Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-11-2019

Graduate Advisor

Allison Brauch, DNP APRN, NP-C, PMHNBC, CARN-AP

Committee

Natalie Murphy PhD, APRN, FNP-BC

Jeanette Holtmeyer, MSN, RN, CIC

Abstract

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing education-based program for Chronic Obstructive Pulmonary Disease (COPD) and its effect on 30-day readmission rates in one hospital in rural Missouri.

Method: A retrospective chart review was completed on 493 patients with an inclusive diagnosis of COPD from June 1, 2018, to March 31, 2019, using a cohort study design and a two-sample t-test analysis. Additional variables were analyzed to determine if there were predictive factors of an elevated risk of readmission.

Results: The two-sample t-test reveals there is no statistically significant difference between the rates of readmission for patients who participated in the COPD education program (n=9, 12.33%) when compared to the rates of readmission of patients who did not participate in the program (n=59, 14.08%) (t=-0.3996, df=490, p-value=0.6896) (See Appendices A-D, Figures A1-D1).

Conclusion: Although primary outcomes data found no statistically significant difference in readmission rates for patients who did and did not participate in the COPD education program, other variables such as smoking, patients’ motivation for participation, socioeconomic status and timing of the data collection may have been factors in the outcome of the study. These variables may have influenced who participated and how they utilized the information they received from the program. Also, the addition of pulmonary rehabilitation to the existing COPD education program should be considered as evidence suggests it improves outcomes of patients with COPD (GOLD, 2018).

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