Development and evaluation of a community respiratory physiotherapy service for children with severe neurodisability

Wolff, Antonia; Griffin, Hayley; Flanigan, Moira; Everest, Sarah; Thomas, David A.; Whitehouse, William P

doi:10.1136/bmjquality.u208552.w3411

Cited by 6 publications

(7 citation statements)

References 12 publications

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“…This is, for instance, also illustrated in a recent study where a community respiratory physiotherapy service was installed for children with disabilities with an acute infection. This resulted in a reduction of hospital admissions and bed days for these children . A relatively new device, the Free‐Aspire (Medical Products Research, Srl, Legnano, Italy) is an electro‐medical machine for removing secretions.…”

Section: Recurrent Aspirationmentioning

confidence: 99%

“…This resulted in a reduction of hospital admissions and bed days for these children. 35 A relatively new device, the Free-Aspire (Medical Products Research, Srl, Legnano, Italy) is an electro-medical machine for removing secretions. The device utilizes Vak} um technology: during expiration the airflow is accelerated by the Venturi effect inside a special connector.…”

Section: Gastro-oesophageal Refluxmentioning

confidence: 99%

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Respiratory morbidity in children with cerebral palsy: an overview

Boel

Pernet²,

Toussaint³

et al. 2018

Develop Med Child Neuro

121

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Respiratory problems have a significant impact on morbidity and mortality in patients with cerebral palsy (CP). In particular, recurrent aspiration, impaired airway clearance, spinal and thoracic deformity, impaired lung function, poor nutritional status, and recurrent respiratory infections negatively affect respiratory status. Bronchopulmonary dysplasia may contribute to pulmonary problems, but asthma is not more common in CP than in the general population. We discuss treatment options for each of these factors. Multiple coexisting and interacting factors that influence the respiratory status of patients with CP should be recognized and effectively addressed to reduce respiratory morbidity and mortality. What this paper adds Respiratory problems are a significant cause of morbidity in patients with cerebral palsy (CP). Respiratory status in patients with CP is influenced by recurrent aspiration and impaired airway clearance. Spinal and thoracic deformity, impaired lung function, poor nutrition, and respiratory infections also negatively affect respiratory status. These factors should all be addressed to reduce respiratory problems in patients with CP.

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Section: Recurrent Aspirationmentioning

confidence: 99%

Section: Gastro-oesophageal Refluxmentioning

confidence: 99%

Respiratory morbidity in children with cerebral palsy: an overview

Boel

Pernet²,

Toussaint³

et al. 2018

Develop Med Child Neuro

121

View full text Add to dashboard Cite

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“…As shown in the present study, these represented a significant part of morbidities requiring pediatric intensive unit care. Considering primary preventive measures such as passive and active immunization and respiratory physiotherapy, secondary protection such as antibiotherapy and bronchodilator therapy and tertiary prophylaxis such as respiratory physiotherapy may reduce pediatric intensive care unit admissions of patients with chronic neurological diseases (5)(6)(7) .…”

Section: Dıscussıonmentioning

confidence: 99%

Evaluation of patients admitted to the pediatric intensive care unit due to neurological problems

Gürbüz¹,

İşgüder²,

Ceylan³

et al. 2018

BUCH

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Objective: The principal objective of this study was to produce a profile of the patients hospitalized in the pediatric intensive care unit due to neurological problems and to identify the major etiologies most commonly leading to mortality. Methods: We detected that 293 of 2843 patients hospitalized in our hospital's pediatric intensive care unit over the 3-year period between 2011 and 2013 were admitted for neurological reasons Patients' etiologies, comorbidities, and dates of admission to the pediatric intensive care unit and of discharge were evaluated. Results: The most frequently seen neurological morbidity was convulsion in 39% (n=114) of the cases. Neurological problems were the sole cause of admission in 186 (63.7%) cases, while 106 (36.3%) patients had a comorbid condition in addition to neurological problems. The most common of these comorbidities was infection in 68.8% (n=73) of the cases. One hundred and sixteen (39.7%) patients were discharged in a healthy condition, while abnormal neurological findings were present in 131 (44.9%) patients. While 28 (9.6%) patients exited during admission. Respiratory problems were the most common cause of death. Mortality, and hospitalization rates in patients under 3 years of age were found to be higher when they are compared with other groups. They are an important cause of admissions to the particularly pediatric intensive care unit and of mortality. Conclusion: Neurological problems constitute a significant group in admissions in pediatric intensive care. They constitute an important cause of admission into the pediatric intensive care unit and of mortality, particularly children under 3 years of age. Effective treatment of infections may reduce mortality rates.

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“…It has been demonstrated that specialist respiratory physiotherapy treatment can be highly effective in the acute and long-term management of CYP with complex disabilities and recurrent or persistent respiratory illness 8 9 and offering these services within the community improves patient experience by keeping CYP closer to home and with their families. 10–12 …”

Section: Introductionmentioning

confidence: 99%

“…An early service evaluation in 2015 identified the CCRPS to be effective in reducing ED attendances, hospital admissions and length of stay for respiratory tract infections. 10 We now report the results of a further service evaluation which was conducted from 1 April 2019 until end of March 2020 to look at admissions prevented and user satisfaction with the service.…”

Section: Introductionmentioning

confidence: 99%

Evaluating a community respiratory physiotherapy service for children with neurodisability

et al. 2022

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BackgroundChildren with neurodisability are at an increased risk of respiratory problems and complications, which often result in prolonged, frequent hospital admissions and are the biggest cause of mortality in this client group. The Children’s Community Respiratory Physiotherapy Service (CCRPS) was established in 2010 to support children with severe neurodisabilities at home during acute chest infections and to prevent emergency department attendances and hospital admissions. This service evaluation looked at patient/parent satisfaction and prevented admissions to ensure clinical and cost-effectiveness, despite the rising demand for the service.MethodsOver a 3-month period, patients and parents/carers on the CCRPS caseload were given a Picker feedback survey following 100 emergency visits from the team. The number of prevented hospital admissions for respiratory tract infection over 12 months (April 2019–March 2020) was identified from existing CCRPS data and hospital admissions costs saved were estimated.ResultsThe Picker survey responses were extremely positive with all respondents reporting that they felt well looked after and that the main reason for the emergency visit was dealt with well. Based on key indicators, the CCRPS prevented 182 hospital admissions for respiratory tract infection in 2019/2020, equating to 1638 bed days and estimated cost savings ranging between £751 728 and £1 009 986.ConclusionsThe Picker survey response demonstrates the positive impact that the CCRPS has on both quality of life and experience for patients and families. The CCRPS rapid response service prevents hospital admissions for respiratory tract infections in children and young people with severe neurodisability and the cost savings from admissions prevented allows the service to more than pay for itself.

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Development and evaluation of a community respiratory physiotherapy service for children with severe neurodisability

Cited by 6 publications

References 12 publications

Respiratory morbidity in children with cerebral palsy: an overview

Respiratory morbidity in children with cerebral palsy: an overview

Evaluation of patients admitted to the pediatric intensive care unit due to neurological problems

Evaluating a community respiratory physiotherapy service for children with neurodisability

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