ประสิทธิผลของการใช้แนวปฏิบัติทางคลินิกสำหรับการวางแผนจำหน่ายในผู้สูงอายุที่เป็นโรคปอดอุดกั้นเรื้อรังโรงพยาบาลดอยหล่อ จังหวัดเชียงใหม่

Abstract

who were hospitalized with COPD at these hospitals during March to June 2014. The study instruments included the discharge planning clinical practice guidelines for older persons with COPD, dyspnea scale, six minute walk test recording form and satisfaction questionnaires for older persons and health care providers. The data on satisfaction were analyzed using descriptive statistics. The data on the proportion of older persons with COPD with different levels of dyspnea and functional capacity between implementation and non-implementation groups were compared using Fisher exact probability test, and the proportion of older persons with COPD readmitted within 28 days between implementation and non-implementation groups were compared using Z-test.

The results of this study revealed that: 1. After implementation of the discharge planning clinical practice guidelines, the proportion of older persons with COPD with different levels of dyspnea in the implementation group was statistically lower than the proportion in the non-implementation group at a significant level of p < .01. 2. After implementation of the discharge planning clinical practice guidelines, the proportion of older persons with COPD with different levels of functional status of the implementing group was statistically higher than the proportion of older persons with COPD in the non-implementation group at a significant level of p < .001. 3. After implementation, a smaller proportion of older persons in the implementation group were readmitted within 28 days as compared with the non-implementation group, but this difference was not statistically significant. 4. Most older persons in the implementation group had high levels of satisfaction for care received with regards to the exacerbation (60.84%), stable (82.61%), and discharge phases (95.66%). 5. Health care providers had high levels of satisfaction with implementing the discharge planning clinical practice guidelines with regards to the exacerbation (58.14%), stable (86.05%), and discharge (93.02%) phases. Study findings demonstrate that implementing discharge planning clinical practice guidelines for older persons with COPD can be effective in decreasing dyspnea, increasing functional capacity, and decreasing readmission rates for older persons with COPD . Therefore, discharge planning clinical practice guidelines should be used to improve the quality of care for elderly persons with COPD.