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Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Self-management of patients with chronic obstructive pulmonary disease: a best practice implementation project
Liping Liao1, Qiuhong Guo1, Yansi Luo2,3
1Department of Respiratory and Critical Care Medicine, Zigong First People's Hospital, Zigong, China.
Background:
People with chronic obstructive pulmonary disease (COPD) experience high prevalence and mortality rates, along with episodes of exacerbation, poorer quality of life, and increased hospital readmission. These aspects place a considerable burden on the economy and society. Despite the availability of COPD self-management guidelines, a gap between recommendations and practice persists.
Objective:
This project aimed to improve self-management among patients with COPD by implementing evidence-based practices in a tertiary hospital in China.
Methods:
The JBI Evidence Implementation Framework was used to structure this project into three phases of work. Phase 1 focused on contextual issues related to barriers and understanding roles and readiness for change. Phase 2 consisted of a baseline audit of six evidence-based criteria. Strategies were implemented to improve patient self-management plans, patient education, application of action planning tools, cognitive behavior related to dyspnea fear, and inter-disciplinary teamwork. Phase 3 comprised follow-up audits to determine any improvements.
Results:
Five of the six criteria demonstrated significant improvement in the follow-up results, increasing from 86.25% to 100%. This included self-management plans (95%), symptom control and exacerbation management instructions (100%), comprehensive patient education (91.25%), action plans (86.25%), and incorporation of cognitive-behavioral strategies (90%). The last criterion on prescribing corticosteroids and antibiotics for patients at risk of exacerbation showed a smaller improvement (16.25%).
Conclusion:
This best practice implementation project significantly improved adherence to COPD self-management practices. The findings demonstrate that the JBI Evidence Implementation Framework is a feasible and effective approach for strengthening COPD self-management and has strong potential for wider implementation and sustainability in clinical practice.
Spanish Abstract:
http://links.lww.com/IJEBH/A572.
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