Reflective Essay Catherine Nolan
This essay is all my own work and patient anonymity has been maintained.
The reflective model I am using in this essay is ‘What? So What? and Now What’ model suggested in the course notes.
I work as a Practice Nurse in a GPs practice in a suburb of Newcastle upon Tyne; Patients are mainly in socio-economic group A-C2 with some in groups D and E. The practice has a list size of 12,000+ patients with a Chronic Obstructive Pulmonary Disease (COPD) register containing 154 patients. I have worked there for 11years; I have been involved in doing spirometry, both in Chronic Obstructive Pulmonary Disease (COPD) annual reviews and new diagnostic spirometry, for ...view middle of the document...
I felt I needed to look at our recall letters and maybe produce a new information leaflet explaining the test and patient preparation necessary so hopefully cutting down on our DNAs and unsuitable patients.
Several studies, including Porak et al 1995, Galetti et al 2002 and the Cambridge Handbook of Psychology, Health and Medicine (2007) show that the more information a patient receives the better they are able to cope with procedures, deal with diagnoses and improves their recovery outcomes. One of the older studies that is cited in the more recent ones was a study for the Royal College of Nursing in 1975 by Haywood, he was looking at how anxiety affected a patient’s ability to recover from surgery, and he found that by increasing the information given to patients prior to any procedure increases patient satisfaction, ability to cope with the stress of the procedure and any subsequent diagnosis.
As a result of this I started looking for information to send to patients I read through the NICE Guidelines for COPD (2010), Diagnostic Spirometry in Primary Care, (Levy et al 2009) and Standardisation of Spirometry, (Miller et al 2005). These all gave good instructions as to what was needed for patient preparation and contraindications for the test.
I decided that two leaflets were required, one for patients who were under- going diagnostic spirometry, explaining exactly what the test entailed ,what preparations were needed by the patient any reasons they should cancel the test and who to inform if they should need to do this. (Appendix 1) and an information leaflet for COPD review patients reminding them when and what the test is and the preparations needed by them prior to the test, when to cancel and who to inform if they need to (Appendix 2).
While collating these leaflets I decided to create leaflets, listing the contraindications to spirometry and a pre- test check list to be used by all members of staff who carry out spirometry, in our practice, to help standardise treatment within my own practice. (Appendix 3 and 4).
My colleagues have found the check lists very useful when seeing patients and we all feel that it has helped standardises our practice.
Although the information sheets have only been going out to patients since mid-October 2010 there has been a drop in the number of Do Not Attends patients and those attending with infections or other contraindications. Several patients have commented that they have found the leaflets very helpful, even those who...