Checking Second Hand Smoke Exposure – ICST

QI

Allowing you to achieve incremental and measurable changes to make a real difference to patients

Checking Second Hand Smoke Exposure

Paediatric Asthma Annual Review

QI projects are built as a TWO-PART component

Part 1

Setup

Here you set up and understand the project, ensuring you have everything in place to start your project

Part 2

Project

Here you have all the tools and resources to keep track of your progress towards completing the project successfully

Better setup, better success

Setup

Getting started

Getting started

Start by working through the set-up phase of this project, setting yourself a goal according to the time you have available to dedicate to this project, ensuring your team are aware of the project and you have been given the authorisation from your practice manager to complete the project.

Progress through the Set-up phase of your QI project before moving down to the Project phase.

The aim of this QI project

The aim of this Quality Improvement Project is to ask 20% or more parents about second-hand smoke exposure and provide very brief advice (VBA) at their children’s asthma review. Evidence with the appropriate SNOMED code in their child’s notes by November 2021.

Who is this project suitable for?

This QI project is aimed at primary care teams who have a register of Paediatric Asthma patients.

Why is this important?

Data collected from GP practices across Wales suggest that less than 1% patients on the paediatric asthma registers have been asked about their exposure to second hand smoke and their parent’s offered Very Brief Advice.

This QI project will ensure that these conversations are happening during every Paediatric Asthma Review, and these conversations are being coded.

What will I get for completing this project?

Good data entry directly improves patient care, which will also help you identify gaps or errors in the patient record or diagnosis.

On completion of this QI project, you will also get a certificate for your work. You will also be able to use this QI project as evidence towards CPD and professional revalidation.

Mark Complete

Readiness

Make sure you have the knowledge and expertise to undertake this project successfully.

If you are confident you have the skills and knowledge to manage a paediatric patient with Asthma and assess their future risk, mark this section as complete using the button below.

If you want to check your level of understanding, or need a refresher, check out the associated learning and assessments for this QI project, in line with the All Wales approach.

Mark Complete
Assessments:
Education programmes:
Mark Complete

Your capacity

Capacity is the most important aspect for the successful completion of any project  – ensure you have the capacity, time and ability to complete your project in a suitable timeframe.

Start by outlining how much time you have to commit to this project.

For example: Over the next six weeks, I will commit one 4-hour clinic (Wednesday afternoon) to completing this project.

And use the calculator provided to work out how many patients you can review in this time.

It is estimated that each patient action for this QI project will take 15 minutes, but adapt locally.

When estimating the time for each patient action on this QI project, think about how long it takes for a paediatric asthma review, and to enter the correct code into the patient’s notes.

When will my project start:

When will my project be completed by:

How much time do I have to dedicate to my project each week

Each patient action for the project will take minutes

Recommended time is minutes per patient.

Your current capacity


Please complete form to calculate capacity

* use the capacity calculator to edit or update your time frame

Mark Complete

Alignment

In order for your project to get underway and to be successful, your manager(s) will need to understand the importance of the project and agree your time commitment.

Name

Job title

Email

Contact 1 details not complete.

Sent email
Responded and signed off project

Name

Job title

Email

Contact 2 details not complete.

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Communication pack

It’s important that your colleagues know about the project.

You may want to include colleagues in the project, and they may need to know about other demands on your time. Let them know that you are focusing on QI with these useful resources.

Resources

NACAP Clinical Audit Report – Wales Primary Care

Communication with colleagues – Presentation template

Communication template – colleagues

Mark Complete

Milestone Map

Keep track of your set-up progress and make sure you are on track to getting started with your project with the timeframe you have added in your capacity calculator.

Your Progress

Getting started

Readiness

Your capacity

Alignment

Communication pack

Milestone Map

113

Start Date

Not Set

113

End Date

Not Set

Mark Complete

Project

Project overview

The aim of this QI project

The aim of this Quality Improvement Project is to ask 20% or more parents about second-hand smoke exposure and provide very brief advice (VBA) at their children’s asthma review. Evidence with the appropriate SNOMED code in their child’s notes by November 2021.

A recap on the evidence

Data collected from GP practices across Wales suggest that less than 1% patients on the paediatric asthma registers have been asked about their exposure to second hand smoke and their parent’s offered Very Brief Advice.

This QI project will ensure that these conversations are happening during every Paediatric Asthma Review, and these conversations are being coded.

What will I get for completing this project?

Good data entry directly improves patient care, which will also help you identify gaps or errors in the patient record or diagnosis.

On completion of this QI project, you will also get a certificate for your work. You will also be able to use this QI project as evidence towards CPD and professional revalidation.

Instructions

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.

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)

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.

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

Recording your progress

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

Resources

QI Project Printable Instructions

Resources

Attached below are a selection of resources to support you through your project.

Resources

QI Project Printable Instructions

Recommended Read and SNOMED codes

NACAP Clinical Audit Report – Wales Primary Care

Progress

Add the number of patients that you have addressed according to this project.

You should see your progress bars increase as you get closer to your goal.

Your current capacity


Please complete form to calculate capacity

* use the capacity calculator to edit or update your time frame

Capacity Calculator

Click on the chevrons for more information on your progress

Project data not set. Please complete your project's capacity settings.

Project data not set. Please complete your project's capacity settings.

Certificate

Your dynamic certificate can be found below. You can generate a certificate at any point during your QI project, and the certificate will be updated when you make further progress.

Sign Off

This QI project can be signed off by yourself.

Please sign off by clicking the button below. This will make your certificate available.

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