Author Faculty (Discipline)

Nursing

Document Type

Article

Publication Date

4-19-2020

JOURNAL

ERJ Open Research

VOLUME NUMBER

6

ISSUE NUMBER

2

PAGE NUMBERS

00270-2019

ISSN

2312-0541

Embargo Period

11-3-2020

ANZSRC / FoR Code

111003 Clinical Nursing: Secondary (Acute Care)| 110203 Respiratory Diseases| 111716 Preventive Medicine

Avondale Research Centre

Lifestyle and Health Research Centre

Reportable Items (HERDC/ERA)

C1

Abstract

Objective: We aimed to assess adherence to the Australian national guideline (COPD-X) against audited practice, and to document the outcomes of patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease (COPD) at discharge and 28 days after.

Methods: A prospective clinical audit of COPD hospital admission from five tertiary care hospitals in five states of Australia was conducted. Post-discharge follow-up was conducted via telephone to assess for readmission and health status.

Results: There were 207 admissions for acute exacerbation (171 patients; mean 70.2 years old; 50.3%males). Readmission rates at 28 days were 25.4%, with one (0.6%) death during admission and eight(6.1%) post-discharge within 28 days. Concordance to the COPD-X guidance was variable; 22.7% performed spirometry, 81.1% had blood gases collected when forced expiratory volume in 1 s was <1 >L,99.5% had chest radiography performed, 95.1% were prescribed systemic corticosteroids and 95% were prescribed antibiotic therapy. There were 89.1% given oxygen therapy and 92.6% when arterial oxygen tension was <80 >mmHg; 65.6% were given ventilatory assistance when pH was

Conclusion: When compared against clinical practice guidelines, we found important gaps in management of patients admitted with COPD throughout tertiary care centres in Australia. Strategies to improve guideline uptake are needed to optimise care.

Link to publisher version (DOI)

https://doi.org/10.1183/23120541.00270-2019

Peer Review

Before publication

Comments

Used by permission: the author(s).

Copyright © European Respiratory Society 2020

Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License


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