The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Louis M. Kaufman, Ann P. Smith; Roberts Home Medical, Inc., Germantown, MD

Background: Nationwide, 22.6% of chronic obstructive pulmonary disease (COPD) patients require re-hospitalization within 30 days of discharge. Beginning in October 2012 hospitals could incur financial penalties for high readmission rates. The purpose of this study was to assess the effectiveness of a respiratory therapist education program on 30 day hospital readmission rates for COPD patients. Method: A retrospective chart review was conducted of 133 consecutive patients with a primary or secondary hospital discharge diagnosis of COPD, who were prescribed either oxygen or a nebulizer, and who were enrolled in the Roberts Home Medical, Inc. COPD education program. The study group included 84 females and 49 males with a mean age of 74 (range 48 to 100). Patients received a respiratory therapist home visit within 3 days of discharge and additional visits one week and one month after the initial visit. During each visit the respiratory therapist performed a clinical evaluation, provided instruction in the use of the medical equipment, and provided information on COPD and management of this disease including breathing exercises and proper nutrition. The respiratory therapist ensured prescriptions were filled and follow-up physician appointments made, reconciled medications, and provided instruction on the proper use of metered dose inhaler, dry powder inhaler, and/or nebulizer. Patients with portable oxygen were evaluated for use of intermittent oxygen flow and, if appropriate, a specific oxygen conserving device was titrated to provide oxygen saturations >/= 90% at rest and with exertion. If indicated, additional information was provided on smoking cessation, immunizations, and pulmonary rehabilitation. Results: The 30 day study was completed by 128 patients; two patients expired, two patients transferred to hospice, and one refused follow-up visits. During the 30 day period after initial discharge seven patients (5.5%) were re-admitted to the hospital for COPD or other diagnoses. Conclusions: In this sample of COPD patients the post-discharge hospital readmission rate was 5.5% compared to the national average of 22.6%. The data supports that this three visit education program delivered by respiratory therapists was effective in decreasing 30 day hospital readmission rates for COPD patients.
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