Article type
Abstract
"Background and Objectives: Chronic obstructive pulmonary disease (COPD), a leading global cause of death, demands critical decisions during crises due to its unpredictable nature. Despite the Patient Right to Autonomy Act of 2015, which encourages advance directives for end-of-life care that respects patient wishes, Advance Care Planning (ACP) remains underutilized in COPD treatment. This project aimed to promote best practices for integrating advance care planning into the care of patients with COPD.
Methods: A clinical audit was conducted using the JBI Practical Application of Clinical Evidence System tool, based on seven audit criteria representing best practice recommendations for implementing ACP in COPD patients. The unit audited during the baseline was the pulmonology ward, the primary inpatient setting for these patients, but currently, ACP has not been implemented in them. Initially, a baseline audit of the pulmonology ward identified gaps between evidence-based recommendations and clinical practice. This was followed by the implementation of multiple strategies over a three-month period to address these gaps. Subsequently, a follow-up audit was carried out to assess changes in practice.
Results: In the audit of seven criteria, three had 0% compliance, two were under 30%, and two not applicable. After three months of strategy implementation, significant improvements in guideline adherence were observed. Improved criteria include ""Advance care planning is integrated into routine supportive care,"" increased from 0% to 100%; ""Trigger points for advanced care planning discussions"" increased from 0% to 80%; ""Advance care planning in an appropriate setting"" increased from 0% to 100%; ""Communication training for end-of-life discussions"" improved from 3.5% to 80%; and ""Open and honest communication"" enhanced from 17% to 80%. Additionally, it enhanced COPD patients' understanding of their disease and increased their satisfaction with the care provided by the medical team.
Conclusions: The project effectively combined COPD management with ACP, raising patient awareness of COPD and aiding in understanding future medical decisions, resulting in care plans that meet their expectations. This highlights the vital role of informed patient involvement in health outcome management.
Keywords: Chronic Obstructive Pulmonary Disease, Advance Care Planning, Advance Decision
"
Methods: A clinical audit was conducted using the JBI Practical Application of Clinical Evidence System tool, based on seven audit criteria representing best practice recommendations for implementing ACP in COPD patients. The unit audited during the baseline was the pulmonology ward, the primary inpatient setting for these patients, but currently, ACP has not been implemented in them. Initially, a baseline audit of the pulmonology ward identified gaps between evidence-based recommendations and clinical practice. This was followed by the implementation of multiple strategies over a three-month period to address these gaps. Subsequently, a follow-up audit was carried out to assess changes in practice.
Results: In the audit of seven criteria, three had 0% compliance, two were under 30%, and two not applicable. After three months of strategy implementation, significant improvements in guideline adherence were observed. Improved criteria include ""Advance care planning is integrated into routine supportive care,"" increased from 0% to 100%; ""Trigger points for advanced care planning discussions"" increased from 0% to 80%; ""Advance care planning in an appropriate setting"" increased from 0% to 100%; ""Communication training for end-of-life discussions"" improved from 3.5% to 80%; and ""Open and honest communication"" enhanced from 17% to 80%. Additionally, it enhanced COPD patients' understanding of their disease and increased their satisfaction with the care provided by the medical team.
Conclusions: The project effectively combined COPD management with ACP, raising patient awareness of COPD and aiding in understanding future medical decisions, resulting in care plans that meet their expectations. This highlights the vital role of informed patient involvement in health outcome management.
Keywords: Chronic Obstructive Pulmonary Disease, Advance Care Planning, Advance Decision
"