meeting takes place from Wednesday 6th to Friday 8th December 2017 at the Queen Elizabeth II Conference Centre in Westminster, London.