1. Care and Management of Asthma Essay.
Care and Management of Asthma Essay. Asthma is a common incurable disease that affects
the small tubes carrying air in and out of the lungs in the airways; it is more common at
childhood stage but can also occur at a later age (British Lung Foundation, 2011). The major
cause of asthma has not been determined but it is believed that some factors as allergies,
exercise and common cold contribute to its development. In the United Kingdom, asthma is
being handled primarily by a General Practitioner or nurse. Healthcare can be provided in
three major means: Primary, Secondary and Tertiary. They are delivered depending on the
severity of an individual's condition. General Practitioners (GPs), Pharmacists, Nurses,
Dentists and Optometrists are the main classes of healthcare providers that deliver Primary
care. It is the basically the first point of contact for most individuals (National Health Service
Choices, 2010). Care distinctively provided in local hospitals is usually on referral from
primary care health providers, such type of care is basically referred to as Secondary Care.
The third aspect of care is the tertiary care which is provided by specialist such as
neurologist and cardiologist in a majorly specialised hospital centre for long term
treatment.Care and Management of Asthma Essay.ORDER A PLAGIARISM-FREE PAPER
HEREEPIDEMIOLOGICAL OVERVIEW OF ASTHMAMajor facts that make Asthma a major
health issue in the UK are:In 2008, a total number of 1,204 deaths were recorded from
asthma in the UK, out of which 29 were children aged 14 years and under.1 person every 7
hours or 3 people per day die from asthma146,000 adults and 36,000 children currently are
on treatment for asthma in northern Ireland making it a sum total of 182,000 people (1 in
10)In Northern Ireland 182,000 people (1 in 10) are currently receiving treatment for
asthma. This consists of 36,000 children and 146,000 adults.In Scotland 368,000 people are
currently receiving treatment for asthma. This consists of 72,000 children and 296,000
adults.In Wales 314,000 people are currently receiving treatment for asthma. This consists
of 59,000 children and 256,000 adults (Asthma UK, 2011).the number of adults with asthma
in the UK has increased by 400,000 since the last audit of UK asthma in 2001about 2% of
adults consult their GP annually with asthmaASTHMA CARE AND MANAGEMENT AND
LOCALITY STUDY OF UKAsthma exists in various forms hence; its heterogeneity has been
well established by a variety of studies that have proven the disease risk from early
environmental factors and susceptibility genes, inflammation and therapeutic agent
response further induces accompanying diseases (Lang et al., 2011). Risk factors associated
with asthma are family history of atopic disease, for exampleAllergic rhinitisAllergic
conjunctivitisMale sex, for pre-pubertal asthma, and female sex, for persistence of asthma
2. from childhood to adulthoodBronchiolitis in infancyParental smoking, including passive
smokingPremature birth, especially in extreme-preterm infants who required ventilatory
support, with consequent chronic lung disease of prematurity (NHS Choices, 2011)In the
UK, asthma is more common among children than in adults and also has an increased rate in
women than men (NHS choices, 2010). A condition referred to as acute asthma
exacerbation could occur and could sometimes be life-threatening but is mostly rare.
Asthma patients are treated with care by GPs and nurses trained for asthma management
and such treatments are specific to the symptoms portrayed by each patient. This treatment
(Primary care) basically involves:Care and Management of Asthma Essay.A personal asthma
procedural plan concurred with your GP or nurseAn annual regular check ensuring proper
control of the patient's treatment and positive response to the treatmentProper seeking of
the patient's consent ensuring his/her decision is involved in decision making of his/her
treatmentComprehensive detailed information about how to control and manage the
patient's condition; while a Secondary or Reactive care is enforced in emergency cases to
regain control of more high-risk symptoms.In treating asthma, reliever inhalers are given to
every patient by the GP; these inhalers serve as immediate relievers and ensure restoration
of normal breathing. It functions effectively due to its composition of a short-acting beta2-
agonist that works by relaxing the muscles surrounding the narrowed airways (British
Medical Journal group, 2011). This further ensures the airways are opened wider, making it
easier to breathe again. Salbutamol and terbutaline are common types of this inhaler. They
have been proven to be generally safe except when their use is abused although they
possess very few side effects. If the asthma is well controlled, then their usage will be
minimal; if a patient uses the inhaler for up to three times or more weekly then it is advised
that the treatment be reviewedSecondary care and management of asthma is implemented
when Patients exhibit a combination of severe asthma, behavioural and psychosocial
features, they hence are at risk of developing near-fatal or fatal asthma. (BTS and SIGN,
2009).Care and Management of Asthma Essay.Asthma care is dependent on the age of the
patients in that children have a different mode of care as compared to adults, a critical look
at the adult care is elaborated below. Prior considerations are basically that the patient is
registered with his GP, will have to book for an appointment with his GP before visiting
(except in emergencies as acute exacerbations), confirmation with the patient of their
understanding of the role of treatment, adherence to treatment, inhaler technique, and
appropriate elimination of trigger factors as: exercise, drugs foods, emotional factors,
weather changes, allergens etc (Shiang et al., 2009)In analyzing the delivery of care to
asthma patients in the UK, data from Office for National Statistics shall be addressed. Table
1 below signifies that there was a remarkable decrease in hospital admission in 2000 for
asthma; it showed a 45 percent decrease among children between ages 5 and 14 years and a
52 percent decrease among children below 5 years (Office for National Statistics,
2004).Care and Management of Asthma Essay.TABLE 1The management of asthma is
patient-specific and is delivered by either the GP or asthma nurse; a respiratory nurse
specialist works closely with the GP and the patient serving as the best form of
encouragement to the patient in the procedural management of his/her asthma condition.
The respiratory nurse specialist has a critical role in the management of asthma as
3. elaborated that he/she:Explains the need for various inhalers (ensuring the best is offered
to the patient) and provides the patient with information on treatment
administeredAdvices on triggers and how to keep off themAssists the patient in quitting
smoking (if applicable)Explicates on how to monitor the conditionProvides the action plan
of treatment and explains it to the patient.Is always available for assistance both at home
and on the phone (NHS Choices, 2006)Nurses are generally recruited into the NHS through
the website www.nursebank.co.uk , the Association of Respiratory Nurse Specialists offer
courses for development and training of nurses and promote clinical excellence in
respiratory care delivery (Association of Respiratory Nurse Specialist, 2010). The selection
of a professional nurse in a recruitment procedure is dependent on factors as Years of
experience, area of expertise and personal record check.CRITIQUE ON ASTHMA
CAREAsthma management involves a wide range of services including primary care, routine
follow up, hospital inpatient and outpatient care, proper education and advice of patient,
emergency calls and prescribed drugs; these services when combined with the intensity and
level of use result to a high cost (Department of Health, 2011). In 2001, England recorded a
net ingredient cost of £442million and around £33million for inhaled therapy Brocklebank
et al (2001). In prescribing drugs, the patient is considered as whether or not to use the
drug/device appropriately; the most effective and clinically proven cost effective drug is
also reasonably considered. However, restrictions imposed on manufacturers make some
inhalers commercially unavailable hence the use of more expensive drugs.Care and
Management of Asthma Essay.The British Thoracic Society (BTS) and Scottish
Intercollegiate Guidelines Network (SIGN) have clinical guidelines on the use of inhalers for
asthma (BTS and SIGN, 2009) however; there are inconsistencies or absence of
recommendations for inhaler devices from these guidelines. Evidence-based guidelines are
currently being prepared by the British Thoracic Society (BTS) and the Scottish
Intercollegiate Guidelines Network (SIGN). There are criticisms on the effectiveness of the
inhaler which largely depends on technique of administration by patient considering
experience, physical ability and education on usage (NHS centre for reviews and
Dissemination, 2003)CONCLUSIONThe role of a nurse in quality care delivery cannot be
overruled especially in a health condition as asthma which could be critical and possibly
fatal. The initial primary care given to asthma patients and subsequent secondary care has
been proven to be appropriate in that the health status of patients is being improved. The
incorporation of a respiratory nurse specialist has been a major milestone in achieving a
better health status for asthma patients in the United Kingdom.Care and Management of
Asthma Essay. LEARNING OUTCOME 2LEADERSHIP IN NURSING AND ASSOCIATED
PROFESSIONSA Leader is someone who guides or chairs a group of people or an
organisation; it is common practice that a leader portrays some leadership skills to enable
him/her be productive and effective. Cook (2001) describes a clinical nursing leader as
someone who endlessly gets involved in direct patient care hence improving care by being
of positive influence to others. All nurses (from those who provide direct care to the
managers) need potent leadership skills. Mahoney (2001) emphasises that anyone (e.g. a
nurse) who gives assistance to others or is responsible for other people is considered a
leader; however, good leadership is reproducible superior performance targeted towards a
4. long term benefit to everyone called for.Care and Management of Asthma Essay.John,
(2011) has defined a manager as an individual with the sole responsibility to plan and
direct the work of a group of people, ensuring proper monitoring and directives are
followed. Management in nursing involves regarding leadership functions of administration
and making appropriate decisions within organisations that employ nurses.Care and
Management of Asthma Essay.SIMILARITIES BETWEEN LEADERS AND MANAGERSLeaders
and managers go hand in hand, none of them tend to possess abilities that make them stand
on their own, and there is no unique or particular way of managing people. Some basic
similarities between managers and leaders are:People development: An effectual manager
and leader have skills and abilities that tend towards the development of the
people.Partnership working: the work of both a manager and a leader tend to be of a
partnership level (Mather, 2009).Motivators: both leaders and managers are motivators of
their subordinatesDIFFERENCES BETWEEN LEADERS AND MANAGERSThinking pattern: A
major difference between a leader and manger is in their level of reasoning, Managers think
incrementally, whilst leaders think radically; managers always work towards doing things
rightly while leaders work in the perspective of doing the right thing (Richard, 1990).Care
and Management of Asthma Essay.Loyalty: Subordinates are mostly subordinate to their
leader than to their manager; this applies often because the leader takes credit in times of
achievement and allocating merit to subordinates (John, 1990).Competencies: A nursing
manager allocates resources and sets timetables while a nursing leader is someone who
clarifies the big picture created by the manager and simplifies it, making the
hospital/nursing home's vision more understandable to the staff and patients (Kristina R,
2009).Care and Management of Asthma Essay.Leadership is a very vital issue in the nursing
practice because nursing requires knowledgeable, consistent and strong leaders, who
inspire and boost people's moral and support professional nursing practice. Nurses need to
be both leaders and managers for some very key reasons as:An Advocate for quality care: a
head nurse who serves as either a leader has to stand out in ensuring the needs of both the
patients and nursing staff are adequately met, sometimes it will require a robust and bold
person to stand before the board in defending these needs.Care and Management of Asthma
Essay.An influential personality: the presence of an influential nurse handling an asthmatic
patient will go a long way in guiding the patient in making informed choices; the patient
becomes free and open to the nurse when she/he exhibits a high level of positive influence
on the patient.CRITIQUE OF NURSING PUBLICATIONS IN RELATION TO LEADERSHIP AND
MANAGEMENT IN ASTHMATIC AND GENERAL NURSING CAREA report by the Royal
College of Nursing (RCN) on the support by Asthma UK on RCN's frontline campaign
published on 14th January 2011 is carefully analyzed highlighting the publisher's aims of
writing, lessons to be learnt, consequences of the article and its impact on positive care
delivery.Care and Management of Asthma Essay.It was rightly stated in this article that
about three-quarters of asthma emergency admissions can be avoided if proper care is
delivered (Royal college of Nursing, 2011). This implies that the need for proper managerial
skills needs to be adapted by the healthcare leaders to manage asthma patients which will
ultimately lead to the reduction of emergency care delivery for asthma patients. He went
further to stress that specialist nurses are the cohesive source of support and stability for
5. care for asthma patients; this issue is supported by the Relationship theory of leadership
(also known as transformational theory) which highlights the connection between the
leader and the led (Kendra, 2011). Leaders that possess this trait tend to motivate and stir
their followers to ensure maximum productivity is achieved. Focus is geared towards the
performance of the group members. When a leader with such trait is employed, the function
of the specialist will be balanced on both as a helper of the patient and a confidant to the
patient. He also said that the role of a specialist nurse has reduced hospital admissions from
22% to 6%, hence saving the National Health Service billions of pounds annually.Care and
Management of Asthma Essay.The writer concluded by turning down the practise of
relieving the specialist nurses of their jobs and employing other nurses and ward clerks to
fit into their roles which he said the adverse effects were of greater negative impacts as
costing the NHS more finance and damage the lives of the patients already receiving care by
the specialist nurses.The lessons from this article cannot be over-emphasized in that there
is an immediate need for the employment of more specialist nurses to manage asthmatic
patients better and to save the lives of their patients.Care and Management of Asthma
Essay.A similar report by Akinsanya (2009) on the Exacerbations of severe asthma;
psychosocial predictors and the impact of a nurse-led clinic stated that the need for
alternate management approaches is paramount in caring for people with severe asthma.
He also recommended further findings on the social and psychological aspects of asthma
management. Recommendations were also made on the holistic approach for long-term
management of asthmatic patients (Akinsanya, 2009).This report clearly shows the
application of the contingency leadership theory that postulates the influence of variables
that relate to the environment on the determination of the specific leadership style fit for a
situation (Kendra, 2011); it further implies the need for a paradigm shift on the care for
acute asthmatic patients towards need for more nurse specialists.Care and Management of
Asthma Essay.PERSONAL REFLECTIONS ON LEADERSHIP AND MANAGERIAL SKILLSAs a
major role player in healthcare delivery, nurses have inevitable functions. This Portfolio has
given me an in depth understanding in various areas of my practice as:Efficiency: I have
learnt that my level of efficiency has a vital impact in saving asthmatic patients' lives; it will
help ease the huge financial burden on Government by saving extra expenses.Leadership
skills: According to the 'great man theory' of leadership (Management Study Guide, 2011a)
which denotes that some people are born with inherent leadership skills which become
apparent when great needs arise. I have understood that as a nurse, I can lead rightly and
manage people if I can nurture the greatness in me. In enhancing my managerial skills, I will
give room for creativity in my area of work by combining both human and non-human
resources (Management Study Guide, 2011b) to achieve the designed goal. Team work is
also a very good point I learnt from this report in that I cannot be an effective leader if I am
regarded as the only member of my team succeeding, there has to be a cohesive effort from
all.Care delivery: The focus is on the nurses to serve as interlocutors between the GP and
patient ensuring the patient adheres to prescriptions and that the nurse is always available
for assistance by the patient.CONCLUSIONThe difference between a leader and manager is
quite small and most leaders tend to end up as managers. Asthmatic guidelines need to be
reviewed often to improve its managerial aspect of care. Nurses are relevant care deliverers
6. and all need to develop leadership and managerial skills in order to safe guard the
healthcare of the United Kingdom.Care and Management of Asthma Essay.
