UCC SONM 25 Year Book

UCC / School of Nursing and Midwifery

NORA MCNAMARA (RANP RESPIRATORY, SOUTH TIPPERARY GENERAL HOSPITAL STGH, CLONMEL)

Nora is committed to the care of patients with Chronic Obstructive Airways Disease (COPD) at South Tipperary General Hospital (STGH) and beyond. She demonstrates this through her work on developing care pathways for these patients and disseminating and sharing that work nationally. Nora identified a significant care deficit for this group of patients and developed a response that has led to dramatic improvements in the services provided at STGH. Her sole focus has been on the patient’s journey and experience and has put the patient at the centre of her service development. This remains evident in recently becoming a peer vaccinator and offering flu vaccinations to her patients in order to prevent hospital and intensive care admissions. Review of data on respiratory patients presenting to STGH revealed that approximately 50% of patients were suffering from COPD. The only service available was a respiratory outpatient appointment with no outreach/integrated care available to these patients or their GPs. In response, Nora developed a rapid access pathway for patients experiencing an Acute Exacerbation of COPD (AECOPD) ensuring specialist review and a prompt safe return home. As well as providing an in-reach service in the hospital, she offers an outreach service whereby each patient receives a telephone call within 72 hours of discharge as well as a discharge bundle including appropriate GP or RANP review in the Outpatients clinic. Nora’s service development have included patient and GP education on how best to manage AECOPD, COPD passports to improve the quality of care and ensure effective medical management. Further innovation in response to need has led to Nora establishing a RANP Led COPD Clinic for diagnosis and management of COPD at STGH. There is an abundance of data to support the impact of Nora’s service including: time to assessment following triage has reduced from 7hrs 10 mins to 1hr 45mins; time to medication has reduced from 5hrs 25mins to 1hr; time to specialist respiratory review from 24hrs 25mins to 2hrs 35mins; time for a decision to admit or discharge has reduced by 5hrs 40mins.

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