Improving self-management support for patients with chronic obstructive pulmonary disease in an acute care chest...

Chronic obstructive pulmonary disease (COPD) remains a leading global cause of morbidity and mortality. Although evidence-based self-management programs are well established, their implementation in routine hospital care is often limited by contextual and behavioral barriers, resulting in suboptimal compliance with recommended practices.

This project aimed to improve patients' COPD self-management through the implementation of evidence-based practices in a hospital in Taiwan.

The project was guided by the JBI Evidence Implementation Framework and used the JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) tool. A baseline audit was conducted to compare current practices with recommended practices. Participants included 32 ward nurses and 30 patients. Factors hindering compliance were identified and educational and workflow strategies were implemented, including staff training, bedside micro-teaching, and digital reinforcement through the ward's official messaging platform. A follow-up audit measured changes in compliance.

Compliance improved across all criteria, increasing from 16.7%-56.7% at baseline to above 90% at follow-up. Nurses' knowledge and perception scores increased from 57.7 to 95.6 points and mean patient COPD Assessment Test scores improved from 6.6 to 4.9, indicating reduced symptom burden. No 30-day emergency department revisits occurred.

This project improved adherence to evidence-based COPD self-management practices and strengthened nurses' capacity for evidence-based education. Repeated bedside micro-teaching sessions (each < 5 min) and digital reinforcement effectively supported patient learning and confidence. Embedding these approaches into staff training and ongoing audits demonstrates a feasible and transferable model for sustaining evidence-based COPD care in acute care settings.

https://links.lww.com/IJEBH/A688.