Home oxygen therapy assessment for COPD patients discharged from hospital: Respiratory NP model of care

Objectives: The research aim was to examine the impact of the introduction of the Chronic Respiratory Disease Nurse Practitioner (CRD NP) Model of Care (MOC) on the assessment for short term oxygen therapy (STOT), provision of care, and patient outcomes for patients discharged with oxygen therapy post an acute exacerbation of chronic obstructive pulmonary disease (COPD).

Design: A retrospective uncontrolled comparative clinical audit was conducted in two six-month periods pre (2009) and post (2011) the introduction of the CRD NP MOC.

Setting: Tertiary referral centre in central Victoria, Australia. Subjects A total of 301 patient admissions with a discharge diagnosis of COPD were examined for hypoxia at rest and on exertion prior to discharge.

Main outcome measures: The audit focused on the incidence of assessment for STOT prior to discharge, supply of STOT where indicated on discharge, and incidence of re-admission within 28 days of discharge with COPD related symptoms.

Results: A statistically significant increase in the proportion of appropriate patients assessed with arterial blood gas analysis for eligibility of STOT from 7.7% in 2009 to 45% in 2011. Provision of STOT on discharge increased from 26.7% to 44.4%. Re-admission to hospital within 28 days of discharge for patients with STOT decreased from 25% in 2009 to 12.5% in 2011.

Conclusion: Since the introduction of the CRD NP MOC there has been an increase in patient assessment for STOT, provision of STOT, reduction in hospital re-admissions, improved adherence to procedure protocols, improved patient outcomes and cost savings for the hospital.