Effectiveness of Implementing Clinical Practice Guidelines for Pulmonary Rehabilitation Among Persons with Chronic Obstructive Pulmonary Disease Chiang Klang Hospital, Nan Province

Abstract

This operation study aimed to examine the effectiveness of implementing clinical practice guidelines (CPGs) for pulmonary rehabilitation among persons with chronic obstructive pulmonary disease (COPD) at Chiang Klang Hospital, Nan Province from, May to September 2016. The samples composed of two groups: 33 persons in pre-implementation group and 35 persons in implementation group. The instruments consisted of: the CPGs for pulmonary rehabilitation in persons with COPD; a demographic data questionnaire; and the patient’s outcome evaluation forms, including the distance of 6-minute walk-test, the severity of dyspnea, readmission rate, and revisit rate to emergency department. Data were analyzed using descriptive statistics.

Results revealed that: the distance of the 6-minute walk test in the pre-implementation group ranged from 215 to 472 meters ( =344.36, SD=52.57). Among 19 persons who had increased the 6-minute walk distance, seven persons (36.84%) passed the criteria for minimal clinically important difference (MCID). In the implementation group, the 6-minute walk distance ranged from 243 to 508 meters ( =403.43, SD=60.67). Among the number of persons who had increased the 6-minute walk distance (n=31), 19 persons (61.29%) passed the criteria for MCID. The dyspnea intensity score in the pre- implementation group ranged from 30 to 70 ( = 51.82, SD=9.78), while in the implementation group ranged from 0 to 40 ( = 22.29, SD=5.79). Concerning the readmission rate, 9.09% of the participants in the pre-implementation group were readmitted to the hospital while in the implementation group only 2.86% were readmitted to the hospital. Concerning the revisit rate, 6.06% of the participants in the pre-implementation group revisited to the emergency department while in the implementation group, only 2.86% revisited the emergency department. The findings suggested that implementation of CPGs for pulmonary rehabilitation in persons with COPD resulted in 4 good outcomes.  Thus, the guidelines should be implemented to improve the quality of care of persons with COPD.