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The Effectiveness of Action Plan Implementation by Primary Care Providers on the Frequency of Preventable Acute Care Visits for Adults with COPD

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Title: The Effectiveness of Action Plan Implementation by Primary Care Providers on the Frequency of Preventable Acute Care Visits for Adults with COPD
Authors: Fried, D. Michiko
Instructor: Davis, Alice
Thornett, Tracy
Van Hoose, Diane
Keywords: Lungs--Diseases, Obstructive
Intensive care nursing
Asthma
Respiratory organs--Diseases
Medical care
show 1 moreMedical personnel
show less
Issue Date: 12 Sep 2018
Abstract: COPD is the 3rd leading cause of death in the U.S. and 4th in the world. The economic
burden of COPD in the U.S. in 2010 was almost $50 billion, which included almost $30 billion
in direct healthcare costs due primarily to hospitalizations following exacerbations. Selfmanagement
skills fostered in a patient-centered primary care setting are essential for symptom
control and the prevention or early detection of the exacerbations and complications that lead to
healthcare utilization. However, adequate self-management is difficult due to the complex
heterogeneity of COPD. Poor symptom control results in more frequent but preventable hospital
visits and an accelerated functional decline. Patients with COPD often have increased health
risks due to chronic co-morbid conditions and wide variations in clinical, functional, and
behavioral patient presentations that challenge practitioners to develop, modify, and reinforce
components of effective care plans whose success depends upon patient self-management.
This paper describes the design and implementation of BREATHE for a Better Life, a
primary care pilot program for adults focused on self-management. As a practice inquiry project
(PIP), BREATHE sought to demonstrate the effectiveness of an action plan on controlling the
symptoms of COPD or COPD with asthma to optimize daily function and quality of life. Quality
measures included the frequency of acute medical visits for respiratory complaints, spirometry
values, and COPD Assessment Test (CAT) scores tracked over a two-month implementation
period. Despite the brief nature of the intervention, results revealed gaps in care, provided
opportunities for workflow improvements, and substantiated the need to evaluate and incorporate
patients’ self-perceptions of health into a comprehensive care plan. The PIP’s supervising
physician committed to continuing BREATHE for a minimum of one year and will continue to
collect data in anticipation of significant results to support its value and sustainability.
Pages/Duration: 92
URI/DOI: http://hdl.handle.net/10790/4361
Appears in Collections:DNP Practice Inquiry Projects



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