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ACI COPD Audit Evidence base practice with COPD-X
By Allison Eastman, Tweed Respiratory Coordinator CNS2
The Tweed Hospital & Community Health
PH: 07 55067851 email: [email protected]
Acknowledgement
Kate Lloyd - A/Director of Acute Care, Agency of Clinical Innovation (ACI)
Cecil Barrack - Respiratory Network Manager, ACI
Liz Hay - Manager, Health Economics & Evaluation Team, ACI
Chris Ball – Program Manager, Implementation ACI
Julie Kirk – Chronic Disease Portfolio, Manager of NNSWLHD
Dr Rob Nickels – Respiratory Physician
Dr Rob Davies – Director of Emergency, Tweed Hospital
COPD definition
The Global Initiative for Chronic Obstructive Lung Disease (GOLD), a project initiated by the National Heart, Lung, and Blood Institute (NHLBI) and the World Health Organization (WHO), defines COPD as follows:
"Chronic obstructive pulmonary disease (COPD), a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Exacerbations and comorbidities contribute to the overall severity in individual patients."
Tweed Hospital Audit Data
AT
Opportunities for ImprovementWhere to from here?
Local area improvements
Appropriate use of oxygen
Spirometry for all patients at least once during hospital admission
Optimal referral to pulmonary rehabilitation
Cessation of nebulizer use at TTH, unless patient is unable to use spacer (not formed from audit but is stipulated in GOLD guidelines as best practice)
ECG for all patients within 4 hours of admission
Advance Care directive documentation
ACI support for capability development around QARS auditing
The team recommended changes to the audit and the ACI approach to analysis for reporting of outcomes and improvements
Questions?
References
GLOBAL INITATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE 2009. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease(Updated 2009).The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease 2015
The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease 2015
Thoracic Society of Australia and New Zealand OXYGEN GUIDELINES FOR ACUTE OXYGEN USE IN ADULTS “Swimming between the flags”Clinical Practice Guideline
VANFLETEREN, L. E., FRANSSEN, F. M., USZKO-LENCER, N. H., SPRUIT, M. A., CELIS, M.,GORGELS, A. P. & WOUTERS, E. F. 2011. Frequency and relevance of ischemic electrocardiographic findings in patients with chronic obstructive pulmonary disease. Am J Cardiol, 108, 1669-74.
