Early specialist intervention and reduced hospital admissions - the benefits of the respiratory ANP in unscheduled care

<bold>Background:</bold> COPD invokes frequent exacerbations, Medical Assessment Unit (MAU)/Emergency Department (ED) attendances and hospitalisation. The chronic nature of the disease instigates morbidity whilst posing a 10% mortality risk with each hypercapnic exacerbation (Matthews <italic>et al.</italic>, 2013). As global health services battle heightened demands posed by an ageing, co-morbid population, an urgent need to restructure care pathways exists to reduce MAU/ED overcrowding, avert unnecessary admissions, heighten patient flow and facilitate safe, timely discharge (Byrne & Daly, 2023). <bold>Objective:</bold> To assess if Respiratory Advanced Nurse Practitioner (ANP) led reviews influence ED/MAU waiting, admission and discharge statistics. <bold>Method:</bold> Over an 8-week period a Respiratory ANP assessed 18 patients presenting to MAU/ED. Key Performance Indicators developed by the Irish National Acute Medicine Programme were utilised to assess if: 1) 95% of patients spent under 6 hours in MAU/ED 2) 95% of patients were seen within 6 hours of arrival to MAU/ED 3) 25% of patients receive appropriate care without requiring admission <bold>Result:</bold> 1) 94% of patients spent under 6 hours in MAU/ED 2) 100% of patients were seen within 6 hours of arrival to MAU/ED 3) 88% of patients receive appropriate care without requiring admission <bold>Discussion:</bold> Adopting ANP-led respiratory assessment in MAU/ED significantly reduced waiting times and hospital admissions for patients in this study. Hence, ANP-led services have the potential to optimise respiratory care in MAU/ED by ensuring the provision of prompt, patient-centred, high-quality care. This study has proven to reduce MAU/ED overcrowding, thereby significantly improving patient flow and creating additional bed vacancies which ultimately reduce hospital costs and create a more efficient health service.