PPT81 As old as breathing itself: establishing and improving the use of handheld fans for refractory breathlessness on an inpatient respiratory ward

<h3>Background</h3> Fans date back thousands of years. An art form, status symbol, instrument for keeping cool, they have persisted through time. Part of their rich history should include their evidence-based potential to give relief in breathlessness and empower patients, yet they remain an underused tool. <h3>Aim</h3> To establish and improve the use of handheld fans for chronic breathlessness on an inpatient respiratory ward. <h3>Methods</h3> We audited admissions over a one-month period to determine suitability for a trial of handheld fans and whether they were offered one. We collected qualitative data via a questionnaire to ascertain confidence in recommending fans to patients and perceived barriers. Common themes included lack of awareness of the indications and evidence, and difficulties finding fans. <h3>First interventions</h3> Creating a ‘fans box’ from borrowed supply. Teaching sessions. <h3>Second interventions</h3> New stock of fans funded by grant on basis of initial results. Fans Champion nominated. <h3>Results</h3> <h3>First data cycle</h3> Combined length of inpatient stay - 223 days, use of handheld fan appropriate – 10/223 days, fan offered – 0/10 days Second cycle (post-1st intervention): Combined length of inpatient stay - 378 days, use of handheld fan appropriate – 8/378 days, fan offered – 0/8 days. Unfortunately, there did not appear to be any increase in the use of fans. However, two fans had been taken, suggesting use not reflected in patient notes. Third cycle (post-2nd intervention): Combined length of inpatient stay - 837 days, use of handheld fan appropriate – 30/837 days, fan offered – 15/30 days, increase in compliance from 0% to 50% <h3>Conclusion</h3> Although we have a strong scientific basis for use of handheld fans, they remain an imaginative suggestion due to limitations in accessibility and knowledge. This quality improvement project suggests a model to increase accessibility and knowledge that could be replicated cheaply and widely.