{"type":"doc","content":[{"type":"heading","attrs":{"level":2},"content":[{"text":"Key objectives","type":"text"}]},{"type":"paragraph","content":[{"text":"Provide patients with an Acute COPD exacerbation plan to record symptoms and measurements at least daily for a 2 weeks, and then on a regular basis.","type":"text"}]},{"type":"heading","attrs":{"level":2},"content":[{"text":"Outcome measures","type":"text"}]},{"type":"paragraph","content":[{"text":"Equip patients with a digital care plan that can be shared and edited by the patient. The ability to access and edit their care plan when anything in their plan changes.","type":"text"}]},{"type":"heading","attrs":{"level":2},"content":[{"text":"Current Baselines","type":"text"}]},{"type":"paragraph","content":[{"text":"All activity is face to face and all care plans currently in paper form. ","type":"text"}]},{"type":"heading","attrs":{"level":2},"content":[{"text":"Acute COPD Exacerbation Template","type":"text"}]},{"type":"mediaSingle","attrs":{"layout":"center"},"content":[{"type":"media","attrs":{"width":1916,"id":"057fc67d-9a96-499c-a9f2-b8a738fd36ea","collection":"contentId-3783524355","type":"file","height":22272}}]},{"type":"expand","attrs":{"title":"Example HTML code for Acute COPD Exacerbation Care Plan"},"content":[{"type":"paragraph","content":[{"text":"

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What is Early Supported Discharge/Hospital at Home?

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Following an assessment and treatment has been started in hospital, many patients with COPD can then be cared for safely and more comfortably at home. The 'Early Supported Discharge Hospital at Home Service' aims to provide care for","type":"text"},{"type":"hardBreak"},{"text":" patients suffering from a COPD flare up in the most appropriate setting and it allow patients who have come into hospital with COPD to return home sooner than previously possible.","type":"text"},{"type":"hardBreak"},{"text":"

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What happens next?

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Firstly, you will be assessed by the COPD Specialist team to see whether you are suitable for this support. Once you are considered suitable, a care plan will be agreed between COPD specialist Team, hospital consultant and you. The COPD","type":"text"},{"type":"hardBreak"},{"text":" specialist team will recommend what is to be provided for you when you go home and will get an agreement from you before discharge.

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These recommendations will consist of:

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Medication such as antibiotics or steroids
Treatment with Oxygen or nebulised medicines as necessary
Contact telephone numbers for you contact for advice about your breathing

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Follow up Visits at Home

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If you do not feel better or need to go back to hospital then this will be arranged.

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Some patients will be asked to wear a remote monitoring device to check their observations regularly. If you have been asked to do this, the specialist team will help set this up for you and show how to use this device, including maintenance.

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As part of your ongoing care, we would like you to use the Acute COPD Exacerbation Care Plan to record your symptoms and measurements at least daily for a 2 weeks using the 'Care Information Exchange'. To do this select the Edit","type":"text"},{"type":"hardBreak"},{"text":" plan button at the top of the page, complete the relevant sections of the plan, and select Save to save the information you have added.

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What do I do if I feel worse?

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While you are under the care of the community respiratory team, you can speak to one of the nurses if you have any questions or problems. They are available between 9am and 5pm. After 5pm the Out of Hours GP service will be available to help","type":"text"},{"type":"hardBreak"},{"text":" you if needed. At times rapid response teams may be involved in your care.

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Whilst you are under the care of the community respiratory team, you will remain under the care of the Hospital Consultant.

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Please ring for ambulance on 999, If you","type":"text"},{"type":"hardBreak"},{"text":" feel any of the following symptoms - Very Short of breath, not able to speak in sentences, chest pain, high fever, confusion, drowsiness.

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Contact numbers

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If you or your family/carers have any concerns of questions regarding your current health please contact:

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The Kensington Chelsea & Westminster (KCW) Community Respiratory Team from 9am-5pm: 07506609186 or 02033127661

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The Hammersmith & Fulham (H&F) Community Respiratory Team from 9am-5pm: 07957 629 023

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West Middlesex Community Respiratory Team from 9am-5pm: 07500 572232

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The Out of Hours Service after 5pm: 0208 969 0808

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If are not improving please discuss this","type":"text"},{"type":"hardBreak"},{"text":" with your nurse however if you feel Very Short of breath, not able to speak in sentences, chest pain, high fever, confusion, drowsiness. Please ring for ambulance on 999.

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Please try to remember to take the medical notes and documents that you have at home with you to hospital.

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What happens when I am better?

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When you are well, you will be discharged from the community respiratory team to the care of your GP. An outpatient appointment will be made for you with the community respiratory consultant. You will also be given a COPD management plan","type":"text"},{"type":"hardBreak"},{"text":" which explains how to recognise the early warning signs of a 'flare up' and how best for you to manage it. You will be given the telephone number of the team to ring them in the future if you have problems with your breathing.

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Treatment with oxygen

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You may have been given temporary oxygen to use at home?

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While you have been in hospital, we have agreed that you need some oxygen to use at home to help you recover. This is because you have low oxygen levels in your blood. The nurses or physiotherapists who visit you at home will continue to","type":"text"},{"type":"hardBreak"},{"text":" monitor your oxygen levels.

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Resources (video and advice sheet links)

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COPD Self-management plan

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please refer to your COPD Self-management plan

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My main concerns and items I would like to ask my healthcare team

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Please use this section to tell us about things that are troubling you and what you would like to discuss with us.

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How I feel today

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We would like you to tell us more about how you are feeling by recording your symptoms on a regular basis. To do this select the Edit plan button at the top of the page, enter your symptoms and weight in the relevant sections of the","type":"text"},{"type":"hardBreak"},{"text":" plan and select Save to save the information you have added.

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What is normal for you

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My symptoms and measurements

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We would like you to tell us more about how you are feeling by recording your symptoms on a regular basis.

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On a scale of 0 to 10 where 0 is extremely poor and 10 is normal for you, please let us know how you are feeling today.

","type":"text"},{"type":"hardBreak"},{"text":" How is your general health today?","type":"text"},{"type":"hardBreak"},{"text":" ","type":"text"},{"type":"hardBreak"},{"text":"

","type":"text"},{"type":"hardBreak"},{"text":" How able are you to manage your usual daily activities? (e.g washing, dressing, cleaning)","type":"text"},{"type":"hardBreak"},{"text":" ","type":"text"},{"type":"hardBreak"},{"text":"

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