Hübsch Christine, Clarenbach Christian F, Franzen Daniel P, Schmid-Mohler Gabriela
Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland.
Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
Int J Chron Obstruct Pulmon Dis. 2025 Jan 28;20:207-216. doi: 10.2147/COPD.S496167. eCollection 2025.
In Switzerland, while the quality of acute inpatient care for patients with AECOPD is high, a lack of post-acute care interventions has been identified. To correct this shortfall, an integrated care program for patients with AECOPD was initiated at University Hospital Zurich. The study's aim was to compare defined post-acute care intervention implementation rates before and after the new program's implementation.
A retrospective medical chart review was performed regarding patients hospitalized due to AECOPD between July 2019 and March 2023. The control group (CG) had received usual care, while the intervention group (IG) received the newly implemented program. Implementation rates were compared with Pearson's chi-squared-test or Fisher's exact test.
Charts of 107 participants (IG: 55, CG: 52) were evaluated. Implementation rates increased significantly in the IG for exacerbation management, dyspnea management, recommendation for rehabilitation, smoking cessation advice, evaluation of inhalation technique and recommendation of vaccination (p < 0.05) but not for physical activity, post-discharge medical follow-up or nutrition.
This study provides promising evidence that the introduction of a hospital-initiated integrated care program can significantly increase the implementation rate of post-acute care interventions in patients hospitalized due to AECOPD.
在瑞士,虽然慢性阻塞性肺疾病急性加重期(AECOPD)患者的急性住院治疗质量较高,但已发现缺乏急性后期护理干预措施。为弥补这一不足,苏黎世大学医院启动了一项针对AECOPD患者的综合护理计划。该研究的目的是比较新计划实施前后特定急性后期护理干预措施的实施率。
对2019年7月至2023年3月因AECOPD住院的患者进行回顾性病历审查。对照组(CG)接受常规护理,而干预组(IG)接受新实施的计划。实施率采用Pearson卡方检验或Fisher精确检验进行比较。
对107名参与者(IG:55名,CG:52名)的病历进行了评估。在IG组中,加重期管理、呼吸困难管理、康复建议、戒烟建议、吸入技术评估和疫苗接种建议的实施率显著提高(p < 0.05),但体力活动、出院后医疗随访或营养方面的实施率没有提高。
本研究提供了有前景的证据,表明引入医院发起的综合护理计划可显著提高因AECOPD住院患者的急性后期护理干预措施的实施率。