Choice Case Studies Database

Background
Patients with recurrent Pleural Effusions were having to spend a lot of time in hospital, away from home and their families, and suffer considerable discomfort.

Patients had to be admitted into acute wards, on average for 3 days or more and contributed to bed pressures for the acute trust. It was sometimes difficult to arrange admission at short notice.

Action Taken
The Consultant Respiratory Physician from the Acute Trust and the PCT Respiratory Nurse Specialist have developed a service that enables patients to have their effusions drained at home by the Respiratory Nurse Specialist.

The Pleurex catheter is inserted in secondary care under local anaesthetic as a daycase procedure.

The Respiratory Nurse Specialist uses a closed drainage system to drain fluid from the patient in their own home.

Results
• The scheme has been running for a year and 6 patients have benefited from this service.
• 161 hospital admissions have been avoided, reducing pressure on acute hospital beds and significantly reducing costs to the PCT under Payment by Results.

Benefits to Patients
• No admission to hospital
• No time away from home and family
• No need to arrange transport to get to hospital
• Timely Treatment and therefore less discomfort from breathlessness and other symptoms.
• Families no longer have to make arrangements, such as taking time off work, to take patients to hospital
• Patients are not exposed to risks of MRSA and other hospital acquired infections
• Patients have more control over their lives.