Development of a patient-centred, evidence-based and consensus-based discharge care bundle for patients with acute exacerbation of chronic obstructive pulmonary disease
Date
2018-01-30
Authors
Ospina, Maria
Michas, Marta
Deuchar, Lesly
Leigh, Richard
Bhutani, Mohit
Rowe, Brian
Marciniuk, Darcy
Goodridge, Donna
Dechman, Gail
Bourbeau, Jean
Journal Title
Journal ISSN
Volume Title
Publisher
British Thoracic Society
ORCID
Type
Article
Degree Level
Abstract
Introduction: 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.
Description
This 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.pdf
Keywords
COPD, Chronic obstructive pulmonary disease, COPD exacerbations, Care bundle, COPD management
Citation
Ospina 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-2017-000265
Degree
Department
Program
Advisor
Committee
Citation
Ospina 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-2017-000265
Part Of
BMJ Open Respiratory Research, 30 January 2018, Vol.5(1)
item.page.relation.ispartofseries
DOI
10.1136/ bmjresp-2017-000265