Source: International Congress 2016 – Non-inflammatory assessment of airway disorders
Disease area: Airway diseases

Abstract

BACKGROUND:The aim was to evaluate the quality of care of patients with acute exacerbation of COPD in territory care hospital and evaluated the change in practice after educational program and recommendations.METHODS:An initial audit from 01/12/2013 to 31/11/2014 was carried out. Standard of care was determined with inpatient mortality, length of hospital stay, accuracy of initial controlled oxygen prescription, history and clinical assessment at admission, adherence of post graduate trainee to GOLD guidelines and discharge recommendations. A re-audit was performed in July 2015 with analysis of 6 months files.RESULTS:Though pattern in mortality remained same,25.8% there is significant reduction in median length of hospital stay from 11 to 7.8 days (p 0.003). Question regarding biomass exposure was increased by 3times. Proper vital documentation and ABGS interpretation improved to 90.4% and 78.8% respectively. After formulating a new discharge card there is substantial improvement from 1st to 2nd audit in vaccination 21.4% to 66.7%, smoking cessation advice 15.5% to 66.7, inhaler technique assessment < 5% to 66.7% , prescription of inhaled LABA with steroid 47.9% to 63.65 (p 0.021).Several other standards were still not met like assessment of baseline severity of disease, documentation of occupation and underlying co-morbidities.Consistent practice was observed with regards to good inpatient prescription of oxygen therapy, systemic steroids and antibiotics.Conclusion:Improvement in quality of care for AECOPD can be achieved with better education of postgraduate doctors, a more systemic approach to patients, adherence to standard guidelines and intermittent audits.


Rating:

Share or cite this content

Citations should be made in the following way:
Saima Akhter (Karachi, Pakistan), Saima Akhter, Nadeem Rizvi, Shaista Ghazal. Standard of inpatient care during exacerbation in territory care Hospital, Pakistan; A completed audit cycle. Eur Respir J 2016; 48: Suppl. 60, 1020

Member's Comments

No comment yet.

Related content which might interest you: Audit 2014: Standard of inpatient care during exacerbation of COPD in Territory Care Hospital, Pakistan Source: International Congress 2015 – Different data in COPD Year: 2015 COPD: Home visits program after admission with an exacerbation Source: International Congress 2015 – Best abstracts in COPD management Year: 2015 Avoiding re-admissions of patients presenting with c (AECOPD) by nurse led telephone call follow up Source: International Congress 2014 – Best posters in chronic care Year: 2014 Home care in patients hospitalized for exacerbation of COPD Source: International Congress 2016 – Hospitalisation and comorbidities in chronic lung diseases Year: 2016 Does increasing the access to specialist respiratory team reduce the presentation and admission of acute asthma to hospital? Source: International Congress 2016 – Non-inflammatory assessment of airway disorders Year: 2016 Perceptions about exercise and pulmonary rehabilitation in two Arabic Gulf countries (Iraq and State of Qatar); a qualitative study in patients with chronic obstructive pulmonary disease (COPD) and their health care providers Source: International Congress 2014 – Best posters in physical activity, exercise testing and muscles Year: 2014 Recommendation of care at discharge after hospital admitted COPD exacerbation: how integrated is COPD care in Europe? Source: Annual Congress 2013 –Optimising health care for COPD across Europe Year: 2013 COPD readmissions in an urban environment: Health service factors Source: International Congress 2015 – Diagnosing and management of COPD in primary care Year: 2015 Outcomes in acute exacerbations of COPD in a UK district general hospital Source: Annual Congress 2010 - COPD exacerbation Year: 2010 Provision of care for acute COPD in UK hospitals: survey of acute NIV provision for COPD exacerbations Source: Annual Congress 2008 - Organisation of care and management of COPD Year: 2008 Integration of hospital and community COPD services including pulmonary rehabilitation can improve patient care and reduce hospital stays Source: International Congress 2016 – Latest insights into the management of chronic respiratory diseases Year: 2016 Hospital care patterns in the management of acute exacerbated chronic obstructive pulmonary disease - A retrospective analysis from Zurich, Switzerland Source: International Congress 2014 – Diagnosis and treatment of COPD in primary care Year: 2014 A disease-specific integrated care intervention (ICI) prevents hospital admission only in COPD patients with recurrent hospitalisation Source: International Congress 2014 – COPD: points to ponder Year: 2014 The impact of implementing a COPD care bundle on the delivery of care to patients admitted with an acute exacerbation of COPD Source: Annual Congress 2013 –COPD: acute exacerbations and others Year: 2013 Are acute asthma admissions preventable with improved patient education? Source: Annual Congress 2013 –Treatment and management of asthma in primary care Year: 2013 Psychological co-morbidities in patients with COPD: Which changes can be observed during inpatient pulmonary rehabilitation (PR)? Source: International Congress 2014 – Best posters in pulmonary rehabilitation 2 Year: 2014 Provision of care for acute COPD in UK hospitals: survey of early discharge schemes (EDS) and pulmonary rehabilitation (PR) Source: Annual Congress 2008 - Organisation of care and management of COPD Year: 2008 Pulmonary rehabilitation appropriateness triage in chronic respiratory diseases Source: International Congress 2016 – Latest insights into pulmonary rehabilitation Year: 2016 Audit of acute admissions of COPD: standards of care and management in the hospital setting Source: Eur Respir J 2001; 17: 343-349 Year: 2001 Patient reported experience measures of an in-patient pulmonary rehabilitation programme Source: Annual Congress 2013 –The latest insights in pulmonary rehabilitation (part 2) Year: 2013