|Title||Presentation and Management of COPD|
By the end of this module the Clinical Scientist in HSST, with respect to the diagnosis, presentation and management of patients with stable COPD, will be able to analyse, synthesise, evaluate and apply their knowledge, to be competent to carry out specialist assessment and form a structured differential diagnosis of causes leading to appropriate further investigation and effective management, within the scope of a Consultant Clinical Scientist.
Knowledge and understanding
By the end of this module the Clinical Scientist in HSST will analyse, synthesise, evaluate and critically apply their expert knowledge with respect to:
- the causes of COPD.
- the investigation of COPD.
- the differential diagnosis of COPD, including from asthma, obliterative bronchiolitis and bronchiectasis.
- the treatment and management of patients with stable COPD
- pulmonary rehabilitation.
- the principles of mechanical ventilation in COPD.
- the principles of oxygen therapy.
- the pharmacology of drugs used.
- the role of lung volume reduction surgery in emphysema.
- the complications of COPD.
- the relevant guidelines/NSF.
- smoking cessation methods.
Technical and clinical skills
By the end of this module the Clinical Scientist in HSST, with respect to the patient with stable COPD will be expected to critically reflect and apply in practice a range of clinical and communication skills to advise and communicate effectively with patients with stable COPD, relevant clinicians, patients and the public and other healthcare professionals and will:
- gain informed consent.
- take a thorough, focused history within limits of respiratory practice.
- elicit relevant and appropriate physical signs within Consultant Clinical Scientist scope of practice.
- plan appropriate investigations in collaboration with medical colleagues where necessary.
- formulate an appropriate differential diagnosis and management plan.
- interpret appropriate Lung Function Tests.
- collaborate with patient to produce an appropriate management plan.
- use tools to assess quality of life and breathlessness, including the St George’s Questionnaire, Hospital Anxiety and Depression Score, CAT, MRC and Borg scores.
- assess the suitability of patients for pulmonary rehabilitation, early discharge schemes and hospital at home schemes.
- assess patients domiciliary oxygen therapy – LTOT, short burst, ambulatory.
Attitudes and behaviours
By the end of this module the Clinical Scientist in HSST will be expected to evaluate their own response to both normal and complex situations demonstrating the professional attributes and insights required of a Consultant Clinical Scientist working within the limits of professional competence referring as appropriate to senior staff and will:
- recognise the importance of taking a detailed history to determine factors contributing to poor COPD control.
- recognise the importance of checking inhaler technique and treatment compliance.
- recognise COPD as a chronic condition requiring ongoing care in the appropriate (primary/secondary/tertiary) care setting and appreciate the role of early discharge/hospital at home schemes.
- establish a trusting Consultant Clinical Scientist-patient relationship.
- respond sensitivity with life-style modifications such as smoking cessation.
- recognise the importance of appropriately trained nurses and other health care professionals in long term care.recognise COPD as a chronic condition requiring ongoing care in the appropriate (primary/secondary/tertiary) care setting and appreciate the role of early discharge/hospital at home schemes.
- recognise the possible role of palliative care team where appropriate.