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Title: Improving compliance with a chronic obstructive pulmonary disease bundle of care in Australian emergency departments: a clinical network quality improvement project.
Author: Kelly, Anne-Maree
Pannifex, Jan
Issue Date: 2019
Publication Title: European Journal of Emergency Medicine.
Volume: 26
Issue: 1
Start Page: 53
End Page: 58
Abstract: Objective The aim of this study was to describe the impact of a clinical network-led quality improvement project on compliance with bundle of care elements (individually and as a ‘bundle’) for patients treated for chronic obstructive pulmonary disease exacerbations in the emergency department. Participants and methods A 9-month quality improvement project was performed by a modified knowledge transfer methodology with analysis by before and after data collection. The primary outcomes of interest were compliance with key bundle of care elements (individually and as a ‘bundle’). The analysis is descriptive. Results Seven emergency departments participated in the project. A total of 179 patients were included in the predata and 203 in the postdata. Administration of controlled oxygen therapy (if oxygen given) increased from 74 to 80% (P=nonsignificant). Administration of inhaled bronchodilators increased from 80 to 91% (P=0.004). Administration of systemic corticosteroids increased from 76 to 88% (P=0.003). Administration of antibiotics (if evidence of infection) increased from 85 to 99% (P<0.001). Analysis of a blood gas in nonmild disease increased from 82 to 91% (P=0.04) and administration of noninvasive ventilation if pH less than 7.3 increased from 53 to 81% (P=0.01). Compliance with all appropriate elements of the defined bundle of care increased from 43 to 63% (P<0.001). Conclusion A locally managed, clinical network-supported quality improvement project resulted in significant improvements in compliance with chronic obstructive pulmonary disease bundle of care elements. Includes date collected from Ballarat Health Services.
DOI: 10.1097/MEJ.0000000000000492
Internal ID Number: 01232
Health Subject: BUNDLE OF CARE
Type: Journal Article
Appears in Collections:Research Output

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