Question

Agee, J. (2017). Reducing chronic obstructive pulmonary disease 30-day readmissions: A nurse-led evidence-based quality improvement project.   JONA: The Journal of Nursing Administration, 47(1), 35-40

In October 2014, the Centers for Medicare and Medicaid Services expanded readmission penalties to include those patients admitted with an exacerbation of COPD. Patient education is a key component in preventing readmission.

Initial Discussion Post:

What is a priority teaching intervention that the nurse must implement for these patients and how will it play a role in preventing readmission?

Identify a member of the interprofessional team and a teaching point that they can contribute to the teaching plan.

Answer 1

COPD is a disease which requires a proper care and management to prevent hospital readmission. The main goal should be improving quality of life,functional status. The priority nursing intervention to be done to avoid readmission are

• Can send patient to pulmonary rehabilitation center with in 30 days of discharge
• If smoking can be sent to smoking cessation program
• Respiratory therapist should teach him self management
• A COPD navigator can be used to find solutions for problem
• Digital diaries for symptom tracking
• Portable spirometer has to be taught
• Purse lip exercise to be taught
• Digital transmission of pulse oxymetre reading to health care provider
• Arrange for outpatient follow up
• Proper inhaler techniques to be taught
• Aware if co morbid disease and its management
• Teaching oxygen administration less than 1 to 2 litre only

One health care professional is the respiratory therapist who can teach patients simple techniques to prevent exacerbating situation.