Shared learning database
Type and Title of Submission
Respiratory Nurse Led Cognitive Behavioural Therapy Service for patients with Respiratory DiseaseDescription:
A Respiratory Nurse led CBT service for patients with long term respiratory conditions. The service is provided within the hospital or community setting.Category:
2011-12 Shared Learning AwardsDoes the submission relate to the general implementation of all NICE guidance?
NoDoes the submission relate to the implementation of a specific piece of NICE guidance?
YesFull title of NICE guidance:
CG113 - AnxietyCategory(s) that most closely reflects the nature of the submission:
Is the submission industry-sponsored in any way?
Description of submission
To integrate cognitive behavioural therapy for patients with long term respiratory problems such as chronic obstructive pulmonary disease, pulmonary fibrosis, cystic fibrosis and asthma. The unique difference for this service is that respiratory nurses undertook training in cognitive behavioural therapy (CBT) to provide holistic care for respiratory patients.Objectives
1. Address the psychological needs of respiratory patients. 2. Provide cognitive behavioural therapy to reduce anxiety and/or depression experienced by respiratory patients attending the hospital. 3. Provide CBT in a number of settings e.g. for housebound patients or within the out-patient or in-patient setting.Context
Eight years ago one nurse identified the need for psychological treatment and trained in CBT. Training was then developed for all respiratory nurses working within the clinic. Audits were undertaken before and after CBT and showed a reduction in anxiety & depression symptoms & a reduction in hospital admissions. This provides an opportunity to improve quality of life and potentially save money on hospital admissions.Methods
To implement this service all patients attending the Chest Clinic needed to be screened using the Hospital Anxiety & depression Scale. Meetings were held for all staff involved. Patients with positive scores were offered information on anxiety & depression. A number of patients were referred to the respiratory nursing team for cognitive behavioural therapy. The additional workload was absorbed without additional costs.Results and evaluation
Initially a case series was undertaken. This was followed by a retrospective audit of patients participating in CBT compared to matched controls. We are now conducting a large randomised controlled trial of CBT versus control as part of NIHR funding for a Clinical Academic PhD Fellowship.Key learning points
1. Ensure nurses receive appropriate training in CBT. 2. Ensure nurses receive monthly supervision to promote safe and effective therapy. 3. Communicate to the whole multi-disciplinary team the importance of psychological care, following NICE Guidelines for COPD; Anxiety & Depression and ensure clear protocols are in place for screening and treatment using CBT. 4. Remember respiratory patients have complicated and often life-threatening medical symptoms that may require both medical & psychological interventions.
|Job Title:||Nurse Consultant|
|Organisation:||Newcastle upon Tyne Hospitals NHS Foundation Trust|
|Address:||Chest clinic, RVI Hospital|
|Town:||Newcastle upon Tyne|
|County:||Tyne & Wear|
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This page was last updated: 26 October 2011