Date of Conferral

2022

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Catherine Garner

Abstract

AbstractApproximately 15.7 million individuals throughout the United States have been diagnosed with chronic obstructive lung disease (COPD), with 700,000 individuals hospitalized annually in the United States. An estimated one in five patients are readmitted within 30 days, raising the costs above $15 billion annually. The gap in practice was a lack of adequate clinical practice guidelines associated with discharge to primary care in this acute care facility. The purpose of this project was to use the expertise of the multidisciplinary team of pulmonologists, acute care nurse practitioners, respiratory therapists, and pharmacists to develop a clinical practice guideline using evidence-based literature and professional organization guidelines and recommendations. The guiding practice focused question was whether an interprofessional team can update COPD guidelines for post discharge care for the management of this high-risk population. The IOWA conceptual framework was used to direct the process. Key points that emerged from the literature were the importance of promoting self-management, and training on home care including medication compliance and standing orders for prescription refills and home oxygen therapy. The team advocated patient access to their health care team 24 hours a day through the telehealth platform. Consensus was documented with the AGREE II. The highest scores were rigor of development (92%) and scope and purpose (90%). Stakeholder involvement received the lowest score of 81%, reflecting lack of patient input. Upon execution, the guideline could improve nursing practice in the support of COPD patients and caregivers in the home environment and to improve health status and prevent readmissions of patients with COPD, promoting social change.

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