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St George’s Hospital asthma team update

17th September 2020

by Jo Lawson, Asthma Senior Clinical Nurse Specialist

We have been living in very unfamiliar times at the moment and like the rest of the country, we have had to adapt the way we work to protect everyone around us.

Since March most children have been homeschooled and kept socially distanced. This has led to a significant reduction in the number of acute asthma attacks presenting to the hospital. Most of our contact with our families has been via telephone rather than seeing them face to face.  As a team, we have missed the regular face to face contact as it is such a huge part of the clinical nurse specialist role.

One of the positives of the last few months is that, as a team, we have had time to develop some of the projects we have been working on and these have now been put into practice. This includes the GP liaison project which is working with 10 local GP surgeries who have higher admission rates. The idea is that we offer training around asthma management and a support network to try and reduce hospital admissions.

We are also working hard to gain asthma-friendly schools accreditation in Merton and Wandsworth borough schools. This project had to be curtailed earlier in the year due to the schools closing but is now back up and running. We have a virtual / socially distanced meeting planned later in September to get more schools involved. This has been very well received and a large number of school nurses and potential school champions have expressed interest in attending this.

School emergency asthma bags have been successfully distributed to schools in Wandsworth and Merton. This year we aim to distribute emergency anaphylaxis kits to all schools and replenish the asthma bags.

Due to the impact of the on-going virus as a Trust we have had to look at sustaining a different way of working in the future with reduced face to face contact and more virtual appointments either by telephone or video. This has a number of benefits:

  • the children and families remain protected and are less likely to catch coronavirus
  • reduction in DNA rates
  • children may not need to miss school
  • only children who need hospital intervention/investigations are brought into the clinic which may reduce waiting times and overcrowded clinics

We are developing a new model for children to attend clinic. They should come with only one parent and preferably no siblings. They should arrive on time as there will be a protected slot and they should be directed straight to a consulting room where the team will come and see them. Hopefully no waiting in the waiting room. The rooms will be appropriately cleaned in between each family

  • Important that people continue to take their preventative treatment regularly.
  • Ensure they have a rescue inhaler and spacer and plan at school.
  • Flu vaccination.
  • Try to exercise.
  • Maintain hand hygiene and social distancing – may reduce transmission of other viral infections too.
  • Not to avoid coming to hospital if unwell.

We are also in the process of updating all the asthma information leaflets we give out to families when they attend the hospital. This includes a new family information booklet and a discharge checklist which is to be signed by the discharging nurse/doctor and parent so we have evidence they have received it.  This is to be made available electronically as well as in paper format as our ED department is now predominantly paperless.

The future of paediatric asthma management, therefore, remains uncertain but hopefully, we can all work together with our families to continue to provide the service they need to keep them safe and well until this pandemic is over.

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