HOME FIRST (Home Followed-up by the Infection Respiratory Support Team): a feasibility study

Royal Liverpool and Broadgreen University Hospitals NHS Trust (UK)0 个研究点目标入组 200 人开始时间: 2012年10月16日最近更新: 2020年3月30日

试验速览

•Patients with any of the following conditions:
•1. Pneumonia - community-acquired (CAP) or hospital-acquired (HAP) - pneumonia definition - a series of clinical symptoms with radiological consolidation
•N.B. All pneumonia CURB-65 scores will be considered but patients with CURB-65 =3 MUST have had at least 24hrs of in-patient observation before recruitment into the study.
•2. Acute tracheo-bronchitis & acute bronchitis
•3. Non-pneumonic lower respiratory tract infection
•4. Influenza with respiratory manifestations
•5. Infective exacerbation of bronchiectasis
•6. Lung abscess
•7. Pneumonia with concomitant COPD (if this service is not provided elsewhere)
•Patient Suitability:
•1. Simple pleural effusions only (if no diagnostic pleural tap performed please discuss)
•2. Can manage ADLs with current support (immediate OT/physio/social assessment/care can be arranged prior to discharge (if needed) and continued at home)
•3. Able to give fully informed consent
•4. Has a phone
•5. Age>18yrs old
•6. EWS =2 AND SBP>90 (all observations must be stable for 12-24hrs) AND mild confusion only (defined as an 10-point AMTS =7)
•7. All observations must be stable for 12-24hrs
•8. Improving inflammatory markers (WCC/CRP)
•9. Stable or improving U&Es

•1. Acute exacerbations of COPD - infective & non-infective (other services already provided)
•2. Patients with CURB-65 >3 admitted<24hrs ago
•3. Patients unable to manage at home even with maximal support from HOME FIRST (this may include some patients IV drug users, with ETOH excess or mental health problems)
•4. Serious co-morbidities requiring hospital treatment (eg: CKD, CCF) or deemed unstable (significant AKD)
•5. Suspected MI/raised TnI/T consistent with NSTEMI (Or acute ECG changes) within 5 days of discharge
•6. Empyema or complicated parapneumonic effusion
•7. SBP<90mmHg
•8. Neutropenia
•9. No fixed abode
•10. Tuberculosis suspected
•11. Well enough for discharge without HOME FIRST homecare support
•12. Sats <92% on air - for patients without chronic respiratory illness
•13. Sats <88% on air [except asthma sats must be >92%] - for patients with chronic respiratory illness. All such cases MUST be discussed as oxygen assessment may be needed.

发起方

Royal Liverpool and Broadgreen University Hospitals NHS Trust (UK)