Standards of inpatient care during Acute Exacerbation of COPD in a tertiary care hospital of Karachi, Pakistan

Saima Akhter; Sadhna Priya; Naseem Ahmed; Nadeem Rizvi

Abstract
Objective: To evaluate the quality of care of patients with acute exacerbation of COPD in our tertiary care hospital and evaluate the change in practice after educational program and recommendations.
Methodology: An initial audit from 01/12/2013 to 31/11/2014 was carried out. Standard of care was determined with inpatient mortality, length of hospital stay, accuracy of initial controlled oxygen prescription, history and clinical assessment at admission, adherence of post graduate trainees to GOLD guidelines and discharge recommendations. A re-audit was performed in July 2015 with analysis of 6 months data.
Results: A total of the 121 files were included in first audit. Though the pattern in mortality remained the same, a significant reduction in median length of hospital stay from 11 to 7 to 8 days (p=0.003) was observed. A significant improvement was seen in documentation of biomass exposure, renal failure, Anthonisen criteria, Performance status, systematic steroids, Anticoagulation (heparin), PEFR before discharge, Inhaler technique, Smoking cessation advice, vaccination advice, outpatient follow-up and oral steroid in re-audit phase of the study. Consistent practice was observed with regards to good inpatient prescription of oxygen therapy, systemic steroids and antibiotics.
Conclusion: Improvement in quality of care for AECOPD can be achieved with continuous education and monitoring of postgraduate doctors, a more systemic approach to patients, adherence to standard guidelines and intermittent audits.

Key words: COPD, AECOPD, Inpatient care.

ABOUT JOURNAL About Publisher Contact Us Editorial & Peer Review Process	POLICIES Privacy Policy Editorial Policy Author's Rights and Obligations Conflict of Interest Policy Plagiarism Policy Advertising Policy	STATEMENTS Terms of Use Author's Rights and Obligations Publication Ethics and Publication Malpractice Statement Protection of Research Participants (Statement On Human And Animal Rights) License Information

This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author. This is in accordance with the Budapest Open Access Initiative (BOAI) definition of open access. The articles in Rawal Medical Journal are open access articles licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-sa/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

Indexed in Scopus, Web of Science, WHO Index Medicus IMEMR, Emromedex, Pakmedinet, ExtraMED and Tehqeeqat

How to cite this article

	Open Access and Peer-reviewed
Home Journal Issues Guide for Authors Editorial Board Aims & Scope About Journal News & Announcements