This example describes an audit project which was developed to evaluate if community physiotherapists in Swindon are implementing cough augmentation techniques to people with MND who are unable to cough effectively.
The audit criteria were based upon the NICE guideline: NG42 Motor Neurone Disease: assessment and management.
The overall aim of this project was to ascertain whether generic community physiotherapists in Swindon are implementing gold standard of care relating to recommendations for cough augmentation.
UK prevalence of MND is 4,487 people: Swindon has a population of over 229,000 with an expected prevalence of 16 people with MND and an expected incidence of 5. However, the number of people supported at the auditors hospice is 21 that is 125% of the expected UK prevalence.
The auditor developed an audit to evaluate if generic community physiotherapists in the Swindon area were implementing NICE guidelines on cough augmentation techniques; these should be considered and offered to people with MND if effective cough cannot be achieved unaided.
There is a need for a dedicated community based MND / complex neurology specialist Physiotherapist to provide assessment, monitoring of respiratory needs, provide physiotherapy chest clearance techniques and treatment, identification of equipment needs and provide training and care plans.
There is a need for a dedicated community MND / complex neurology specialist Physiotherapist to provide respiratory training and refresher training to Health Care Professionals. To update education resources and be a point of contact to support other Health Care Professionals managing their patients with MND.
There is a need to formulate a clear funded pathway which can be used to access ordering and funding of specialist respiratory equipment in a timely manner. Equipment should include Lung Volume Recruitment devices, specialist MND neck collars, and Cough Assist machines.
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