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dc.contributor.authorOspina, Maria
dc.contributor.authorMichas, Marta
dc.contributor.authorDeuchar, Lesly
dc.contributor.authorLeigh, Richard
dc.contributor.authorBhutani, Mohit
dc.contributor.authorRowe, Brian
dc.contributor.authorMarciniuk, Darcy
dc.contributor.authorGoodridge, Donna
dc.contributor.authorDechman, Gail
dc.contributor.authorBourbeau, Jean
dc.contributor.authorBalter, Meyer
dc.contributor.authorCamp, Pat
dc.contributor.authorHernandez, Paul
dc.contributor.authorGoldstein, Roger
dc.contributor.authorStickland, Michael
dc.date.accessioned2019-01-15T18:21:01Z
dc.date.available2019-01-15T18:21:01Z
dc.date.issued2018-01-30
dc.identifier.citationOspina MB, Michas M, Deuchar L, et al. Development of a patientcentred, evidence-based and consensus-based discharge care bundle for patients with acute exacerbation of chronic obstructive pulmonary disease. BMJ Open Resp Res 2018;5:e000265. doi:10.1136/ bmjresp-2017-000265en_US
dc.identifier.urihttp://hdl.handle.net/10388/11722
dc.descriptionThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. https://bmjopenrespres.bmj.com/content/bmjresp/5/1/e000265.full.pdfen_US
dc.description.abstractIntroduction: Hospital and emergency department discharge for patients with chronic obstructive pulmonary disease (COPD) is often poorly organised. We developed a patient-centred, evidence-based and consensus-based discharge care bundle for patients with acute exacerbations of COPD. Methods: A purposeful sample of clinicians and patients were invited to participate in a two-round Delphi study (July–November 2015). In round 1, participants rated on a seven-point Likert scale (1=not at all important; 7=extremely important) the importance of 29 unique COPD care actions. Round 2 comprised items selected from round 1 based on consensus (>80%endorsement for Likert values 5–7). A list of 18 care items from round 2 was discussed in a face-to-face nominal group meeting. Results: Seven care items were included in the COPD discharge bundle based on clinician and patient input: (1) ensure adequate inhaler technique is demonstrated; (2) send discharge summary to family physician and arrange follow-up; (3) optimise and reconcile prescription of respiratory medications; (4) provide a written discharge management plan and assess patient’s and caregiver’s comprehension of discharge instructions; (5) refer to pulmonary rehabilitation; (6) screen for frailty and comorbidities; and (7) assess smoking status, provide counselling and refer to smoking cessation programme. Conclusion: We present a seven-item, patient-centred, evidence-based and consensus-based discharge bundle for patients with acute exacerbations of COPD. Alignment with clinical practice guidelines and feasibility of local adaptations of the bundle should be explored to facilitate wide applicability and evaluation of the effectiveness of the COPD discharge bundle.en_US
dc.description.sponsorshipAlberta Innovates Health Solutions Partnership for Research and Innovation in the Health System Program (AIHS PRIHS 201400390), Alberta Health Servicesen_US
dc.language.isoenen_US
dc.publisherBritish Thoracic Societyen_US
dc.relation.ispartofBMJ Open Respiratory Research, 30 January 2018, Vol.5(1)en_US
dc.subjectCOPDen_US
dc.subjectChronic obstructive pulmonary diseaseen_US
dc.subjectCOPD exacerbationsen_US
dc.subjectCare bundleen_US
dc.subjectCOPD managementen_US
dc.titleDevelopment of a patient-centred, evidence-based and consensus-based discharge care bundle for patients with acute exacerbation of chronic obstructive pulmonary diseaseen_US
dc.typeArticleen_US
dc.description.versionPeer Revieweden_US
dc.identifier.doi10.1136/ bmjresp-2017-000265


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