Chronic Obstructive Pulmonary Disease’ Management

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Table of Contents

Problem Statement
Purpose Statement
Project Goals and Objectives
Project Question
Significance and Relevance to Practice
Definition of Terms
Role of the NP Student
Limitations
Summary
References

Chronic obstructive pulmonary disease (COPD) is a common lung disease characterized by progressive airflow limitations. Patients suffer from different exacerbations, including frequent cases of dyspnoea and cough. The risk of complications and poorly organized hospitalization may lead to death. COPD is the third leading cause of death around the whole globe that took more than 3 million lives in 2016 (World Health Organization, 2018).

In the United States, the situation is almost the same because of the absence of curative therapy: people die from COPD frequently in comparison to other conditions except for cancer and cardiovascular diseases (Martinez, 2016).

COPD provokes the development of such dangerous illnesses like lung cancer and ischemic heart disease. Chest tightness, a regular cough, shortness of breath, and mucus in the throat are the main signs of COPD (Global Initiative for Chronic Obstructive Lung Disease, 2017). However, patients should know that COPD is treatable, and there is a good opportunity to reduce the risks of serious complications and mortal outcomes. In this project, COPD management, treatment, and prevention will be discussed within the frames of obligatory education developed by nurse practitioners for hospital patients.

Problem Statement

People can live with COPD without even knowing about this disease but considering its sings as the symptoms of other diseases. According to the Global Initiative for Chronic Obstructive Lung Disease (2017), COPD is a mix of several small airway diseases like obstructive or chronic bronchitis and emphysema. Chronic inflammation may be developed in different ways, and these changes influence the structure of lung parenchyma and airway functions during expiration.

These problems occur because of different reasons, including genetic and environmental factors. Still, tobacco smoking remains one of the main causes of COPD in patients globally (Ospina et al., 2018). Even non-smokers but people who just exposed to tobacco smoking can be at risk of having this disease. Such irritants as occupational dust, burning fuel, and chemicals can be dangerous for people and provoke the destruction of lung elastic fibers (Bennington-Castro, 2018).

The results of these airway complications include depression, hypertension, heart and lung problems, and additional respiratory infections (Global Initiative for Chronic Obstructive Lung Disease, 2017). Ordinary people can hardly be aware of all these details, and the role of a nurse is to share this information with patients.

The main problem is the absence of a clear guide on how patients should improve their knowledge about COPD, its management, and prevention. It is possible to discover multiple care bundles and inconsistencies in clinical guidelines and decision-making (Ospina et al., 2018). The development of practices is a crucial step in communicating evidence-based hints for clinicians to make them ready to offer care and support patients (Overington et al., 2014).

The lack of guides for patients and their role in the management and prevention of COPD is the problem that has to be solved. While nurses and medical workers understand the threat of COPD development in patients, many people are still not aware of its actual threats and complications. There is a chance for people who are already diagnosed with COPD to obtain a clear plan of care and treatment for this disease. The point is to provide patients with hints on how to avoid this lung problem and improve the quality of life by removing COPD exacerbations. This capstone project is an attempt to discuss the peculiarities of education of patients on COPD treatment, including potential limitations and benefits.

Purpose Statement

Patients should have a clear guide on how to prevent or manage COPD at its early stage. The main purpose of this evidence-based project is to educate patients about COPD by improving their level of knowledge about the chosen disease’s symptoms, discussing the main preventive steps, and communicating about the risks of its exacerbations and complications. COPD is a serious chronic disease that may result in a variety of structural lung, behavioral, and emotional changes over time, and patients must be properly educated by nurse practitioners to understand how to prevent and manage this diseases under different conditions.

Project Goals and Objectives

The main goal of this project is to educate patients on management, treatment, and prevention of COPD. It is a general statement that has to be divided into several supporting objectives in order to get a clear idea of what steps should be taken at different periods. First, it is expected to give a definition to this disease and describe its signs and symptoms to develop a clinical presentation of the case. The second objective is to gather credible and comprehensive statistics about COPD.

For example, using the results of research developed by the World Health Organization and the Burden of Obstructive Lung Diseases, the Global Initiative for Chronic Obstructive Lung Disease (2017) state that people aged 40 are at higher risks of developing COPD with its prevalence more than 11% for men and approximately 8% for women. The third step is to search for available guidelines at the moment of research and report on them and make a list of recommendations. Finally, direct communication during 10-20 minutes with patients and their families for one week is an obligatory step that accomplishes the goal to improve people’s knowledge about COPD.

Project Question

In this capstone project, it is expected to answer one question: “Why should people be educated on COPD, its management, and prevention?”. In terms of this question, it is planned to focus on the clinical findings of this disease and direct participation in COPD treatment or prevention. Patients have to understand that they are the main contributors to their health and the quality of life. The question if they are ready to spend some time and receive the necessary portion of knowledge.

Significance and Relevance to Practice

The essence of education on COPD treatment and management is to identify and relieve symptoms and promote the improvement of lung function. The goal of any nurse practitioner is to improve the overall quality of life, and this practice is also relevant to the scope of the current capstone project (Bennington-Castro, 2018). It is not enough to tell patients that they have to stop smoking in order to avoid all COPD-associated complications. COPD treatment should begin with avoidance of all possible lung irritants and including of such exercises as breathing activities, muscle strengthening, and psychological counseling (Bennington-Castro, 2018).

Education to patients is significant because it is a good chance to enhance adherence to clinical practices and develop the required decision-making skills (Overington et al., 2014). Sometimes, people want to know more about the possibility of this disease in their lives and address the Internet to search for help. However, each case of COPD depends a lot on personal characteristics, the natural history, and the environment. Therefore, direct communication with an expert is the best solution for modern patients who find themselves at risk of developing COPD.

The significance of education for patients, as well as this capstone project, is the possibility to identify the steps for a nurse practitioner. It is important for a nurse to realize that he/she is the person who combines the personal qualities of a patient and choose the most appropriate strategies to manage COPD in a particular situation. Individuals should not only get a list of tasks to be followed but be provided with examples and explanations.

For example, education includes the description of breathing activities to stabilize the work of the lungs. There is the same plateau to check the correctness of lung function that has to be “measured by the forced expiratory volume in 1 second (FEV₁)” (Martinez, 2016, p. 871). Breathing for patients with COPD includes the necessity to relax neck muscles, breathe in with the mouth closed for the next two seconds, keep the air for one second, and breathe out through lips as long as possible. It is recommended to begin this activity under control of a nurse or another medical worker who can provide care in case of emergency such as unexpected dizziness or fainting.

Prophylactic breathing is not the only aspect of COPD education. A nurse is responsible for the explanation of such steps as control of medications taken by a patient, healthy eating, drinking a lot of water or other non-harmful fluids, and avoidance of dangerous environments and people (those who have the flu or other virus diseases). Vaccination and no-smoking programs can be a part of education promoted by a nurse practitioner for patients. Although it is evident that the prevention of COPD is based on smoking avoidance, some people believe that one or two cigarettes per week are not dangerous. The task of a nurse is to use any possible means and make the patient stop smoking for good.

Definition of Terms

In this capstone project, a list of specific terms has to be identified to avoid further misunderstandings or additional explanations:

Bronchodilator is a type of medication that is frequently used to relax muscles and open lungs’ airways;
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease in the lungs that is characterized by difficult breathing, obstructed airflows, cough, and mucus production;
Dyspnea is one of the major symptoms of COPD when shortness of breath is observed;
Exacerbation is a condition when symptoms of COPD get worse;
Hyperventilation is a condition when a person starts breathing frequently and fast because of anxiety or panic;
Inhaler is a device that is used by COPD patients to inhaled the necessary medications directly in the lungs (COPD Foundation, n.d.);
Nurse practitioner (NP) is a person who promotes education to patients using their personal data and external factors;
Spirometry is a part of a Pulmonary Function Test that is used to check the condition of airflow and measure the amount of air breathed forcefully (COPD Foundation, n.d.);
Sputum is mucus that is located in the lungs and coughed up with time.

Role of the NP Student

In terms of this capstone project, my goal as an NP student is to get prepared for educating patients on management and prevention of COPD. These preparations include the necessity to choose credible sources and gather verifiable information about COPD, its symptoms, prevalence, and diagnostic tools from them (Global Initiative for Chronic Obstructive Lung Disease, 2017). The second obligation that cannot be ignored is the choice of patients who have to become the participants in educational activities.

The role of a student is to study all the patients, their main medical recommendations, and histories in order to develop a correct course of actions. Finally, as a developer of the project, my task is to create a plan and follow a specific structure not to confuse participants and achieve the established goals.

As an educator for patients with COPD, my role is to provide them with support and explanations of all medical and nursing terms. It is important to listen to patients and report on their symptoms, preferences, and concerns to clarify what kind of help is required. My goal is not only to educate but to listen and recognize the areas that have to be improved. Education is a chance for patients to improve their life quality, and an educator must observe all internal and external factors of treatment and management. The consideration of personal needs and expectations is an important aspect of COPD education because patients should feel care and respect for their demands.

Limitations

Taking into consideration the goals and potential participants of the project, education of COPD management and prevention can be associated with several significant limitations. For example, education may be challenged by the impossibility to gather all information about medications taken by patients. Such noncompliance from patients may influence the results of education and the process of treating the chosen disease.

Another limitation includes the impossibility or at least a considerable challenge to change the styles of patients’ lives. Many people cannot stop smoking even if they are aware of its threats and health consequences. They like the idea of smoking and are not able to quit it even to save their lives. COPD may lead to a fatal outcome, but this reason is not enough for the majority of patients. Finally, communication with healthcare professionals defines correct therapies and treatment for patients, and this cooperation depends on their schedules and free time.

Summary

In general, COPD education is an important aspect of treatment that has to be offered to patients. This capstone project proposal contains a brief plan of actions that should be taken by an NP student to succeed in goals’ performance and educate patients. There is no need to choose just one direction and focus on its excellent completion. Education touches upon different aspects of COPD, including anti-smoking programs, healthy eating, breathing exercises, and avoidance of the dangerous environment.

Patients with COPD may have their own needs and expectations, and an educator must recognize them to make sure all recommendations and lessons are properly accepted and followed. COPD is the disease that may be developed along with other serious health problems like strokes, depression, or respiratory illnesses, and the task of an educator is to find out a common approach and define all available options for patients and their families to contribute to the development of high-quality life.

References

Bennington-Castro, J. (2018). COPD treatment and prevention. Web.

COPD Foundation. (n.d.). Glossary of COPD related terms. Web.

Global Initiative for Chronic Obstructive Lung Disease. (2017). GOLD 2017 global strategy for the diagnosis, management and prevention of COPD. Web.

Martinez, F. D. (2016). Early-life origins of chronic obstructive pulmonary disease. New England Journal of Medicine, 375(9), 871-878. Web.

Ospina, M. B., Michas, M., Deuchar, L., Leigh, R., Bhutani, M., Rowe, B. H.,… & Stickland, M. K. (2018). Development of a patient-centred, evidence-based and consensus-based discharge care bundle for patients with acute exacerbation of chronic obstructive pulmonary disease. BMJ Open Respiratory Research, 5(1), 1-9. Web.

Overington, J. D., Huang, Y. C., Abramson, M. J., Brown, J. L., Goddard, J. R., Bowman, R. V.,… & Yang, I. A. (2014). Implementing clinical guidelines for chronic obstructive pulmonary disease: Barriers and solutions. Journal of Thoracic Disease, 6(11), 1586-1596. Web.

World Health Organization. (2018). The top 10 causes of death. Web.

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