Improving Assessment and Management of COPD

Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the United States. In 2014 approximately 142,000 individuals in the U.S. died from COPD (Office of Disease Prevention & Health Promotion, Healthy People 2020). The Global Obstructive Lung Disease Initiative (GOLD) (2019) provides evidence-based practice (EBP) guidelines for diagnosing, managing, and treating Chronic Obstructive Pulmonary Disease (COPD). This Doctor of Nursing Practice (DNP) quality improvement project used best practice recommended by GOLD (2019) to improve assessment of COPD by use of the Chronic Obstructive Pulmonary Disease Assessment Test (CAT). The implementation process for using the CAT was guided by a conceptual framework called the Transtheoretical Model (TTM) (Prochaska & DiClemente, 1983; Prochaska, DiClemente, & Norcross, 1992) to initiate change. The underlying philosophical foundation for this project was from Nursing as Caring (NAC) envisioned by Boykin and Schoenhofer (1993). The use of the CAT Score recognized the experience of symptoms by COPD patients and then allowed providers to follow GOLD (2019) guidelines and enabled best practice in the management of pharmacotherapy for COPD patients. 174 patients who had a diagnosis of COPD at a pulmonary practice were administered that CAT before an office visit over three months. The use of the CAT for patients with COPD demonstrated that the board-certified pulmonologists at a pulmonary practice adhered to GOLD (2019) guidelines in their plans of care for patients with COPD. Given the CAT measures eight quality of life items related to COPD, the CAT result allowed providers to follow the evidencebased practice (EBP) found in GOLD (2019) and to demonstrate NAC.