Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
Embargo Period
5-14-2014
Degree Program
Doctor of Nursing Practice
Degree Track
Public Health Nurse Leader
Year Degree Awarded
2014
Month Degree Awarded
May
Keywords
COPD, Self-Management, Palliative Care, Dyspnea Protocol
Advisor
Jeungok Choi
DNP Project Chair
Jeungok Choi
DNP Project Member Name
Raeann Leblanc
DNP Project Outside Member Name
Elizabeth Robitaille
Abstract
Chronic Pulmonary Obstructive Disease (COPD) is a chronic and incurable disease that affects over 12 million Americans. The number of people with COPD is rising, and it is the third leading cause of death in the United States. Management and palliation of COPD symptoms has become a public health issue. The capstone project, the COPD Palliation Project, was a pilot study that combined nursing case management and patient education to provide optimal patient dyspnea palliation and self-efficacy of dyspnea management to end-stage COPD hospice patients. For the intervention, end-stage COPD patients were taught to use a dyspnea algorithm to palliate increasing levels of dyspnea, with weekly follow up for four weeks. Patient dyspnea and efficacy were the outcome measures monitored pre and post-intervention. The study findings showed that there was improvement in the percent of patients who scored in less than “2” in the modified Borg scale from 55% to 75% after the intervention. However, there was no improvement in the percent outcome of patients’ efficacy. Improvement in dyspnea scores may be attributed to use of the dyspnea protocol and follow up case management and education. The fact that patient efficacy scores did not improve can be largely attributed to the patients’ terminally ill, end-stage hospice status. Major limitations of the project were: lack of study population viability, limited time to implement the study, staff investment and patient discomfort in using morphine. Further research in combining dyspnea protocols with case management techniques in COPD dyspnea palliation is warranted.
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