Evidence-based Construction Of Discharge Preparation Service Program For Elderly COPD Patients And Empirical Study

Objective:To construct an evidence-based discharge preparation service program for elderly COPD patients,and to explore its effect through empirical application.Methods:The first part,based on evidence-based construction of elderly COPD patients discharge preparation service program.Systematic retrieval of domestic and foreign evidence-based evidence related to discharge preparation services for elderly COPD patients,and its quality evaluation,grading,refining and integration,formed the first draft of discharge preparation services for elderly COPD patients.Based on the FAME attribute of evidence,experts were selected to demonstrate the draft protocol in combination with the specific clinical situation of the pilot ward,and corresponding review indicators were constructed.With the review index as the evaluation standard,the status quo of evidence application in the pilot ward was investigated,obstacles to evidence application were clarified,corresponding action strategies were formulated,and the final program contents were drawn up.The second part is similar experimental research.The convenience sampling method was used to select 86 elderly COPD patients hospitalized in a class,a hospital of Bengbu City,Anhui Province from November 2020 to February 2021 as the study subjects,including November to December 2020 as the control group,and January to February 2021 as the experimental group.The control group was given routine care in respiratory medicine,and the experimental group was given discharge preparation service program intervention for elderly COPD patients.COPD Assessment Test（CAT）,BODE Index,Readiness for Hospital Discharge Scale（RHDS）,Quality Of Discharge Teaching Scale（QDTS）,Understanding COPD Questionnaire（UCOPD）and COPD related acute nursing events were assessed before intervention and 3 months after intervention,respectively,to compare the differences between the two groups.Results:1.Establish an evidence-based practice plan for discharge preparation services for elderly COPD patients.Based on evidence summary,this study formed a draft of discharge preparation service plan for elderly COPD patients,demonstrated it in the way of expert group meeting,reviewed the status quo according to the formulated 11 review indicators,summarized 10 obstacle factors,and constructed corresponding action strategies.Finally,24 items of discharge preparation service plan for elderly COPD patients were formed,including the necessity of service,service principle,service team,service content,discharge standard,quality control and effect evaluation.2.Effect evaluation after application of evidence-based practice program.The results showed that the scores of CAT,BODE,RHDS,QDTS and UCOPD in experimental group after intervention were significantly better than those before intervention,with statistical significance（P < 0.05）.The baseline data before intervention were comparable between the two groups,and there was no statistical significance（P > 0.05）.After 3 months of intervention,the scores of CAT,BODE,RHDS,QDTS and UCOPD in the experimental group were significantly better than those in the control group（P<0.05）,and the acute nursing events related to COPD in the experimental group were lower than those in the control group,with statistical significance（P<0.05）.Conclusion:1.The evidence-based construction of discharge preparation service plan for elderly COPD patients is formed based on the steps of evidence synthesis,scenario analysis and status review,and the revision process is rigorous and standardized,which can provide evidence-based reference for clinical nursing work.2.The Chinese version of UCOPD scale introduced from abroad has good reliability and validity,which can be used as a reliable tool to evaluate self-management ability of COPD patients in the cultural background of China.3.Based on evidence-based build elderly COPD patients discharged from hospital to prepare service solution the maneuverability is strong,to a certain extent,can effectively improve the quality of life and prognosis of patients,improve the quality of patients discharged from hospital readiness and discharge guidance,improve patients self management ability,reduce the patients discharged from hospital after COPD number related to acute care event occurs,to ensure the safety of patients discharged from hospital,Save social medical resources.