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Evaluating a Discharge Bundle for Chronic Obstructive Pulmonary Disease

机译：评估慢性阻塞性肺疾病的放电束

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Acute exacerbation of chronic obstructive pulmonary disease (COPD) is one of the leading causes of hospital readmissions within 30 days. Frequent readmissions negatively affect hospital reimbursements and patient outcomes. Creative strategies, such as COPD care bundles, have been shown to reduce readmission rates according to existing studies. A COPD discharge bundle was developed and implemented at 1 community hospital in response to an identified problem with COPD readmissions. Evaluation of this quality improvement initiative was the purpose of this project study. The practice-focused question was: Have 30-day readmission rates changed following the implementation of a COPD discharge bundle prior to transitioning from hospital to home? The framework selected for this project was the model for improvement. Sources of evidence included existing hospital data to evaluate the change in readmissions. The chi-square test of independence was used to assess the difference in frequency of 30-day readmissions. Pre and post-bundle implementation comparisons of readmission rates showed a decrease for 3 out of the 4 groups compared; these results were not statistically significant. Analysis of the post-bundle intervention groups revealed lower 30-day readmissions for individuals who were bundle compliant versus noncompliant and for those who spoke with a pharmacist within 48 hours of discharge opposed to those who did not; these results were statistically significant. Continued use of the bundle and maintaining the role of the pharmacist was recommended. Reduction of readmissions within 30-days has positive social implications for hospitals through financial gains and for the COPD population by improving overall health outcomes.

机译：慢性阻塞性肺疾病（COPD）的急性加重是30天内医院再次入院的主要原因之一。频繁的再次入院会对医院的报销和患者结局产生负面影响。根据现有研究显示，COPD护理包等创新策略可降低再入院率。针对已确定的COPD再入院问题，在1所社区医院开发并实施了COPD排放束。此质量改进计划的评估是此项目研究的目的。着眼于实践的问题是：在实施COPD出院捆绑服务后，从医院过渡到家庭之前，30天的再入院率是否发生了变化？为该项目选择的框架是改进的模型。证据来源包括现有医院数据，以评估再次住院的变化。卡方独立性检验用于评估30天再入院频率的差异。捆绑前和捆绑后实施再入院率的比较显示，与之相比，四组中的三组减少了。这些结果没有统计学意义。对捆绑后干预组的分析显示，符合捆绑与不遵守捆绑的个人以及在出院后48小时内与药剂师交谈的人相对于不遵守捆绑的人，其30天再入院率更低；这些结果具有统计学意义。建议继续使用该药包并保持药剂师的作用。 30天之内再入院率的减少对医院的财务收益和改善整体健康状况的COPD人群都有积极的社会影响。

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作者
Jones, Sharon S.;
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Walden University.;

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授予单位 Walden University.;
学科 Nursing.
学位 D.N.P.
年度 2018
页码 78 p.
总页数 78
原文格式 PDF
正文语种 eng
中图分类建筑科学;
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1. Examining the Effects of Age on Health Outcomes of Chronic Obstructive Pulmonary Disease: Results From the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease Study and Evaluation of Chronic Obstructive Pulmonary Disease Longitudinally to Identify Predictive Surrogate Endpoints Cohorts [J] . Amit D. Parulekar, Carlos Martinez, Chu-Lin Tsai, Journal of the American Medical Directors Association . 2017,第12期

机译：检查年龄对慢性阻塞性肺病的健康结果的影响：慢性阻塞性肺病研究和慢性阻塞性肺病的遗传流行病学的结果纵向识别预测替代终点队列
2. Evaluating the disease and treatment information provided to patients with chronic obstructive pulmonary disease at the time of discharge according to GOLD discharge guidelines [J] . Letícia de Araújo Morais, Samylla Ysmarrane Ismail Eisha de Sousa Cavalcante, Marcus Barreto Conde, Einstein (So Paulo) . 2020,第4期

机译：根据黄金排放指南，评估对慢性阻塞性肺病患者提供的疾病和治疗信息
3. Development of a patient-centred, evidence-based and consensus-based discharge care bundle for patients with acute exacerbation of chronic obstructive pulmonary disease [J] . Brian H Rowe, Richard Leigh, Marta Michas, BMJ Open Respiratory Research . 2018,第1期

机译：以患者为中心，循证和共识的出院护理包的开发，用于慢性阻塞性肺疾病的急性加重患者
4. CHRONIOUS: An open, ubiquitous and adaptive chronic disease management platform for Chronic Obstructive Pulmonary Disease (COPD), Chronic Kidney Disease (CKD) and renal insufficiency [C] . Rosso R., Munaro G., Salvetti O., 32nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society . 2010

机译：慢性病：针对慢性阻塞性肺疾病（COPD），慢性肾脏病（CKD）和肾功能不全的开放，无处不在的适应性慢性疾病管理平台
5. The influence of physiological factors, psychological factors, and informal social support on hospital readmission in discharged patients with chronic obstructive pulmonary disease (COPD) in Taiwan. [D] . Chen, Yea-Jyh. 2005

机译：台湾地区慢性阻塞性肺疾病（COPD）出院患者的生理因素，心理因素和非正式的社会支持对住院率的影响。
6. Evaluating the disease and treatment information provided to patients with chronic obstructive pulmonary disease at the time of discharge according to GOLD discharge guidelines [O] . Letícia de Araújo Morais, Samylla Ysmarrane Ismail Eisha de Sousa Cavalcante, Marcus Barreto Conde, 2020

机译：根据GOLD出院指南评估出院时向慢性阻塞性肺疾病患者提供的疾病和治疗信息
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Evaluating a Discharge Bundle for Chronic Obstructive Pulmonary Disease

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