WS14.5 SARS-CoV-2 driving rapid change in cystic fibrosis services: the role of the clinical nurse specialist

Abstract

Objective: COVID-19 led to rapid changes in healthcare services across the globe. At this adult CF service, much of the CF multidisciplinary team (MDT) were re-deployed and the CF ward, ambulatory care and outpatients were closed. However, a small team remained, including the nurse specialists (CF-CNS). The CF-CNSs quickly adapted their role and as well as providing support and advice by phone and email, they implemented an emergency service in an area previously not used for this to ensure patients did not feel abandoned, provide treatment for exacerbation and prevent disease decline. Methods: All patient contacts and reasons for contact were recorded. QI methodology was used (Plan, Do, Study, Act) alongside process mapping to design the emergency service. Success was measured by the reduction in number of contacts and the number of patients reviewed with or without intervention in the emergency service. Results: In the first two weeks of the emergency service the CF-CNSs had assessed (by phone), reviewed (face-to-face) and consequently started two patients on home intravenous antibiotics. Twelve weeks later, 36 patients had been taken through the same process, medically reviewed ± intervention. There were 1,187 patient contacts in March (mostly related to COVID-19, unwell, medication), 904 in April and 870 in May (related to blood test results, unwell, medication). Conclusion: The motivation of the CF-CNSs was pivotal to the success of this initiative. They were supported by the remaining CF MDT and CF consultants who provided phone advice.