COPD Teaching Plan and Its Contribution to Healthcare:
Nurses not only strive to restore health in sick individuals but they also seek to promote maximum health potential in healthy people. The major way through which nurses achieve this goal is through patient teaching in which these health practitioners assist patients and their families to develop effective health behaviors and lifestyles. During this process, nurses use various teaching plans including Chronic Obstructive Pulmonary Disease (COPD) teaching plan. The need for using this teaching plan is attributed to various factors such as the increase in chronic obstructive pulmonary disease in the past 25 years despite COPD cases being largely underreported or misdiagnosed. The other reason necessitating the use of this teaching plan is the fact that management of COPD is complex as patients need to make changes in their lifestyles as the take medications.
Contribution to the Future of Healthcare:
The contribution of COPD teaching plan to healthcare is that it assists patients with this lung disease to make necessary behavioral and lifestyle changes in order to enhance the quality of their health. Since COPD is the fourth leading cause of death in the United States, the teaching plan will help lessen the rates of these deaths and reduce the overall costs of healthcare expenditures. Generally, people diagnosed with the disease have comprehensive learning needs that can be addressed through an effective teaching plan. These contributions to healthcare are attributed to the fact that the teaching plan will help healthcare practitioners to improve the education they provide to patients with the condition resulting in better outcomes.
Change Model Overview:
In light of the increase in COPD cases, there is need for nurses to develop effective teaching plans that contribute to better patient outcomes. The implementation of such change requires the use of change models such as the change model proposed by Rosswurm and Larrabee in 1999. The proposed model provides guidelines for nurses to implement change through a systematic process in evidence-based practice. The change model acknowledges that the translation of research into practice needs strong basis in change theory, principles of using research, and utilization of consistent nomenclature (Pipe et. al., 2005, p.365).
Rosswurm and Larrabee’s Six Steps:
As part of the proposal to implement evidence-based nursing practice for COPD patients, the proposed change model contains six phases that nurses can use to help patients manage their condition through making necessary lifestyle and behavioral changes. These steps are geared towards demonstrating the increased need for an effective teaching plan for patients suffering from Chronic Obstructive Pulmonary disease. Generally, by implementing these steps the nursing field will make significant contributions in improving the overall health of the population in light of the challenges posed by the disease. These six steps are
Step 1- Assess the Need for Change:
Given that COPD patients have comprehensive learning needs, there is need to educate them regarding suitable ways of managing their symptoms. Currently, COPD treatment is mainly geared towards enhancing airflow obstruction through anti-inflammatory therapy and bronchodilator. However, there are numerous indications that airflow obstruction is irreversible, which makes the existing treatment measures ineffective. Moreover, there is seeming lack of impact of pharmacological interventions on the gradual decline in health status. Patient education and self-management programs have proven successful in lessening the costs of disease and enhancing lung function and quality of life when used to manage other lung conditions like asthma (Monninkhof et. al., 2003, p.394). As compared to the existing therapy, patient education through effective teaching plan is seemingly effective in dealing with COPD.
Step 2 – Link the Problem, Interventions, and Outcomes:
The Agency for Research Healthcare and Quality defines Chronic Obstructive Pulmonary Disease as a chronic lung disease that currently affects more than 16 million people in the United States (“Chronic Obstructive Pulmonary Disease Care,” n.d.). This disease damages a patient’s lungs and makes it difficult for him/her to breathe. Moreover, Chronic Obstructive Pulmonary Disease causes shortness of breath, sputum generation, and chronic cough because it closes up airsacs and airways. Since the disease cannot be cured, adequate education through COPD teaching plan provided by nurses can help patients manage their symptoms and enhance their quality of life. Some of the probable interventions include smoking cessation, oxygen therapy, medication, breathing exercises and conditioning, and nutritional assessment. These interventions will enable the patient to improve his/her quality of life and deal with complications that may arise from time to time because of the disease.
Step 3 – Synthesize Best Evidence:
People are likely to develop COPD because of exposure to risk factors like smoking, environmental triggers, probable genetic factors, and indoor pollutants (Weinhold, 2006). Despite the increase in potential risk factors, the costs associated with the management of this incurable disease are not only huge but also enormous. According to Ramani & Pickston (2010), the costs of this disease are huge while hospital admissions account for the single largest cost of caring for these patients.
Nurses continue to use ineffective treatment measures that contribute to increased costs in managing the disease. Actually, Monninkhof et. al. (2003), states that frequently used bronchodilator and anti-inflammatory therapy is ineffective because airflow obstruction is irreversible (p.394). Nonetheless, research findings indicate that home-based interventions and self-management programs have the ability to reduce hospital admissions and re-admissions, which escalate costs of managing COPD. Harris & Crawford (2008), argue that outpatient care based on nursing education is a necessity in dealing with the disease that tends to worsen over time. This kind of care is necessarily in dealing with the chronic condition because it incorporates various initiatives that deal with the potential risk factors. One of these interventions is physical activity because the disease physically weakens patients. In agreement with Scullion (2010), Moy & Matthess (2009), state that COPD patients need to make certain lifestyle changes including increased physical activity.
Step 4 — Design Practice Change:
The design for practice change to assist COPD patients to improve their quality of life will require the involvement of patients, their families, physicians, and nurses who are some of the major stakeholders. This practice change will be based on a structural approach or structured education program that demonstrate the significance of self-care methods. These self-care initiatives include smoking cessation, oxygen therapy, medication, breathing exercises and conditioning, nutritional assessment, and regular physical exercise. They will enable the patient to deal with potential risk factors that could exacerbate their conditions while taking medication.
Step 5 — Implement and Evaluate the Change in Practice:
The structured education program will be implemented as part of self-management education for COPD patients. Patients will be encouraged to implement these lifestyle changes for a period of three months after COPD diagnosis. After the three months, an assessment will be carried out to determine any cases of increase in symptoms. The results of the assessment will be compared with the baseline for other COPD patients who did not take part in the education in order to determine the effectiveness of this structured education program.
Step 6 — Integrate and Maintain Change:
Upon the determination of the effectiveness of this self-management education program, necessary improvements will be made and examined for a short period of time i.e. A month. If these improvements contribute to an overall effectiveness of the program by dealing with probable weaknesses, the program will be adopted. The health care organization will adopt this program as part of its management and treatment of patients with COPD.
Implement and Evaluation Plan:
The implementation of the education program will incorporate a series of steps that help in determining its effectiveness. First, the health facility will choose 20 patients suffering from the disease randomly and provide them with self-management education. Secondly, another group of 20 patients will be selected randomly and carefully assessed though they will not be provided with the education. Third, the families of patients under the education program will be encouraged to implement the proposed lifestyle changes while recording each of the changes that occur when implementing the stages for a period of 3 months. On the contrary, nurses and caregivers will carefully assess the other group of patients and record any changes, especially on exacerbation of the condition during the same period. Fourth, families of patients under the self-management program will present their reports to the health practitioners who will compare them with the conditions of the other group. The goal of this evaluation will be to determine the effect of the structured education on hospital admissions and readmissions, lung function, visits to emergency rooms, and days lost from work because of the disease.
Maintaining the Change:
The results of the change will be documented as well as any shortcomings or factors that hindered the effectiveness of the program. The maintenance of the change will also entail conducting more research on the effect of structured self-management education on COPD patients while further evaluations are carried out. In this case, necessary improvements to the program will be made from time to time based on the underlying issues to ensure the longevity of the approach. Patients and their families will also be encouraged to make necessary changes to the program in ways that improve its effectiveness in dealing with the disease and improving patient outcomes. To ensure that this program will still around in years to come, research findings will be documented and improved upon based on changes that occur in practice.
Conclusion:
Chronic Obstructive Pulmonary disease is a major health issue and the fourth leading cause of death in the United States because of the effect of the disease on lung function. While several treatment options have been utilized from time to time, it is increasingly evident that COPD is incurable. Based on the results of other management programs that have been used on other lung diseases, patient education is considered as an effective way of dealing with COPD. This requires an effective teaching plan whose main goal is to improve patient outcome and quality of life as they deal with complications that are likely to arise from time to time. In essence, lifestyle and behavioral changes, which are at the center of the patient education programs, help in effective management of COPD.
References:
“Chronic Obstructive Pulmonary Disease Care.” (n.d.). United Healthcare. Retrieved June 12,
2014, from https://www.uhcrivervalley.com/Health_Programs/Chronic_Obstructive_Pulmonary_Disease_Care.html
Harris, H. & Crawford, A. (2008, January 1). COPD: Help Your Patients Breathe Easier.
Retrieved June 12, 2014, from http://www.modernmedicine.com/modern-medicine/news/copd-help-your-patients-breathe-easier
Monninkhof et. al. (2003, January 17). Self-management Education for Patients with Chronic
Obstructive Pulmonary Disease: A Systematic Review. Thorax, 58(5), 394-98. Retrieved June 12, 2014, from http://thorax.bmj.com/content/58/5/394.full
Moy, M.M. & Matthess, K. (2009, March-April). Free-living physical activity in COPD:
Assessment with accelerometer and activity checklist. Journal of Rehabilitation Research & Development, 46(2), 277-291. Retrieved from http://www.questia.com.
Pipe et. al. (2005). Implementing Evidence-Based Nursing Practice. Urologic Nursing, 25(5),
365-70. Retrieved June 12, 2014, from http://www.medscape.com/viewarticle/514532_5
Ramani, A.A. & Pickston, A.A. (2010, December 1). Role of the management pathway in the care of advanced COPD patients in their own homes. Care Management Journals, 11(4),
249-261. Retrieved from http://www.questia.com.
Scullion, J. (2010). Helping Patients with Chronic Obstructive Pulmonary Disease Adhere to Regimens. Primary Health Care, 20(5), 33-39.
Weinhold, B. (2006, August). Deaths out West: The link to COPD. Environmental Health
Perspectives, 108(8), 350. Retrieved from http://www.questia.com.
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