CH25. Asthma in Care Homes
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Asthma in Care Homes Policy
This document sets out the values, principles and policies underpinning {{org_field_name}}’s approach to its treatment of people with asthma. The home believes that every person has the right to the highest possible quality of care in the management of their health needs.
Policy Background
The home follows the British Guidelines on the Management of Asthma. It understands that asthma is a long-term condition involving the respiratory system in which the airways constrict and become inflamed, causing symptoms such as wheezing, shortness of breath, chest tightness and coughing.
Episodes or “attacks” may be triggered by such things as exposure to an environmental stimulant such as environmental tobacco smoke, cold or warm air, perfume, pet dander, moist air, exercise or exertion, or emotional stress. These are sometimes referred to as “triggers” and can include allergies.
Policy Aims
The aim is to reduce the impact of asthma on people’s lives and improve their quality of life where possible, helping them to manage their condition where required and ensuring they are able to live with dignity and independence by:
- informing people with asthma about their condition and about the support available within the home
- improving their access to services and reducing health inequalities
- ensuring a high standard of care and treatment for all people with asthma.
Diagnosis, Treatment and Care
In {{org_field_name}}:
• each person with asthma will have their condition included in their initial needs assessment conducted when they are first assessed for care — this will include discussion of how they cope with activities of daily living, medication needs, how they manage any asthma attacks and what, if any, help they require
• where input from a GP is required for a needs assessment, an appropriate appointment will be made
• an individual care plan will be agreed between the person (with relatives or carers where appropriate), GP and care staff; this plan may include elements of care related to asthma where such a need is identified, people themselves will be seen as equal and expert partners in care plans will be person focused and fully negotiated with each client at every stage, the plan should include input from specialist agencies involved in the care of the person where necessary
• where relevant, the plan will include:
a) the identification of a designated and appropriately trained member of care staff to function as a key worker
b) the identification of a designated doctor (usually the GP) who has overall medical responsibility for the asthma care
c) a full list of medications and asthma treatment, including dosage and frequency information — and arrangements for the administration of the medication (ie whether self-administered or where help is required by appropriately trained care staff)
d) arrangements for an annual review which will include a complete assessment of the person’s asthma control
e) measures to minimise the risk of both long-term and short-term complications of the person’s condition
f) any additional support or help required in activities of daily living
• care plans for people who use services with asthma may include details of exactly how episodes of shortness of breath should be managed and details of how the person should be managed if they are unwell and having difficulty breathing
• care plans will be reviewed on an annual basis or more frequently if a person’s condition changes
• all people who have been diagnosed with asthma should be encouraged to have an annual review with their GP; it is the home’s understanding that, for patients with severe asthma, such reviews should include:
a) a review of reliever and preventer medication
b) a review of the number of asthma attacks suffered
c) a review of other medication prescribed, such as steroids
d) side effects of medication
e) an investigation into any links to triggers or allergies
f) checking correct use of inhalers
g) appropriate lung function tests such as spirometry
h) an opportunity to discuss concerns or issues
i) referral to specialist teams if required
• those people who use services with severe asthma should expect to be referred for specialist assessment if their asthma is difficult to control
• people with asthma will be provided with information about asthma and support groups/networks as required, information will be tailored to the needs/language of the individual concerned; it will include information on local treatments/support/helplines as well as information on smoking, diet and exercise
• people with asthma will be provided with any specialist diet support required
• support will be provided as required for relatives and carers
• the approach taken should be one of empowering people with asthma, where possible, to be as self-caring and as independent as possible, self-managing their condition and thus maintaining and enhancing their dignity and privacy; as part of this self-empowerment, people who use services will be encouraged to:
a) talk to staff about any concerns or worries they may have
b) understand what triggers their own asthma attacks
c) know what to do if they have an asthma attack
• where a person with asthma is a smoker, they will be offered all appropriate help and support to stop smoking, including referral to local smoking cessation services if they wish; all options will be discussed with the person whose choices will be respected.
Medicines
The home understands that there are two main types of medicines used to treat asthma: relievers and preventers. Relievers (blue inhalers) are emergency medicines taken during an asthma attack. They are small tubes that contain medication in a vapour form. When a person suffers an asthma attack they struggle to breathe and the inhaler can be used to introduce the medication directly into the lungs by breathing it in. The medication then acts on the airways, dilating them and allowing the victim to breathe. Preventers (brown, red, orange inhalers, sometimes tablets) are used to prevent attacks.
In {{org_field_name}}:
- standard medication used for the treatment of asthma will either be self-administered by people who use services or administered by care staff according to the Medication Management in Care Homes Policy
- inhalers are classed as emergency medication which is required on an “as when needed” basis; inhalers should therefore be kept in a safe place but must be easily accessible in the event of an emergency, in the case of an asthma attack immediate access to reliever medicines, usually an inhaler, is essential
- help will be provided by appropriately trained care staff to people who have difficulties in self-administering their inhalers
- care staff will monitor all medicines use for side effects.
Training
{{org_field_name}} believes that the education and training of care staff in the treatment and care or people with asthma is fundamental if they are to understand the potential effects and complications of the condition and provide effective care for people who use services.
All new staff should be encouraged to read this policy on asthma care as part of their induction process as well as any associated policies and care protocols. Care staff will be offered additional training in the basic care of asthma and covering the use of inhalers. They will also be trained in what to do if a person has an asthma attack.
Nursing staff will be offered appropriate skills training or refresher courses in modern evidence-based practice as identified in appraisal or learning plans and as dictated by their need for continuous professional development.
Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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