Authors (including presenting author) :
Chan WH, Ng CH, Tang LS, Chan CT, Leung SY, Yeung NK
Affiliation :
Extended Care Unit, Lai King Building, Princess Margaret Hospital
Introduction :
According to GOLD guideline, structured COPD rehabilitation program can enhance patient’s quality of life and reduce unplanned readmission rate. From 1.1.2015- 31.12.2016, total 377 COPD patients among 308 male patient and 69 female patients were treated in extended care unit of LKB. Their average length of stay (LOS) was 17.11 and unplanned readmission rate was 34.4%. Due to the high readmission rate and long LOS, restructure COPD rehabilitation program was implemented in a male extended ward from 1st December 2017.
Objectives :
1.Enhance patient’s quality of life 2.Enhance the referral of COPD patient to rehabilitation program 3.Reduce patient ‘s length of stay in hospital 4.Reduce the readmission rate due to COPD
Methodology :
A COPD rehabilitation program was structured with multidisciplinary approach in 2017. Inclusion and exclusion criteria were set out for patient recruitment. All COPD cases to LKB from acute medicine were screened by 3 trained nurses since 1st December 2017. A comprehensive assessment such as history taking, inhalation technique assessment and spirometry would be performed by the trained nurses. Suitable patients would be referred to the program for further training. After the program training, patient will be discharged to community and follow up by CNS or Pulmonary Rehabilitation Program(PRP) day clinic.
Result & Outcome :
96 patients were screened and 37 patients were recruited to the program from 1st Dec 2017 to 30th Nov 2018. Average FEV1 (percentage predicted) increased from 38.4% to 41.3%. Although result of spirometry is not much improved on patient’s discharge, average patient’s satisfaction survey is 80%. Patients’ inhalation technique is greatly improved. Average technique score of pressurized metered dose inhaler increased from 55% to 84%, dry powder inhaler increased from 45% to 78% and soft mist inhaler increased from 51% to 86%. Improvement found on health status and exercise tolerance. The average COPD Assessment Test score decreased from 15 to 11 and six minute walk test increased from 170m to 190m. Median LOS is 8 days and unplanned readmission rate is 28%. As compared with the data in 2015- 2016, the LOS is greatly dropped from 17.11 to 8 and unplanned readmission rate was reduced by 6.4%.
Co-location with:
