งานนำเสนอเรื่อง: "Strategies for improving asthma care"— ใบสำเนางานนำเสนอ:
1 Strategies for improving asthma care Orapan Poachanukoon, MD.Associate Professor of Allergy and ImmunologyFaculty of Medicine, Thammasat University
2 Failure to use guideline Assessing compliance with asthma guidelinesMake it simpleUse data record sheet/order formPatients and HCW education
3 Implementing interventions Patient identificationPatient self-assessmentChart remindersCommitted nurses and pharmacistsAn improved diagnostic toolInternal audits: case based review of successes and pitfalls
4 Implementing interventions Improve the frequencyIncrease use the PEFR/spiromerty for diagnostic toolEnsure that every asthma patients received flu shotActivate patients to involve by asthma action plan/peak flow/act
5 6 Resources for improving asthma treatment Asthma educator spending time in the officeStandardized curriculum to teach patientsAsthma action planTraining for office staffConsistent contact personPayment to carry out the program: P4P (Pay for Performance)
6 Key for asthma long term management Treatment with long-term controllers to prevent asthmatic attacksAvailability of SABA to treat asthmatic attacksDevelop asthma action planRemove environmental triggersManage of other triggers
7 Factors influencing ER visit Lack of transportation for routine check-upDifficulty obtaining or paying for prescription refillsDifficulty to contact health care providerDifficulty in obtaining an office visit for urgent careParental perception that physicians prefer them to use ED for exacerbation
13 Factor affecting total asthma control pharmacotherapyEnvironmentLife stylesupport
14 Patient Education% of patients in UK receiving different types of information when first diagnosed
15 Patient education Topic for patient discussion -nature of the disease -nature of their prescribed treatment-identify area where patient most wants treatment to have effect-how to use their treatments-development of self-monitoring-recognition and management of exacerbation-appropriate allergen and trigger avoidance
16 Asthma action plan priority patients Those having frequent exacerbationsThose requiring frequent courses of steroid tabletsUsers of high-dose inhaled steroidsED/hospital attendeesThose at risk of developing severe/fatal asthma
17 Factors that increase risk of asthma death History of near-fatal asthma requiring intubation or ventilationHospitalization or emergency visit in past yearCurrently using or recently stop using oral steroidsNot currently using ICSOver use SABAPsychological problemPoor adherence, lack of asthma action planFood allergy in patients with asthmaGINA 2014.
18 การดูแลตนเองเบื้องต้น Keys components to asthma action planการให้ความรู้ในการดูแลตนเองเมื่อหืดกำเริบ (Asthma Action Plan)อาการหืดกำเริบประเมินความรุนแรงการดูแลตนเองเบื้องต้นเมื่อไหร่ควรไปรพ.According to asthma guideline, the goal of asthma treatment is no exacerbation and no loss work. The results of a study in Thailand show that asthma symptom is still uncontrolled in large number of patients as you can see that 15% of patients were admitted, 20% need ER visit and 24% were absent from work due to asthmatic attack.
21 TU Asthma Club Web Page TU Asthma Club Fan Page TU Asthma Club Channel https://www.tuasthmaclub.comTU Asthma Club Fan Pagehttps://www.facebook.com/TU.AsthmaClub2014TU Asthma Club onTU Asthma Club Channelhttps://www.youtube.com/channel/UCEIGp_oLSG_W65fqE-b_GCwApplication on iOS
23 Key to success Empowering nurses and engaging them in the process Make it easyInternal chart audit: Change and ImprovementRedesign model to make it easy and do the right thing: chart flag and toolreport data for motivationUnderstand the importance of vision, planning and commitment