Date of Conferral

2020

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Mattie Burton

Abstract

COPD is a progressive, multifaceted, chronic disease with steadily increasing worldwide rates of prevalence, morbidity and mortality, making improved COPD care a global health priority. Current practice guidelines are in place, but the literature continues to demonstrate inadequacies in practice, for example the inconsistent use of pulmonary rehabilitation (PR). The purpose of the project was to conduct a quality improvement initiative evaluation of the PR program at a hospital in south-central Idaho. The practice-focused question was: What impact has implementation of a PR program had on COPD care in the area? Donabedian’s framework for healthcare quality evaluation was the theoretical foundation for the project; de-identified data from the hospital and PR program were used. Sources of evidence included current clinical practice guidelines for COPD and PR programs, literature on current COPD care practices, and national standards for rate of COPD readmissions. Results indicated a 21% increase in PR use since program inception, improvements in functional capacity in those who completed at least 10 weeks of PR as measured by the objective measures of max METS and get up and go scores and a higher probability than chance that participating in PR improved the subjective functional capacity measures of strength, endurance and balance. Due to lack of access to readmission data prior to initiation of the PR program, a direct relationship between PR use and readmission rates could not be determined. This project resulted in positive social change through increasing awareness and understanding of the essential role of PR in COPD care.

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