Evaluating a Discharge Bundle for Chronic Obstructive Pulmonary Disease

• Main Author: Jones, Sharon Scardina
• Format: Others
• Language: en
• Published: ScholarWorks 2018
• Subjects: Chronic Obstructive Pulmonary Disease; COPD; COPD Discharge Bundles; COPD Discharge Interventions; Discharge Bundles; Evidence-Based Care Bundles; Nursing
• Online Access: https://scholarworks.waldenu.edu/dissertations/4861; https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=6140&context=dissertations

Acute exacerbation of chronic obstructive pulmonary disease (COPD) is one of the leading causes of hospital readmissions within 30 days. Frequent readmissions negatively affect hospital reimbursements and patient outcomes. Creative strategies, such as COPD care bundles, have been shown to reduce readmission rates according to existing studies. A COPD discharge bundle was developed and implemented at 1 community hospital in response to an identified problem with COPD readmissions. Evaluation of this quality improvement initiative was the purpose of this project study. The practice-focused question was: Have 30-day readmission rates changed following the implementation of a COPD discharge bundle prior to transitioning from hospital to home? The framework selected for this project was the model for improvement. Sources of evidence included existing hospital data to evaluate the change in readmissions. The chi-square test of independence was used to assess the difference in frequency of 30-day readmissions. Pre and post-bundle implementation comparisons of readmission rates showed a decrease for 3 out of the 4 groups compared; these results were not statistically significant. Analysis of the post-bundle intervention groups revealed lower 30-day readmissions for individuals who were bundle compliant versus noncompliant and for those who spoke with a pharmacist within 48 hours of discharge opposed to those who did not; these results were statistically significant. Continued use of the bundle and maintaining the role of the pharmacist was recommended. Reduction of readmissions within 30-days has positive social implications for hospitals through financial gains and for the COPD population by improving overall health outcomes.