Understanding COPD Emergency Department presentations: using thematic analysis to explore the voices of patients, nurses, and doctors on the lived experience of managing COPD
Article
Moloney, Clint, Gow, Jeffrey, Beccaria, Gavin, Mullens, Amy, Phillips, Tania, Isaac, Hancy, King, Alex, Keijzers, Gerben, Rana, Rezwanul and Huang, Ya-Ling. 2023. "Understanding COPD Emergency Department presentations: using thematic analysis to explore the voices of patients, nurses, and doctors on the lived experience of managing COPD." Australian Journal of Advanced Nursing. 40 (1), pp. 12-20. https://doi.org/10.37464/2023.401.195
| Article Title | Understanding COPD Emergency Department presentations: using thematic analysis to explore the voices of patients, nurses, and doctors on the lived experience of managing COPD |
|---|---|
| ERA Journal ID | 14058 |
| Article Category | Article |
| Authors | Moloney, Clint, Gow, Jeffrey, Beccaria, Gavin, Mullens, Amy, Phillips, Tania, Isaac, Hancy, King, Alex, Keijzers, Gerben, Rana, Rezwanul and Huang, Ya-Ling |
| Journal Title | Australian Journal of Advanced Nursing |
| Journal Citation | 40 (1), pp. 12-20 |
| Number of Pages | 9 |
| Year | 2023 |
| Publisher | Australian Nursing and Midwifery Federation |
| Place of Publication | Australia |
| ISSN | 0813-0531 |
| 1447-4328 | |
| Digital Object Identifier (DOI) | https://doi.org/10.37464/2023.401.195 |
| Web Address (URL) | https://www.ajan.com.au/index.php/AJAN/article/view/195 |
| Abstract | Aim: To describe for areas of improvement in the management of COPD and reduction in emergency department presentations in Queensland. Background: If current trends in the management of COPD do not change, the predicted 4.5 million Australians diagnosed with COPD by 2050 will place significant burdens on already over-utilised frontline ED services. Separately COPD is more costly per case than cardiovascular disease and is a more common presentation to Emergency Departments in any year than most types of cancer, road traffic accidents and heart disease. Study Design and Methods: This study used a qualitative thematic analysis methodology in which field convergent interviews were employed to generate data. Sixteen staff and nine patients across three major Southern Queensland Health acute care facilities participated in the study. The authors analysed interview data using qualitative thematic analysis. Results: This research has revealed several noteworthy concepts worthy of further exploration. Thematic analysis from both staff and patient interviews identified the following issues: 1. Nurse case management, 2. Integrated communication of patient assessment and history data, 3. Failure in COPD management, and 4. Knowledge utilisation among ED clinicians. Inherent among these key concepts is a primary goal of coordinated congruent COPD management that optimise a patient’s functional status and quality of life, improving symptoms management, and avoiding recurrent exacerbations. Discussion: These insights into the experience of patients and hospital staff into the management of COPD provides valuable insight into current and desired practices that can help to minimise presentations to Emergency Departments. The findings of the research provide insights and future direction for improvements by addressing the inconsistency in disease management. The need for more accessible and consistent patient management and a more congruent centralised patient support framework was also identified. Conclusion: There is indication of support stemming from the voices of patients and hospital staff around the need for COPD case management to become the dominant method of care. Future research should consider the cost benefit and patient outcomes of the implementation of such a role and the avoidance of ED presentations. Implications for research, policy, and practice: The findings of this research imply a need to streamline the patient support and disease management discharged planning process by ensuring one health professional maintains ongoing education, support, and assessment to the patient. Future research needs to better ascertain the positive economic benefits to healthcare organisations by employing Case Managers for patients with COPD. What is already known about the topic? • Case management roles can be effective in reducing ED usage for adults with chronic illnesses. • The World Health Organization (WHO) has called for planned ongoing assessment, care and support coordinated by a proactive investment in real time solutions that address the increasing burden of this disease on the healthcare sector. • The WHO has endorsed targeted patient support strategies that coordinate care over time, addressing the physical and mental health needs of people with chronic illness. What this paper adds: • Findings from this research show that discharged planning support practices with Southern Queensland Healthcare Organisations require review and ongoing evaluation. • This may include, streamlining the patient support and disease management discharged planning; or designated case management or integration of systems to prevent ED presentations. • This research adds to the voices of patients and staff that confirm published research recommendations. |
| Keywords | Chronic Obstructive Pulmonary Disease; Emergency Department; Discharge Planning |
| Related Output | |
| Is supplemented by | Corrigendum to "Understanding COPD Emergency Department presentations: using thematic analysis to explore the voices of patients, nurses, and doctors on the lived experience of managing COPD '' [Australian Journal of Advanced Nursing, volume 40, issue 1 |
| Contains Sensitive Content | Does not contain sensitive content |
| ANZSRC Field of Research 2020 | 420501. Acute care |
| Public Notes | Files associated with this item cannot be displayed due to copyright restrictions, but may be accessed online. Please see the link in the URL field. |
This article has been corrected. Please see the Related Output. | |
| Byline Affiliations | School of Nursing and Midwifery |
| Centre for Health Research | |
| University of KwaZulu-Natal, South Africa | |
| School of Commerce | |
| School of Psychology and Wellbeing | |
| University of Queensland | |
| Gold Coast Hospital and Health Service, Australia | |
| Bond University | |
| Griffith University | |
| Macquarie University | |
| Southern Cross University |
Permalink -
https://research.usq.edu.au/item/z266q/understanding-copd-emergency-department-presentations-using-thematic-analysis-to-explore-the-voices-of-patients-nurses-and-doctors-on-the-lived-experience-of-managing-copd
208
total views2
total downloads5
views this month0
downloads this month