Impacto de un paquete de recomendaciones al alta tras reingreso por una exacerbación de la EPOC

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0116187#sec009

Contenidos del paquete de recomendaciones:
The care bundle recommendations are that all patients admitted with an AECOPD receive the following interventions from staff who have the appropriate competencies, most often delivered by one or more clinicians who are members of a respiratory team; 

• (1) Evidence-based smoking cessation interventions (support and pharmacotherapy) and offer of referral to smoking cessation service if a current smoker; 
• (2) Assessment for, explanation of, and referral to, a pulmonary rehabilitation programme; 
• (3) Appropriate education, written personalised information including information about patient support groups (British Lung Foundation (BLF) Breathe Easy Groups), self-management plans (for example, BLF self-management booklet), and, if appropriate, rescue packs for future exacerbations and an oxygen alert card or equivalent; 
• (4) Assessment of patient understanding and use of medications with focus on enabling effective inhaler technique; 
• (5) Leave hospital with booked review once discharged from hospital. 

Care bundles aim both to improve quality of care, and to standardise delivery, so that all of the included elements are delivered routinely.

Conclusions

The COPD discharge care bundle appeared to be associated with a reduction in readmission rate among hospitals using it. The significance of this is unclear because of changes to background trends in London and nationally.