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Project steps

Step 1

Update Paediatric Asthma Annual Review templates if necessary, to ensure patients are asked about exposure to second-hand smoke.

Step 2

During reviews, record correct code for every patient asked, and where there is exposure to second-hand smoke offer very brief advice to parents/ carers.
[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][vc_row el_class="qitaskouterrow"][vc_column][vc_row_inner el_class="qigrey"][vc_column_inner][vc_column_text]Step 1 - Update the Asthma Review templates Update the templates that inform a Paediatric Asthma Annual Review, ensuring that the following actions are made for every patient:
  1. The patient is asked about their exposure to second hand smoke
  2. If the parent/ carer of a child with asthma smokes, that caregiver is offered some very brief advice (VBA)
[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][vc_row el_class="qitaskouterrow"][vc_column][vc_row_inner el_class="qigrey"][vc_column_inner][vc_column_text]Step 2 - During the Asthma Review For every paediatric asthma patient who attends a review of their asthma, ask whether they are being exposed to second hand smoke and code accordingly: Not a passive smoker
  • Read Code: 137U
  • SNOMED Code: 315213009
Passive smoking risk
  • Read Code: 13WF4
  • SNOMED Code: 161080002
If the patient is at risk, it is important to offer Very Brief Advice to the parent/ carer, and a referral made to smoking cessation. See below for more information.[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][vc_row][vc_column][vc_tta_accordion active_section="0" collapsible_all="true"][vc_tta_section title="Scenario 1: Patient is exposed to second hand smoke" tab_id="1614005719562-799eea7b-bf9e"][vc_column_text]If the child is being exposed to second hand smoke or are at risk of exposure, the caregiver should be offered some very brief advice and/or referred for smoking cessation, and this should also be coded. Very brief advice (VBA) to reduce the patient's exposure to second hand smoke should include the following three steps:
  • ASK and record smoking status—is the patient a smoker, ex-smoker, or non-smoker?
  • ADVISE on the best way of quitting—the best way of stopping smoking is with a combination of medication and specialist support
  • ACT on patient response—build confidence, give information, refer, and prescribe. Patients are up to four times more likely to quit successfully with NHS support
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Recording your progress

For every patient whose record you change, be sure to record this in the 'Progress' section of the QI platform.
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Related Resources

QI Project Printable Instructions

© Institute of Clinical Science and Technology (ICST) 2020 Support: support@icst.org.uk