Latest news from ARNS
Results of COPD and Malnutrition Questionnaire

Results of COPD and Malnutrition Questionnaire

At the ARNS 20th Anniversary Conference last month, delegates were invited to complete a questionnaire on COPD and Malnutrition.  The results of the questionnaire are shown below:

Thank you for taking the time to complete the questionnaire at the ARNS 2017 Conference in Loughborough.  We had 47 responses in total.

Just over half of respondents (52%) said that they carry out a nutritional assessment at every visit with 42 % only doing assessments if they had concerns.   BMI is still the most common recorded assessment being used by 75% of HCP to assess Nutritional status with 59 % completing a full MUST score.

See full results of the questionnaire here COPD and Malnutrition Questionnaire Results from ARNS conference 2017 (002)

Nutricia is holding a study day on 24th Jully 2017 at Nutiricia offices in Chiswick Park, focusing on the ffects of malnutrition.  If you would like to attend please contact Jo Lessells emial:   or call her on 07500 577889



Education for Health celebrates its 30th anniversary

Education for Health celebrates its 30th anniversary

Education for Health is celebrating 30 years of improving the lives of people with long term conditions.

The education charity will mark this important milestone by sharing the stories of 30 people involved in its success on its website and social media channels – one each day in June.

It is also offering healthcare professionals the opportunity to apply for 30th anniversary bursaries and attend a number of its workshops for just £30

Chief Executive, Monica Fletcher OBE, said thanks to the ambition, passion and hard work of its staff, Trainers, Trustees and partners that the charity has grown from humble beginnings into a highly respected leader in providing education for health care professionals.

“It’s time to celebrate, to thank those who have contributed to our success, reflect on our achievements and make ambitious plans for the future,” she said.

“Over the years we have empowered many thousands of health care professionals, not just in the UK but around the world, to improve the lives of their patients. This is something we are immensely proud of.
“And while we have grown and evolved significantly over the past 30 years we have remained true to our founder’s vision, which is that we exist to improve the lives of people with long term conditions.”
Greta Barnes MBE founded the Asthma Training Centre in Stratford-upon-Avon in 1987 as she was aware that too many patients with asthma in the community (and secondary care) were being seen in an emergency, and sometimes life threatening, situation.

She believed route to improved management lay in organised preventive care, personally tailored treatment and the giving of practical advice as well as regular follow up and review.
In the early days students attended a three-day course in Stratford-upon-Avon and were awarded the Diploma in Asthma Care. Within two years of being set up a regional training network had been established to cope with demand.

Today Education for Health delivers education and training across a wide range of long term conditions including respiratory disease, cardiovascular disease and diabetes. In 2016 it educated more than 4,800 individuals and ran 340 courses ranging from workshops to level 5, 6 and 7 modules. The charity also delivers bespoke training to meet the specific needs of commissioners in
the NHS and other organisations, and provides a number of free-to-access online resources. Advocacy, influencing and research activities are an integral part of Education for Health’s activities. All of the charity’s education leads and trainers are practising clinicians who sit on a wide range of specialist networks, advisory boards, voluntary, NHS and professional bodies, and guideline development groups.
Education for Health believes in taking a collaborative approach and works with many partners in industry, the NHS and other charities.

Monica explained: “We work hard to raise awareness of the importance of an educated workforce and impart our knowledge and expertise to influence key reports, policies and guidelines.
“By doing so we are able to share our knowledge more widely to contribute to the body of science in long term conditions, a key area of activity for us and one we are very proud of.”

As for the next 30 years, Education for Health has ambitious plans for the future. “The charity’s role in helping to create a well informed and well-educated workforce will be
more important than ever and we will explore new ways of working to have a positive impact on the lives of even more people with long term conditions,” explained Monica.
“Above all, we will remained focussed on improving the lives of many more patients and doing the best we can to empower, encourage and support with long term conditions to look after themselves, manage their conditions and navigate health services.”

Find out more about Education for Health at or find the charity
on facebook and twitter @EdforHealth

Wendy Preston, Chair of ARNS encourages members to complete RCN Safer Staffing Survey

Wendy Preston, Chair of ARNS encourages members to complete RCN Safer Staffing Survey

As Chair of ARNS, I would urge you to complete the following RCN  Safer Staffing survey (you need not be a member to complete it). The survey aims to capture what nurse staffing levels are like across all area’s and identify relevant issues/ themes to inform recommendations. There is a section to add narrative that you may find useful. Please complete this even if your ‘last shift/ work day’ was fully staffed, you can add previous issues, such as:

  • Not taking breaks
  • Staying after work
  • Covering nurse vacancies by doing another role to yours e.g. working as a Staff Nurse on a ward
  • No time in establishment for training/ annual leave
  • No leadership time

The deadline is May 31st and it is important to get the Respiratory Nurse contribution to this survey.

Complete the survey here

Wendy Preston
Chair, ARNS

Clinicians urged to use new guidance on emergency oxygen to save lives

Clinicians urged to use new guidance on emergency oxygen to save lives

Health professionals from across the NHS and beyond are being urged to adopt the latest version of the world’s first evidence-based guideline on the use of emergency oxygen, published today (Monday 15 May).

The updated guidance is based on new evidence about how effective prescribing and delivery of emergency oxygen for patients can both improve health and save lives.

The updated British Thoracic Society (BTS) Guideline for Oxygen Use in Adults in Healthcare and Emergency Settings, first published in 2008 and endorsed by over 20 clinical societies and colleges, advises health practitioners when prescribing oxygen to always specify a safe ‘target range’ of oxygen in the blood, which can then be monitored.   This vital action is designed to ensure that patients are not given too little, or too much, oxygen which can result in greater illness and, in rare cases, even death.

The rationale for giving emergency oxygen treatment is to treat low blood oxygen levels (hypoxaemia) where the body’s cells are starved of oxygen, which can cause damage to vital organs which can lead to death.  Oxygen can be used to help treat a number of lung diseases, such as pneumonia or deteriorations in asthma or chronic obstructive pulmonary disease (COPD). Oxygen is also used with other diseases such as heart failure and sepsis, which do not directly involve the lungs.

The updated Guideline now covers:

  • Emergency oxygen use, and most other oxygen use, in healthcare settings
  • Short-term oxygen use by healthcare workers outside of healthcare settings

The new areas included are:

  • Endoscopy (for example, gastroscopy) and other procedures requiring sedation
  • Care before, during and after operations including patient-controlled analgesia
  • Palliative care settings like hospices
  • Use of oxygen mixtures, like Entonox (‘gas and air’) – widely used in childbirth
  • Use of high-flow humidified nasal cannulae (a relatively new method for oxygen delivery)
  • Use of oxygen by healthcare professionals in patients’ homes
  • Use of oxygen by voluntary rescue organisations and other non-NHS first responders

Evidence of the Guideline’s effectiveness has been increasing since it was first launched in 2008.

Among a number of studies in support of its impact, one randomised controlled trial and two observational studies have supported decades of evidence that giving high concentration oxygen to patients with severe exacerbations of COPD can increase the likelihood of death, often associated with critically high levels of carbon dioxide in the blood. These studies support the case for the BTS Guideline’s recommendation of a lower safe ‘target range’ of 88-92% oxygen saturation for patients with COPD.

Another example of evidence spotlights the issue of patients with heart attacks with normal blood oxygen levels being given high concentration oxygen – this was common practice until very recently but probably increases the size of the heart attack due to constriction of the blood vessels in the heart in response to high doses of oxygen.  There is also mounting evidence which indicates that very high blood oxygen levels in intensive care unit (ICU) patients are also associated with increased death rates.  These recent studies support the effectiveness of the BTS Guideline-recommended ‘target range’ for improving patient outcomes.

Dr Ronan O’Driscoll, Consultant Respiratory Specialist at Salford Royal NHS Foundation Trust, and first author of the British Thoracic Society’s Guideline for Oxygen Use in Adults in Healthcare and Emergency Settings, said:

“Oxygen is a very important drug and should always be prescribed and monitored like any other medication.  It is very beneficial to many patients, but can be harmful if misused.

We urge all clinicians to adopt the updated BTS Guideline so that emergency oxygen is always used in an optimal and safe way.

We’re delighted that a new body of evidence is confirming how effective following the Guideline can be in improving patient outcomes and reducing avoidable deaths.

The Guideline has now been extended to include more uses of oxygen ranging from procedures requiring sedation such as endoscopy, through to use of oxygen mixtures like ‘gas and air’ widely used in childbirth, to benefit an even greater number of patients.”

1 in 7 patients in UK hospitals receives oxygen therapy for their condition on any given day, according to the BTS Emergency Oxygen Audit report (2015).  Yet more than 4 in 10 of these patients (about 6,000 on an average day) are receiving oxygen with no prescription or other written order to help ensure that staff deliver and monitor oxygen use safely and effectively. Furthermore, over half of hospitals don’t provide sufficient training in oxygen provision and monitoring for doctors or nurses.

However, the 2015 audit also reflected some real progress in the UK:

  • 85% of hospitals have implemented an oxygen policy
  • 100% used pulse oximeters to measure a patient’s oxygen levels on all nursing observation rounds
  • 72% recorded the patient’s oxygen levels in a dedicated oxygen section on the monitoring chart consistent with the BTS oxygen guidelines

BTS won a National Patient Safety Award in 2011 for its campaigning work in the area of safe oxygen use, which has included the delivery of Guidelines, educational resources and audit to help hospitals provide oxygen safely and effectively.

The BTS Guideline for Oxygen Use in Adults in Healthcare and Emergency Settings can be downloaded here:

The BTS Guideline for oxygen use in adults in healthcare and emergency settings has been endorsed by: Association of British Neurologists, Association of Chartered Physiotherapists in Respiratory Care, Association for Palliative Medicine, Association of Respiratory Nurse Specialists, Association for Respiratory Technology and Physiology, British Association of Stroke Physicians, British Geriatrics Society, College of Paramedics, Intensive Care Society, Joint Royal Colleges Ambulance Liaison, Primary Care Respiratory Society UK, Resuscitation Council (UK), Royal College of Anaesthetists, The Royal College of Emergency Medicine, Royal College of General Practitioners, Royal College of Nursing (endorsement granted until April 2020), Royal College of Obstetricians and Gynaecologists, Royal College of Physicians London, Royal College of Physicians of Edinburgh, Royal College of Physicians and Surgeons of Glasgow, Royal Pharmaceutical Society and The Society for Acute Medicine.

New website for Asthma UK Centre for Applied Asthma Research

New website for Asthma UK Centre for Applied Asthma Research

On World Asthma Day (2 May 2017) the Asthma UK Centre for Applied Research launched a new website – a brand new virtual home for the Centre.

The website celebrates the wealth of applied asthma research across the UK conducted by members of the Asthma UK Centre for Applied Research, as well as the supporting platforms that support and facilitate the research process.  It makes it easy to find out about recent activity, recent research publications, news and events.

People affected by asthma are at the core of all Asthma UK Centre for Applied Research work. The new website celebrates our active patient and public involvement groups and provides information for people affected by asthma on how they can get involved and provide a valuable contribution to help transform the lives of people affected by asthma across the UK.

The website contains a unique, curated catalogue of big data sets on Asthma in the UK – so researchers can see at a glance what data are available, where they are held and how to obtain data relevant to their research. This will be an invaluable resource, and will continue to grow and develop.

A fantastic postgraduate training programme supports the next generation of researchers – current PhD students form a vibrant and active group, though they are based at various locations around the UK. The new website highlights opportunities for prospective PhD students, as well as giving lots of information on current students.

The Asthma UK Centre for Applied Research Methodology Platform shares expertise in planning, executing and analysing data from trials, and is developing mechanisms to facilitate secondary uses of data.  The new website is a great resource for researchers across the UK to find out about events, workshops and more information from experts across the Centre.

Centre co-director Professor Aziz Sheikh, of the University of Edinburgh, said

“I am delighted to launch this new website on World Asthma Day. It will be a great resource for anyone interested in applied asthma research”

Visit the new website and have a look – find out what the Asthma UK Centre for Applied Research has been up to and how you can get involved:

Key features

Fun film encourages children to use inhalers

Fun film encourages children to use inhalers

A fun short film that encourages children with asthma to use their inhalers effectively has been released by
Education for Health to mark World Asthma Day, 2 May 2017.
Jack Blows His Own Trumpet has been written by Education for Health’s Chief Executive, Monica Fletcher OBE and
Jane Scullion, Trustee and Respiratory Nurse Consultant University Hospitals of Leicester NHS Trust, to mark the
charity’s 30th anniversary.
The two-minute film can be viewed here
It features a heart-warming poem that tells the story of a little boy, Jack, who longs to play the trumpet in a band but
is unable to because of his asthma. Inspired by his friend Molly, Jack learns to take his inhalers correctly and fulfils
his dream. The vibrant film includes colourful illustrations of Jack, his friend Molly and a herd of trumpeting
Health professionals, teachers, parents and children’s activity leaders will be encouraged to share the film with
children with asthma.
Monica and Jane are passionate about improving the lives of children with asthma and ensuring inhalers are taken
correctly. Monica chairs the UK Inhaler Group (UKIG) and Jane is a professional advisor to the group, a coalition of
not-for-profit organisations and professional societies with a common interest in promoting the correct use of
inhaled therapies.
Monica said she and Jane are delighted the characters in their poem have come to life.
“Sadly, we know far too many children with asthma, a serious medical condition, are reluctant, or unable, to use
their inhalers properly and this can have a huge impact on their lives.
“Many miss out unnecessarily on enjoying important everyday activities such as sport or music. This is unacceptable
and often unnecessary if their asthma is managed properly.
“We hope this film will provide a fun way for those who care for children with asthma to get across an important
message about effective inhaler use and encourage these children to take part in a whole range of activities and
enjoy life to the full.”

Thanks to all of our sponsors

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