Transferring COPD care from a busy medical ward to the comfort of the home

World COPD day takes place today, Wednesday 20th November. It aims to raise awareness, share knowledge and discuss ways to reduce the burden of COPD worldwide. 

COPD is a common, preventable and treatable disease that is characterised by ongoing breathing difficulties, usually caused by significant exposure to noxious particles or gases. Major risk factors for developing COPD are tobacco smoking or exposure to occupational, outdoor and indoor air pollution.

There are an estimated 380,000 people living with Chronic Obstructive Pulmonary Disease (COPD) in Ireland, with over 15,000 people requiring admission to hospital with this condition annually.

The Respiratory Integrated Care Team (RICT) in Donegal provide a range of services for people living with COPD.  These include assessment and management clinics which offer diagnostic testing to include spirometry.

Patients with exacerbating COPD often require multiple admissions and readmissions to hospital for their care.  A newly developed alternative care pathway called the CARE Virtual Ward has been available to people living with COPD in Donegal since November 2023, with 192 admissions to the virtual ward to date. This has resulted in a 22% decrease in overall admissions to Letterkenny University Hospital, with a presenting condition of COPD.

The Community and Acute Respiratory Excellence (CARE) Virtual Ward (CVW) is an alternative care pathway to hospital admission for patients with COPD in Donegal. The CVW provides 20 beds and is delivered by the Respiratory Integrated Care Team under the governance of the respiratory consultant in Letterkenny University Hospital. The Virtual Ward allows monitoring and care for patients experiencing an exacerbation of their COPD while remaining in their own home instead of hospital admission.

The virtual ward is available for people with COPD throughout Donegal.  It can be accessed by referral from GPs and through Consultants and Respiratory Specialist nurses in Hospital.  

Patients are educated to recognize early deterioration of their condition and avail of prompt treatments and interventions. Rescue prescriptions are provided recommending the appropriate medications and patients are instructed on when and how they are to be used.  

Ahead of World COPD Day, CARE Virtual Ward team in Donegal have released a video showing the patient’s experience.  The video features Janet Gibbons, star of Virgin Media’s ‘Gogglebox’ , who was one of the first patients to avail of supported discharge from her hospital bed to home based care on CARE virtual ward. She shares her experience in the video:   

Transferring COPD care from a busy medical ward to the comfort of the home - YouTube

Janet said “It was an absolute education, I never realised what I would be learning. I would recommend anyone to go for it, anyone who is diagnosed with COPD.”

Janet was provided with wearable technology that recorded her respiratory rate, pulse and oxygen saturations.   She was shown how to use the equipment and how to navigate the bespoke digital app and educational content. This easy to use technology allowed the CARE team to monitor Janet’s condition and detect any deterioration.  

Sonya Murray, Advanced Nurse Practitioner in Respiratory said, “The Care Virtual Ward has given patients who are experiencing an exacerbation of their COPD the choice to receive the care they need safely at home monitored by experienced nurses and physiotherapists, supported by technology and under the clinical governance of consultants in Letterkenny University Hospital. It has also supported those that have required hospital treatment to be discharged earlier, allowing them to recover in the comfort of their own homes.”            

The project has been shortlisted for several awards in 2024 and has won a Bright Spark Award, ‘Best Digital Project 2024’.