“This integrated approach to patient care has enabled these individuals to remain at home while ill rather than in a hospital bed,” according to Advanced Nurse Practitioner Antoinette Doherty, commenting after the launch of a new virtual ward initiative in Letterkenny. 

“The results and feedback from patients prove that this alternate care pathway works. The individuals living with COPD demonstrated higher levels of empowerment and improved knowledge and understanding of their condition. The early detection of infection resulted in a lower acuity level of exacerbation which directly impacted quality of life.”

Community virtual ward support

A first of its kind, the new innovative service gives community virtual ward support to individuals with Chronic Obstructive Pulmonary Disease (COPD). The services are offered as an alternate pathway to COPD care through the Community Virtual Ward bespoke platform.

A community virtual ward platform that incorporated respiratory rate trends was designed, implemented, and offered as an alternative to inpatient care in Co. Donegal between May and August of this year to a small group of suitable individuals. The main aim was to explore the feasibility and clinical outcomes.

Ten patients known to specialist respiratory services with COPD were selected and admitted to the Community Virtual Ward for remote monitoring and optimisation of the existing care plan. The results were early identification of exacerbation through respiratory rate monitoring and the patient started treatment sooner as they had improved access to prescriptions for antibiotics and steroids which was organised with relevant GPs.

The patients were reviewed daily at the start of each shift by the advanced nurse practitioner. When a trend from normal became apparent the patient was contacted and their self-care management was assessed and advanced nursing support was provided as indicated on the day. Nineteen courses of antibiotics and eight courses of oral steroids were dispensed to treat multiple episodes of acute exacerbation. None of the patients needed to be admitted for treatment of their condition. Improvements in health outcomes were also recorded.

Early intervention and management

The Community Virtual Ward offered an alternate pathway to COPD individuals, it facilitated early intervention and management of exacerbation. A significant increase in patients' ability to manage their health was displayed and the feedback indicated that patients loved this new care pathway and they displayed increased knowledge and understanding of their condition and confidence to manage it.

Mandy Doyle, Head of Primary Care, Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo noted that “the CARE programme is a fine example of how new pathways of care, new technological improvements and innovations can positively impact on the patient experience of healthcare. This innovation demonstrates the vision of Sláintecare in achieving the right care being available in the right place at the right time and given by the right team and most importantly enables patients to become increasingly empowered in the management of their healthcare”.

Antoinette Doherty added:  “I would like to thank all those who participated in this service improvement and I hope that we will see more patients being offered this type of care here in Donegal and nationally as it can assist in reducing hospital admission for this group”.