Going Home from Hospital with Asthma

Going Home from Hospital with Asthma

Discharge from hospital

During your stay in hospital with asthma, you will be monitored closely by the healthcare team to ensure you are responding to treatment. You are considered safe to leave hospital when;

• You aren’t relying on treatments such as oxygen, nebulisers or medicines given via infusion. These treatments aren’t usually available in the home environment if we are expecting you to make a full recovery
• Your clinical observations are stable
• You can achieve 75% or more of your usual or estimated peak flow reading.
• The doctor responsible for your care feels it’s safe for you to leave hospital

Recovery

You may not be fully recovered when you are sent home from hospital but are judged to be safe to recover in your home environment. Discharge home at the earliest safe opportunity removes risks associated with hospital stays, such as infections. Every person recovers differently, and it cannot be predicted when you will feel back to normal. It can be helpful to plan at these times, particularly if you think you may have to miss work or seek assistance from friends and family. If you need a note to hand to your employer confirming the dates of your hospital stay, please let the ward staff know before you leave. You can self-certify for absence from work due to ill health for up to 7 calendar days, after which you should contact your GP surgery for a sick note. Most surgeries have this facility available online.

If you are concerned that your symptoms or condition have deteriorated after leaving hospital, please call your GP surgery, NHS 111 or 999.

Maintenance treatment

Please continue and complete courses of medication such as steroids and antibiotics as directed, even if you feel recovered before finishing. Please also continue your asthma maintenance medications until you are seen by either your GP or hospital clinician in outpatients. Asthma is a long term condition and your symptoms should be unnoticeable if on the correct medication. There is a risk your symptoms will return if you choose to stop these. Your GP will be advised of any long term medications advised by the hospital and should make these available to order via your repeat prescription. Should you be concerned about your prescription charges, it can be helpful to consider a pre-payment certificate. Details of this are available online via www.gov.uk/get-a-ppc or by phone to 0300 330 1341.

Follow Up

We advise you contact your GP surgery within 2 working days following discharge from hospital to discuss your recovery. They will likely inform you of any follow up they feel you should have. Persons with asthma should be offered a review appointment with their practice nurse around once a year.

You should have received information about how to best use your inhaler. If you feel you need further/ repeated info, or if this hasn’t happened, please check out the web page https://www.asthmaandlung.org.uk/living-with/inhaler-videos There are a range of training videos showing the best technique for each inhaler type

Your inhaler type(s) is;

You will be contacted by the hospital asthma team via telephone within 4 weeks of you leaving hospital, unless alternative arrangements have been made e.g. a clinic appointment. Please make every effort to be available for your appointment, and contact us if you need to change the date/ time/ your contact details

Your telephone appointment is
Date:	Time:

What if I’m not feeling better?

If you or the hospital asthma nursing team feel that your recovery isn’t going as well as it should be, you will be offered a face to face appointment with an asthma specialist nurse at one of our 3 hospital sites. Here, we can discuss your concerns and symptoms and look at ways in which these can be improved. Diagnostic testing can be arranged to ensure we are giving you the correct treatment. Your current treatments can be reviewed to ensure you are getting the best from them, and alterations to your medications can be considered. Should you continue to struggle, we can arrange for you to see relevant health professionals to include consultant physicians and physiotherapists.

What if I don’t have asthma?

Some people live with asthma symptoms for a long time without realising they have asthma. If you haven’t been diagnosed with asthma before your stay in hospital, we will advise on what the next stages are on your follow up call; you may receive input from your GP or the hospital asthma clinic to arrange diagnostic investigations.

When unwell, some of your symptoms may appear as though you have asthma, when later testing may reveal that you do not. If you have been started on any asthma treatments before you have a diagnosis, we will advise you if these can be stopped safely. In some instances, it is less of a risk to begin asthma treatment before a confirmed diagnosis.

Is my asthma serious?

Asthma varies in severity from person to person. Although a stay in hospital can be worrying, it doesn’t always mean you have severe asthma. Sometimes, regular symptoms and/ or attacks can be caused by controllable factors. If those are identified and treated, then your asthma control should improve dramatically.

If you have to use a reliever inhaler more than 3 times a week, this can be a sign that your maintenance medications and self-management strategies need review. Your GP surgery or hospital asthma clinic can help with this.

If you have more than 2 attacks within a 12 month period where you are prescribed steroid tablets, your GP should arrange referral to the hospital severe asthma clinic. Please ask your surgery if you think you should be referred.

Contact Information

If needed, our contact information is;

By telephone:  07935 701667

We aim to be available to answer calls between 09:00 and 12:00 Mon- Fri. Please be patient during busy times. Voicemails/ texts can be sent to this number. Please include your name and at least one identifier (casenote number, date of birth, NHS no)

By email : [email protected]

Information Sources

We would recommend the following information sources should you wish for further advice in between appointments

• www.asthmaandlung.org.uk/conditions/asthma There are a wide range of topics covered relevant to persons with asthma for post hospital recovery and beyond
• Asthma & Lung UK telephone helpline- 0300 222 5800
• Asthma & Lung UK WhatsApp helpline- 07999 377775
• For emotional wellbeing support contact Talking Therapies www.talkingtherapies.hwhct.nhs.uk
• Stopping smoking advice- call 0300 123 1044

On behalf of the asthma nurse team, we wish you a speedy recovery

Peak Flow Diary

It can be helpful to monitor your peak flow readings as you recover. You should have been shown how to measure your peak flow when in hospital. Instructions on how this is done can be found at asthmaandlung.org.uk/symptoms-tests-treatments/tests/peak-flow if you are unsure. A peak flow reading varies from person to person, and is affected by factors such as age, height and gender. It can be useful to become familiar with what your normal peak flow reading is, as it can help monitor your asthma, and provide you with an alert if things are worsening. It can be helpful to monitor your peak flow for 1-2 weeks, twice a day following a hospital stay. When you are familiar with your normal readings, there is only need to check it around once a week unless you become unwell.

	Day 1		Day 2		Day 3		Day 4		Day 5		Day 6		Day 7
	AM	PM	AM	PM	AM	PM	AM	PM	AM	PM	AM	PM	AM	PM
800
750
700
650
600
550
500
450
400
350
300
250
200
150
100
50

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:

Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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