Active Endorsement

National Occupational Standard

CPD Mapping Toolkit

D520 Design, agree and adapt a physical activity programme for adults with chronic respiratory disease

Mapping CPD Courses to National Occupational Standards (NOS)

·  NOS or ‘standards’ establish the benchmark of competence required in different fitness industry roles/skills. Each NOS consists of a detailed breakdown of the minimum skills and knowledge needed to be competent.

·  Developed in conjunction with technical experts and employers, NOS act to ensure employability skills are reflected in qualifications and CPD.

·  Training providers are required to part-map CPD courses to demonstrate occupational relevance (e.g. to the learner and employer). N.B. There is no requirement to fully-map CPD to the NOS.

How to Complete this Mapping Toolkit

1.  Review the content of your course (including learning outcomes and assessment criteria) in relation to the NOS contained within this mapping toolkit.

2.  Demonstrate how and where your CPD course covers the NOS by completing the relevant sections within the ‘Mapping Evidence’ column throughout this mapping toolkit.

3.  Mapping need only be completed for elements of the NOS where there is a clear link to content and/or assessment covered by the CPD course. All areas that are not covered by the CPD should be left blank or denoted as not applicable (N/A). You will not be penalised for leaving mapping blank where it is irrelevant to your course.

4.  The information you add to the ‘Mapping Evidence’ column can include any aspect of course delivery/resources/assessment etc such as, PowerPoint presentations, course manuals, handouts, assessments, lesson plans. It is, however, important that you are able to submit anything you have mapped as evidence for the endorsement process.

D520 Design, agree and adapt a physical activity programme for adults with chronic respiratory disease

Summary

Many exercise referral schemes exclude patient/clients with established chronic respiratory disease. However, ongoing maintenance of exercise behaviour is an important component of condition management for patients/clients with stable chronic respiratory disease who have either been transferred from clinically-based rehabilitation or assessed by a pulmonary rehabilitation professional as a suitable candidate for community-based exercise/physical activity. Delivery of this service should follow current guidelines which provide guidance on patient/client inclusion and exclusion criteria and competency of instructors to protect both the interests of patients/clients and instructors.

Therefore pulmonary rehabilitation professionals and other healthcare professionals may direct a patient/client to suitably trained instructors and facilities where a structured and individualised physical activity programme can be designed and delivered for them, including group and home exercise.

Fitness instructors who are responsible for designingand delivering structured and individualised exercise/physical activity programmes for a patient/client with chronic respiratory disease must have a range of appropriate knowledge and skills specific to current guidelines and monitoring the effects of physical activity on the condition. These instructors should have established close liaison with pulmonary rehabilitation professionals in their local area.

Tailoring an exercise programme will use many of the core aspects of programme design and delivery such as communication skills, principles of training and teaching skills. In addition, there are specific knowledge and skills related to working practice and the technical exercise aspects to consider in programme design including: understanding ofthe disease process and how it is managed; the impact of the disease on physical activity levels;the benefits of physical activity on chronic respiratory disease; adaptations to exercise for individuals with chronic respiratory disease; an understandingof respiratory medications; exercise testing modalities and the management of breathlessness and emotional well-being.

Elements covered:

D520.1 Design and agree a physical activity programme for patients/clients with chronic respiratory disease

D520.2 Deliver, review and adapt a physical activity programme for patients/clients with chronic respiratory disease

D520.1
Design and agree a physical activity programme for patients/clients with chronic respiratory disease
Competencies/Skills / Mapping Evidence
1  Establish an effective working relationship with your patients/clients and appropriate health care professionals
2  Collect, record and interpret information about your patients/clients with chronic respiratory disease using safe, appropriate and recognised methods
Information to cover:
a)  personal goals
b)  referral form from pulmonary rehabilitation professional
c)  informed consent to participate to transfer medical information
d)  medical history and medication
e)  current and previous physical activity history and preferences
f)  social and psychological considerations
Methods to cover:
a)  reports
b)  interview
c)  questionnaire
d)  observation
e)  functional assessment
3  Follow the correct procedures and protocols for accepting referrals from and maintaining ongoing communication with pulmonary rehabilitation professionals, including those for confidentiality
4  Establish and agree the patient/client’s readiness to participate
5  Plan and agree goals that are appropriate to your client and their current level of ability
6  Plan and prepare objectives, activities and delivery methods (see 1 above) that are appropriate to your client’s goals and condition
7  Design and agree a programme adapted to your patient/client using relevant principles of training
8  Assess and manage risk according to appropriate guidelines and protocols
D520.2
Deliver, review and adapt a physical activity programme for patients/clients with chronic respiratory disease
Competencies/Skills / Mapping Evidence
1  Assess, monitor and manage risk to your patient/client throughout the programme
2  Manage medical complications and emergencies within the boundaries of your role until the required medical help is available
3  Deliver planned activities to your patient/client with chronic respiratory disease, adapting activities according to their individual needs
4  Communicate and consult with your patients/clients on issues to do with their physical activity programme and progress
5  Provide appropriate attention to your patients/clients with common co-morbidities
6  Support your patient/client in a way which will promote sustained change in physical activity levels
7  Monitor your patient/client’s progress against agreed goals and adapt the programme accordingly
8  Provide ongoing reports to communicate relevant outcomes to the appropriate health care professional.
D520 Design, agree and adapt a physical activity programme for adults with chronic respiratory disease
Knowledge and Understanding / Mapping Evidence
K1  Government policy and published international and national guidelines for pulmonary rehabilitation (e.g. ERS/ATS and BTS)
K2  Awareness of national agencies and organisations (e.g. GOLD, BLF) relating to chronic respiratory disease
K3  Relevant medico-legal requirements
K4  How to interact appropriately with pulmonary rehabilitation professionals, other health care professionals and personnel and general practitioners, involved in the process of pulmonary rehabilitation
K5  The information that must be reported on the referral form to include:
·  Main diagnosis and significant co-morbidities
·  Oxygen requirements
·  Smoking history
·  Medication
·  Lung function (FEV1 % predicted and FEV1/FVC (%)
·  Exercise tolerance (distance achieved, heart rate at rest and post test/s, breathlessness score pre and post test/s, reason for termination of test and oxygen saturation)
·  Pre and post exercise test (e.g. incremental shuttle walk test (ISWT), 6 minute walk test or endurance shuttle walking test) (indication as to whether undertaken with or without oxygen)
·  Exercise completed during pulmonary rehabilitation (frequency, intensity, type and duration)
·  Other relevant information (e.g. BODE Index score, if used)
K6  Local protocol that should be followed when dealing with the patient/client who has been transferred from clinically-based rehabilitation to ongoing maintenance of exercise behaviour
K7  The importance of an agreed link with a named specialist from the pulmonary rehabilitation team
K8  Barriers to communication with the referred patient/client and the communication skills needed to overcome these
K9  How to identify when the patient/client needs to consult health care professionals
K10  Considerations involved in ongoing maintenance of exercise behaviour, including respecting inter-professional boundaries and patient/client confidentiality
K11  Methods of information collection and interpretation, appropriate storage of confidential records and management processes encountered in running ongoing maintenance of exercise behaviour
K12  The significance of measurements of lung function and oxygen saturation and their implications for practice
K13  The respiratory system and the components of respiration
K14  The physiology and pathology of Chronic Obstructive Pulmonary Disease with consideration for other conditions such as asthma, bronchiectasis and interstitial lung disease
K15  Causes, presentation, diagnosis and treatment of Chronic Obstructive Pulmonary Disease with consideration for other conditions such as asthma, bronchiectasis, interstitial lung disease
K16  The impact of chronic respiratory disease on functional performance and emotional well-being
K17  How the pathophysiology of respiratory disease contributes to the altered response to exercise in individuals with respiratory disease
K18  The range of respiratory medications and their exercise considerations
K19  Oxygen therapy and potential requirements during exercise
K20  Acute responses and chronic adaptations to aerobic and resistance training and implications for the individual with chronic respiratory disease
K21  Evidence-based beneficial effects of physical activity on chronic respiratory disease
K22  Contra-indications to exercise which need to be taken into account for the patient/client with chronic respiratory disease
K23  Initial assessment including appropriate assessment of exercise level using recognised tests, for example the Incremental Shuttle Walk Test, the Endurance Shuttle Walk Test and One Repetition Maximum Test
K24  On going screening process prior to each exercise session
K25  How to set up and manage a safe physical activity environment relevant for a patient/client with chronic respiratory disease
K26  Principles of individual exercise prescription (aerobic and resistance) for the patient/client with chronic respiratory disease
K27  Evidence-based methods for monitoring intensity e.g. breathlessness (use of the breathlessness scale and perceived exertion (RPE scale))
K28  Causes and management of breathlessness (e.g. breathing techniques)
K29  Exercise considerations for the patient/client with other medical conditions/co-morbidities for example:
·  Heart failure
·  Diabetes (Type 1 and Type 2)
·  Hypertension
·  Obesity / low weight
·  Peripheral Vascular Disease
·  Osteoarthritis/Rheumatoid arthritis/osteoporosis
·  Depression and anxiety
K30  How to determine and progress physical activity programmes appropriate to the condition using results from the physical / exercise assessments, medical information, national guidelines, consultation and patient/client aims
K31  The motivational processes, models and techniques involved in behavioural change for the referred patient/client to encourage beneficial lifestyle changes and providing appropriate support to sustain such changes
K32  How to communicate and consult effectively with the referred patient/client about their programme and progress
K33  How to recognise and understand the impact of an exacerbation of the chronic respiratory disease and adapt the exercise programme appropriately
K34  How to manage medical complications e.g. angina, arrhythmias, until the required medical help is available
K35  How to respond safely and appropriately to emergencies e.g. myocardial infarction, hypoglycaemia until appropriate medical help is available
K36  The management, evaluation and reporting of information, in verbal and written formats
K37  How to use and adapt a system for monitoring and recording the patient/clients progress and updating their physical activity programme
K38  How to evaluate the effectiveness of on-going maintenance of exercise behaviour

CPD Mapping Toolkit Page 5

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