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Post hospitalization management of patients with COPD

Nursing Management (Springhouse): January 2018 - Volume 49 - Issue 1 - p 1
doi: 10.1097/01.NUMA.0000530022.11070.64
CE Connection

GENERAL PURPOSE: To provide information about a study to improve post hospitalization management of patients with COPD and reduce readmission rates. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Identify the challenges and factors related to readmission of patients with COPD. 2. Discern transition theory and how it's used to reduce readmissions.

  1. In the United States, managing patients with COPD carries an annual cost of about
  2. $500 million.
    $13.2 billion.
    $32 billion.
  3. When readmissions occur for patients with COPD, the Centers for Medicare and Medicaid Services
  4. imposes penalties on hospitals.
    holds staff accountable.
    requires follow-up documentation for each patient.
  5. Attempts to reduce the risk of COPD readmission
  6. have resulted in evidence-based strategies for patient care.
    have resulted in a dramatic reduction in readmissions since 2013.
    may involve many contributing factors unrelated to COPD.
  7. This improvement project to reduce COPD readmissions encompassed all of the following except
  8. American Medical Association guidelines.
    Canadian Thoracic Society guidelines.
    American College of Chest Physicians guidelines.
  9. The national readmission rate for COPD patients using Medicare is
  10. 20%.
    30%.
    40%.
  11. An analysis of causes for COPD readmissions in this study showed
  12. incorrect use of inhaled medications.
    inconsistent postdischarge follow-up by the transition nurse.
    lack of understanding about taking medications.
  13. Recent studies addressing reduction of COPD readmissions support
  14. the use of pulmonary rehabilitation.
    frequent visits by the home healthcare nurse.
    the use of physical and occupational therapy.
  15. Studies focusing on reduction of readmissions for patients with COPD support all of the following except
  16. self-management education.
    medication management.
    weekly calls from the transition nurse.
  17. The trajectory of a patient's adaptation to COPD
  18. is linear.
    is predictable.
    is individual and variable.
  19. Which wasn't a causative factor for readmission?
  20. psychosocial factors
    misdiagnosis and errors
    health system complexity
  21. An individualized and holistic transition should include medical intervention, emotional support, and
  22. financial planning.
    lifestyle promotion.
    psychosocial counseling.
  23. When discharged following a COPD exacerbation, patients experience role transition that changes
  24. comprehension and cognizance.
    reasoning and analytical thinking.
    behavior and definition of self.
  25. The LACE Index Scoring Tool calculates readmission risk by factoring in
  26. the patient's age.
    comorbidities.
    documentation of adherence to the medication regimen.
  27. A method used to optimally manage the transition of COPD patients was
  28. follow-up with an internist in 3 to 4 weeks postdischarge.
    referral to an occupational therapist.
    education on the use of scheduled and as-needed medications.
  29. The 2017 readmission rate using new guidelines for COPD transition management in comparison with 2016 was
  30. 8.3% lower.
    38% lower.
    unchanged.
  31. Using this quality improvement project, an important finding was
  32. a coordination gap between inpatient and outpatient services.
    lack of referral to phase two pulmonary rehabilitation.
    lack of transportation to scheduled appointments.
  33. With limited resources to treat patients with COPD, the researchers recommend
  34. using a standardized treatment protocol.
    targeting interventions to the highest-risk patients.
    delegating discharge planning responsibilities to others.
  35. A key concept from this research is that
  36. the results are easily generalizable to most large organizations.
    use of a theoretical framework was unnecessary and cumbersome.
    nurses are the key to successful case management of chronic conditions.
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