Initial Chronic Obstructive Pulmonary Disease Training for ... · NES Initial Chronic Obstructive Pulmonary Disease Management Training for GPNs Resource Booklet 2 Content Sections

NES Initial Chronic Obstructive Pulmonary Disease Management Training for GPNs Resource Booklet

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NES General Practice Nursing

Learning & Development Coordinated Network

Initial Chronic Obstructive Pulmonary Disease

Training for

General Practice Nurses to Undertake

Annual COPD Reviews

Resource Booklet

For Participants

Course Leaders:

Vicki Waqa. RGN. BA (Hons).

ANP.

Specialist Educator, NES.

Gill Dennes. RGN. BA (Hons) MSc (Primary Care)

ANP

Clinical lead for Fife Respiratory MCN

NES GPN Education Advisor for Fife.

Course Aim:

To provide general practice nurses with the knowledge and skills to perform an annual review of COPD in primary care.


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Content

Sections Title

Page

1 Course Structure

3

2

Course Administration

7

3 Assessment Process

8

4 Course Forms:

a. Nurses’ Personal Record Document

b. Worksheets for COPD Reviews

11

5 Resources

23

6 References

24

7

Appendix

25


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Section 1: Course Structure

Title: NES Initial Chronic Obstructive Pulmonary Disease

Training for General Practice Nurses to Undertake Annual

COPD Reviews.

Rationale

Chronic Obstructive Pulmonary Disease (COPD) is a disease characterised by

persistent limitation of airflow. It is associated with a chronic inflammatory response

in the airways. It is usually progressive but it is both preventable and treatable

(GOLD 2018). Symptoms of COPD include persistent breathlessness especially on

exertion, and chronic cough with chronic sputum production.

Making a diagnosis relies on clinical judgement based on a combination of history,

physical examination and confirming the presence of airflow obstruction using

spirometry. A diagnosis of COPD should be considered in people over age 35 with

the above symptoms, +/- wheeze +/- frequent ‘winter bronchitis’, who have risk

factor(s) of which a history of smoking is the most common (NICE 2010)

COPD has high levels of morbidity and mortality. It is estimated that 1.2 million

people in UK are living with diagnosed COPD and 1.7% of all hospital admissions

are due to COPD. 20% of all deaths in UK are a result of lung disease, and COPD

comes a close second to lung cancer as the cause of lung disease deaths (BLF

2016). The main aims of treatment are to reduce symptoms, prevent further decline

and improve quality of life. These aims are arguably best achieved within regular

structured, comprehensive and patient centered reviews at least annually and

practice nurses with appropriate training are well placed to undertake COPD reviews

as part of the multidisciplinary team (NICE 2010)

References:

British Lung Foundation (2016) Battle for Breath: The impact of lung disease in the

UK. Available online www.blf.org.uk

http://www.blf.org.uk/


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National Institute for Clinical Excellence (2010) COPD in Over 16s: diagnosis and

management. Available online www.nice.org.uk

Global Initiative for COPD (2018 update) Pocket Guide to COPD diagnosis,

management and prevention. A guide for health care professionals. Available online

www.goldcopd.org

Course Aim:

To provide general practice nurses with the knowledge and skills to perform an

annual review of COPD in primary care.

Learning Outcomes:

On successful completion of the course participants will be able to:

1. Describe the condition of COPD including diagnostic criteria and its

presentation in general practice.

2. Perform robust use of spirometry and pulse oximetry for an annual review

when appropriate.

3. Perform an accurate clinical history defining pharmacological, non-

pharmacological treatments in support of the GOLD COPD Guidelines

(2017).

4. Demonstrate correct inhaler technique performing the 7 steps recognized as

essential for accurate technique (Baverstock et al 2010).

5. Conduct annual reviews in people diagnosed with COPD in General

Practice in accordance with GOLD (2018) Guidelines.

6. Recognise indicators of exacerbation of COPD and refer to the named

clinical lead for appropriate management options.

7. Identifying end of life care and a palliative approach to COPD.

8. Adopt an inclusive team approach with appropriate referral back to the

named clinical lead in the surgery for COPD in accordance with their NMC

Code (2015).

http://www.nice.org.uk/

http://www.goldcopd.org/


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9. Understand the cycle of physical inactivity and activity and the role of

pulmonary rehabilitation.

10. Formulate a Personal COPD Action Plan for self-management in

collaboration with the patient to improve COPD care, in support of the either

local or national guidelines.

11. Practice person centered care during a COPD review, demonstrating the

principles outlined by the Healthcare Improvement Scotland (HIS) such as

respect, holism, choice, empathy, autonomy and compassion.

Applicants:

The following criteria must be met in order for applicants to commence on this short

course:

Be currently employed in general practice as a registered adult nurse.

Have the written support of the employer because their current role will

include annual COPD reviews.

Be able to attend both taught days.

Be prepared to undertake a Directly Observed Practical Skills assessment

(DOPs) as detailed below.

Be prepared to complete a minimum of 5 COPD reviews for within a 3-

month period.

Be prepared to complete two 500 word reflective accounts demonstrating

implementation of learning as a result of the 2-day COPD course. One to

be submitted between Day 1 and Day 2 and should reflect on your current

knowledge and learning and a clear action plan. The second reflective

account to be submitted with the assessment handbook/completed

reviews and should demonstrate your progress and how your clinical

development has evolved. Do not evaluate the course itself in your

reflections – your course evaluation will be completed separately

Have access to an experienced COPD practitioner for supervision

including clinical supervision. The supervisor will be required to confirm in

writing that the participant has completed the five reviews specified in the

COPD assessment handbook.


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Applicant Preparation:

Applicants are expected to name a supervisor for clinical practice that has

successfully completed a recognised training programme in COPD. In addition, the

supervisor should be managing patients with COPD in their current role and can

demonstrate they have kept their knowledge and skills up to date.

In order to learn more effectively successful applicants are asked to prepare for the

2-day course in initial COPD training by reading and participating in the following

learning resources:

1. COPD in Adults. Nice Quality Standards 2011. Last update 2016 Available online https://www.nice.org.uk/guidance Accessed 7th Feb 2018

2. Global Strategy for the Diagnosis, Management and Prevention of COPD

2018 Report www.copdgold.org Accessed 7th Feb 2018

3. Reflective practice available at: http://www.flyingstart.scot.nhs.uk/learning-programmes/reflective-practice/ Accessed 7th Feb 2018

4. Revise and refresh understanding of respiratory anatomy and physiology available at: https://www.cdc.gov/niosh/docs/2004-154c/pdfs/2004-154c-ch1.pdf Accessed 7th Feb 2018

5. My lungs my life – a self-management website available at: http://www.chss.org.uk/chest-information-and-support/how-we-can-help/support-for-you/my-lungs-my-life/?gclid=CJHXyrqvuc0CFbMK0wodsz0OJw accessed 7th Feb 2018

6. Sign up for a TURAS Account. This will be the one of the major resources you will use to submit assignments and your portfolio. Please read Appendix 2 in this Handbook, and follow the steps to register for a TURAS account. TURAS is the online eportfolio platform hosted by NES. Use of TURAS will greatly assist you with your CPD and especially your annual appraisal and revalidation process so learning how to use this will have wider benefits for you in your professional role. Once you register you will be able to access the simple ‘how to’ online guide presentation. Please familiarize yourself with this before the NES COPD Programme. We will discuss further on Day 1.

https://www.nice.org.uk/guidance%20Accessed%207th%20Feb%202018

http://www.copdgold.org/

http://www.flyingstart.scot.nhs.uk/learning-programmes/reflective-practice/

http://www.chss.org.uk/chest-information-and-support/how-we-can-help/support-for-you/my-lungs-my-life/?gclid=CJHXyrqvuc0CFbMK0wodsz0OJw




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Course Facilities:

The course will be held at the NES office, 102 Westport, Edinburgh, EH3 9DN

Lunch, tea and coffee will be provided.

Course Speakers:

Gill Dennes. RGN. BA (Hons) MSc

Gill has been a practice nurse for 27 years and now an advanced nurse practitioner

working in General Practice and Out of Hours. She completed her Masters in

Primary Care 2010. She has a special interest in respiratory, and completed the

asthma, paediatric asthma, allergy and COPD Education for Health diploma

modules. Gill has been Clinical Lead for Fife Respiratory MCN for 8 years.

Gill also works for NES as GPN Education Advisor for Fife, Shetland and Orkney

Vicki Waqa RGN. Ba (Hons)

Vicki qualified as an Emergency Nurse Practitioner in 2004, following an 8-year

career as an A&E Nurse. Over the years she has worked in a variety of

environments – including secondary care, minor injuries, Walk in Centres and has

been working in General Practice as an ANP for the past 12 years. Vicki has

extensive experience in assessing, monitoring and treating patients with COPD.

Recently Vicki has undertaken the post as Specialist Educator within NES


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Section 2: Course Administration

The course will consist of two taught days 8 weeks apart.

Day 1 will focus on recognising and describing the condition of COPD, diagnosis and

pharmacological and non-pharmacological options, with particular emphasis on

accurate inhaler technique using delivery devices.

Day 2 will outline the importance of a written action plan to support self-

management, using person centred approaches promoting better outcomes in

people living with COPD. There will be a Direct Observed Practical Skills

assessment component for course participants to demonstrate practical skills of

simple spirometry interpretation, promoting physical activity, therapeutic

interventions and evidence of knowledge of self-management/ person centred

approach in the management of COPD.

Date:

Time: Venue:

Full Day 1 Thursday 15th March 2018

9:00 to 16:30 hrs

NES Office, 102 Westport Edinburgh EH3 9DN

Full Day 2 Thursday 24th May 2018

9:30 to 16.30

As above

Applicant Numbers: 15 maximum Course fee: £150 / person

Contact Details: Elizabeth Cook Programme Administrator email: [email protected] Contact for clinical queries: Gill Dennes Course Leader Email: [email protected]

NHS Education for Scotland

2 Central Quay

89 Hydepark Street

Glasgow G3 8BW 0141 223 1559

mailto:[email protected]

tel:01412231559


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Section 3: Assessment Process

Assessment

The assessment is structured as follows:

Part A: Two reflective accounts 500 words each: one to be submitted between Day 1

and Day 2. Date of submission will be confirmed on day 1. The first reflective

account should specify and challenge your current position regarding annual COPD

reviews. Using a reflective cycle of your choice, define what you are hoping to

achieve from the course.

The second reflective account is to be submitted with the Assessment Handbook

sent electronically by 4pm on the agreed date to the first and second markers (you

will be given more information regarding this on Day 1) This reflective account

should demonstrate your progress and show how your clinical development has

evolved.

Submission of both reflective accounts will be via TURAS

Part B: Accurate demonstration of review techniques in COPD.

Direct Observed Practical Skills Assessment (DOP); demonstrating simple

spirometry interpretation, simple therapeutic change recommendation and

communication of essential information on COPD to the course speakers on the

second day of the course.

Part C: Be prepared to carry out 5 annual COPD reviews in participant’s practice

under supervision of supervisor.

Submission of Assessment Handbook:

The Assessment Handbook and the second reflective piece are to be submitted

6 weeks after Day 2, sent electronically by 4pm on the agreed date.

All students are provided with a course resource booklet which describes the

required assessment structure in order to be awarded a certificate of successful

completion. The assessment will be double marked for quality control as pass or fail.

If a student is unable to complete any of these elements they may be given:


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an extension for the reflective accounts and/or annual reviews or

provided with an alternative opportunity to complete the Direct Observed

Practical Skills (DOPS) only if unable to attend Day 2 due to extenuating

circumstances such as illness, bereavement and other similar life

circumstances. If the participant is unable to complete the Direct Observed

Practical Skills they will be offered another opportunity after an agreed

learning period. Successful completion is required as part of passing the

programme.

A student should send an email to the course leader to request an extension if

required due to extenuating circumstances. The course leader will decide how long

an extension should be granted if necessary.

A certificate of attendance only will be provided for the taught days if any part of the

assessment process is not achieved or submitted.

A certificate of successful completion is provided when all parts of assessment

process are submitted and meet course outcomes.

Successful Completion:

In order to be awarded a certificate of successful completion participants on the

course must successfully complete Part A, B, C and D

Part A: Submission of two reflective accounts typed and sent electronically via

TURAS

Part B: Accurate demonstration of COPD review techniques. This will be observed

on Day 2.

Part C: Submission of 5 annual reviews with completed testimony from supervisor

typed electronically as in the Assessment Handbook and submitted via TURAS.

Reflection on Learning:

Reflective practice in nursing is strongly encouraged and a requirement of the

revalidation process (NMC 2015). Reflection can be written in the first person

however care should be taken not to overuse this style as it should read as a

professional piece of writing. If you are not familiar with reflective writing, we


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recommend that you read the resources on the following website called Flying Start


Tips for reflective writing are:

Avoid just describing – explore and explain what happened.

Be honest – it is ok to admit to making mistakes as well as success. But you

should also show how you understand why things happen and what you are

going to do to improve.

Be selective – identify the key events or ideas, you are not required to write

about everything that happened.

Look to the future – reflect on what happened in the past and how it will

have an impact on future ideas or activities. What might you change to make

improvements this is important.

In your reflection you can include some or all of the following;

how your knowledge and professional practice developed as a result of the

activity

the extent to which you have achieved your learning, and any contributing

factors

any additional achievements

clinical work which is most significant for you and why

clinical work with which you are least satisfied and why

your further learning needs and strategies to meet these.

Structure your writing by using a model of reflection and reference this such as Gibb’s or John’s models of reflection (Johns C (2000) Becoming a Reflective Practitioner.

Oxford: Blackwell Science).

Section 4: Resources

Participants are provided with this resource booklet which contains course forms and

instructions for assessment. There are also lists of other resources which

participants should access, read and use in practice.


http://www.google.co.uk/url?url=http://www.cumbria.ac.uk/public/liss/documents/skillsatcumbria/reflectivecyclegibbs.pdf&rct=j&frm=1&q=&esrc=s&sa=U&ved=0CCUQFjAGahUKEwiy4tWG6JnJAhUCSBoKHY0XBmc&usg=AFQjCNGxWCLRmlOdGhGizqxtHEPO4GCmSg


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Useful References:

Gibbs G (1988) Learning by Doing: A guide to teaching and learning methods. Further

Education Unit. Oxford Polytechnic: Oxford

Healthcare Improvement Scotland (HIS) Person Centred Care. Available at: http://www.healthcareimprovementscotland.org/our_work/person-centred_care.aspx Johns C (2000) Becoming a reflective practitioner: a reflective & holistic approach to clinical nursing, practice development & clinical supervision. Oxford; Blackwell Science Nursing and Midwifery Council (NMC) (2015) The Code: Professional Standards of Practice and Behaviour for Nurses and Midwives. Available at: http://www.nmc.org.uk/standards/code/ Royal College of Nursing (RCN) (2015) Person-centred Care Available at: http://www.rcn.org.uk/development/practice/cpd_online_learning/dignity_in_health_care/person-centred_care Scottish Credit and Qualifications Framework (SCQF) (2012). Level Descriptors Available at http://scqf.org.uk/wp-content/uploads/2014/03/SCQF-Revised-Level-Descriptors-Aug-2012-FINAL-web-version1.pdf

Scottish Credit and Qualifications Framework (SCQF) (2015) Handbook. Available at http://scqf.org.uk/wp-content/uploads/2014/05/SCQF_handbook_WEB_FINAL_2015.pdf Somerville, D., Keeling, J. (2004) A practical approach to promote reflective practice within nursing. Nursing Times; 100: 12, 42–45.

http://www.healthcareimprovementscotland.org/our_work/person-centred_care.aspx

http://www.nmc.org.uk/standards/code/

http://www.rcn.org.uk/development/practice/cpd_online_learning/dignity_in_health_care/person-centred_care

http://www.rcn.org.uk/development/practice/cpd_online_learning/dignity_in_health_care/person-centred_care

http://scqf.org.uk/wp-content/uploads/2014/03/SCQF-Revised-Level-Descriptors-Aug-2012-FINAL-web-version1.pdf

http://scqf.org.uk/wp-content/uploads/2014/03/SCQF-Revised-Level-Descriptors-Aug-2012-FINAL-web-version1.pdf

http://scqf.org.uk/wp-content/uploads/2014/05/SCQF_handbook_WEB_FINAL_2015.pdf


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Section 5: References

Appendix 1

Letter to COPD Supervisor

Dear COPD Supervisor,

Thank you for agreeing to supervise the general practice nurse who is undertaking the NHS

Education for Scotland “Initial Chronic Obstructive Pulmonary Disease Training for General

Practice Nurses to undertake annual COPD reviews”. This course follows the GOLD (2017)

guidelines. The training requires that a participant in the course has a named mentor with

the following characteristics:

As a supervisor you will be experienced in leading clinical reviews in the management of

COPD. In addition, you should have undertaken a recognised programme of learning with

regard to COPD management and updated your learning in the last three years. On

commencing the short course your participant is provided with a resource booklet which he

or she is asked to share with you. We will provide information on:

Course content and structure.

Learning outcomes to be achieved.

Participant assessment.

Your role is to support their learning through organising the observation of COPD reviews for

your participant. When you feel they are capable you should supervise them undertaking five

non-complex COPD reviews. They need to conduct these reviews and record anonymised

information in order to reflect on their understanding and ability to carry out a safe COPD

review.

If you need more advice / support, please contact either [email protected] or

[email protected] . If you have not been a supervisor before we suggest

undertaking the NES educational module available at:

http://www.effectivepractitioner.nes.scot.nhs.uk/learning-and-development/facilitation-of-

learning/supporting-learning.aspx

Kind regards,

Vicki Waqa

NES Specialist Educator

mailto:gill.dennes@


http://www.effectivepractitioner.nes.scot.nhs.uk/learning-and-development/facilitation-of-learning/supporting-learning.aspx

http://www.effectivepractitioner.nes.scot.nhs.uk/learning-and-development/facilitation-of-learning/supporting-learning.aspx


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NHS Education for Scotland, 2 Central Quay, 89 Hydepark Street, Glasgow G3 8BW

Appendix 2

Registering a TURAS Account

GPN COPD course

Guidance on using ePortfolio (updated June 2017)

Access the TURAS platform at https://turasnmportfolio.nes.nhs.scot/ and sign in if you

already have an account

To Register for an Account Follow the instructions to Register for an Account – you will be sent a link to your email

address so please ensure you use and email adrress that you can access easily. Home or

Work is fine.

Any problems – use the HELPDESK tab

Access the HOME Page The HOME page is good to keep going back to. Here is a screen shot of the home page –

there are 4 areas in your ePortfolio. Profile/ Evidence Forms/Uploaded

Documents/Sharepack

https://turasnmportfolio.nes.nhs.scot/


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Record your First Reflection for the COPD course

Use Reflective Model

Select Reflection – it is up to you which form you use

record your reflection using a Reflective Model select either the Gibbs or Driscoll Model –

whichever you prefer


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Complete the reflection template an click on the save button

Example - This is the Gibbs Reflective Model Form


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Now you are ready to Share your First Reflection

Select Create Sharepack

Add a Title COPD First Reflection – Your Name


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Add your details so by selecting the “Add to Sharepack

2 box

Select the Form you want to include

Share the link with Gill Dennes [email protected]


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Now send Gill TWO Feedback Requests

Firstly select the Generic Feedback so that Gill can give you feedback on your Reflection

Secondly Select the DOPS/Mini CEX feedback option so that Gill can give you feedback

on your Direct Observed Practical Skills (DOPS). In the next drop down box choose DOPS

feedback


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Title the Generic Feedback – First COPD Reflection Your Name and complete the

request

Title the DOPS Feedback – Feedback on Direct Observed Practical Skills–


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Getting your evidence together You will need to

1. Complete 5 COPD patient reviews and record in the Assessment Handbook

2. Ask your Supervisor to enter an electronic signature to confirm completion of the 5

COPD patient reviews and to add any comments as necessary on page 3 of the

Assessment Handbook. Or Scan your Supervisor signature as a word document and

save to your TURAS – this can then be attached to a share pack along with your

completed Handbook

3. Upload your completed COPD handbook (and Supervisor signature)

Complete a second reflection

Follow the same steps as for the first reflection. You don’t need to share it separately as this

will be included with your other final completed Handbook in the Sharepack.


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How to upload your completed COPD Assessment Handbook

Save your completed handbook to your PC/laptop

From the home page select “Uploaded documents” and “Select Document”

Tag the Evidence and Title the document “COPD Handbook completed YOUR NAME

Select the Document from your PC/laptop and click “Upload”


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When you are ready to submit your evidence at the end of the

programme

Create a Sharepack to share with two people

[email protected] and the external examiner

[email protected]

This time add all your evidence

- Your uploaded COPD Assessment Handbook which must include the 5 reviews and

the supervisor’s signature of completion

- Your first reflection

- Your feedback from your first reflection

- Your second reflection

Now send Course Leader a Feedback Request

Use the same process as before but title the request” COPD Course Final Feedback

Request - YOUR NAME” and request final feedback and summative assessment

The Course Leader will prepare this feedback and confirm the assessment with the external

examiner. They will then send you feedback which will include your overall assessment.

You will also receive a certificate.

Once you have completed the programme You may like to Create another Sharepack to save it for your own reference and to support

your NMC revalidation. You can add ALL your evidence for your COPD course plus your

feedback and your completion certificate, including anything else you want to keep from the

programme. That way you have everything in one place.
