Hospital without dyspnea: rationale and design of a multidisciplinary intervention.
Dyspnea is a common and disabling symptom of respiratory and heart diseases, which is growing in incidence. During hospital admission, breathlessness is under-diagnosed and under-treated, although there are treatments available for controlling the symptom. We have developed a tailored implementation strategy directed to medical staff to promote the application of these pharmacological and non-pharmacological tools in dealing with dyspnea. The primary aim is to decrease the rate of patients that do not receive an adequate relief of dyspnea. This is a four-stage quasi-experimental study. The intervention consists in two teaching talks that will be taught in Cardiology and Respiratory Medicine Departments. The contents will be prepared by Palliative Care specialists, based on available tools for management of dyspnea and patients' needs. A cross-sectional study of dyspnea in hospitalized patients will be performed before and after the intervention to ascertain an improvement in dyspnea intensity due to changes in medical practices. The last phase consists in the creation of consensus protocols for dyspnea management based in our experience. The results of this study are expected to be of great value and may change clinical practice in the near future and promote a changing for the better of dyspnea care.
Department of Cardiology, Gregorio Marañón General Hospital, Madrid, Spain.
Lourdes
L
Vicent
Department of Palliative Care, Gregorio Marañón General Hospital, Madrid, Spain.
Juan Manuel Nuñez
JM
Olarte
Department of Respirology, Gregorio Marañón General Hospital, Madrid, Spain.
Luis
L
Puente-Maestu
Department of Palliative Care, Gregorio Marañón General Hospital, Madrid, Spain.
Esther
E
Artajona
Department of Cardiology, Gregorio Marañón General Hospital, Madrid, Spain.
Francisco
F
Fernández-Avilés
Department of Cardiology, Gregorio Marañón General Hospital, Madrid, Spain; European University of Madrid, Madrid, Spain; Complutense University of Madrid, Madrid, Spain.
Manuel
M
Martínez-Sellés
Chronic pulmonary disease; Dyspnea; Heart failure; Palliative care