Authors (including presenting author) :
Ruth Lau KY (1), Lam WC (1), Yeung YC (1), Jessica Yik (1), Mak KM (1)
Affiliation :
(1) Department of Medicine and Geriatrics, Princess Margaret Hospital
Introduction :
Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, sputum production, exacerbations) due to abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that cause persistent, often progressive, airflow obstruction. In Hong Kong, COPD is ranked as second respiratory cause for hospitalization and inpatient bed-days. In 2016, COPD was resulting in over 30,000 hospitalizations in public hospitals. In order to reduce the burden imposed by COPD, the most important is to provide comprehensive assessment, education and training to empower patient to manage their disease in community. Princess Margaret Hospital IMSN COPD Nurse Clinic was established in 2020, our service using integrated model with patient-centered approach to empower COPD patient for self-manage of COPD to improve quality of life, prevent exacerbation leading unplanned admission.
Objectives :
COPD patients can be empowered with the required knowledge and skills for self-management of the disease through: 1: Education on disease nature, symptoms and progression 2: Training on breathing technique, symptom control and inhalation technique 4: Health education on smoking cessation and vaccination injection
Methodology :
1. Conduct comprehensive health assessment in the first visit 2. Regularly reassess patient’s respiratory status, knowledge and skill of self-management of COPD 3. Assess patient’s inhalation technique in every visit, ensure patient can use the inhaler with proper technique and accurate regime 4. Help patient to modify health lifestyle and avoid exposure in risk factor 5. Provide tailor made COPD self- management plan, instruct patient to use it as daily life guide (Figure I).
Result & Outcome :
There were 168 COPD patient were recruited to IMSN COPD nurse clinic from Apr 2021 to Mar 2022. Total 1350 attendance were achieved from Apr 2021 to Mar 2022 with 100% service deliverable target in 2022 during COVID-19 pandemic. Data was consolidated from 148 cases. Compare with the first visit, patients had significant improvement in symptom control by COPD Assessment Test (CAT) scoring from 9.11 to 8.79; ~14% improvement in Test of Adherence of Inhaler (TAI); significant improvement in inhalation technique (Figure II) and positive feedback from patient and staff on the service satisfaction survey (Figure III). There were 168 COPD patient were recruited to IMSN COPD nurse clinic from Apr 2021 to Mar 2022. Total 1350 attendance were achieved from Apr 2021 to Mar 2022 with 100% service deliverable target in 2022 during COVID-19 pandemic. Data was consolidated from 148 cases. Compare with the first visit, patients had significant improvement in symptom control by COPD Assessment Test (CAT) scoring from 9.11 to 8.79; ~14% improvement in Test of Adherence of Inhaler (TAI); significant improvement in inhalation technique (Figure II) and positive feedback from patient and staff on the service satisfaction survey (Figure III).
