Quality of care of patients with chronic obstructive pulmonary disease provided by specialized community nurses: a process evaluation

Abstract

An ageing population, shorter periods of hospitalization, and advances in medical technology have meant that community nurses have become increasingly confronted with patients demanding skilled and specialized nursing care. The quality of care provided by 47 general and eight specialized community nurses was studied in a group of 115 patients with severe chronic obstructive pulmonary disease (COPD) after discharge from hospital. Four process variables were studied: the content of the home visit, the time spent on the home visit, the quality of the report, and the number of home visits. Results show that the content of the home visit differed between general and specialized community nurses. General nurses were more focused on analysing care needs and specialized nurses paid more attention to psycho-social problems. The number of home visits and the time spent on the care provided did not differ significantly between both groups. The quality of the report of specialized nurses was significantly higher. In conclusion, specialized community nurses demonstrated a higher clinical competence in the care of patients with COPD. Further research is required to conclude whether positive changes in nursing process result in positive patient outcomes.

Nursing care in the chronic phase of COPD: a call for innovative disciplinary research

“…2006). Finally, there were studies on the impact of specialisation and the role of respiratory nurses in relation to patients’ outcomes (Ketelaars et al. 1996, 1998, Steinel & Madigan 2003, Coultas et al.…”

“…Main content of services were health assessment, teaching patients about the disease, disease management, breathing technique and medications, advice on activities of daily living (ADL), adoption of a healthy life style (e.g. smoking cessation), symptom identification, management of exacerbations, information on service referrals and availability of telephone contact with health professionals (Ketelaars et al. 1996, 1998, Smith et al.…”

“…Duration of services was from being unspecified (Ketelaars et al. 1996, 1998) to 3 months (Hermiz et al.…”

“…1999, Steinel & Madigan 2003). The frequency of home visits varied from a total of 1–2 visits (Ketelaars et al. 1996, 1998, Hermiz et al.…”

“…Training of nurses for the role in respiratory nurse clinics has been given some attention (Ketelaars et al. 1996, Steinel & Madigan 2003, Coultas et al.…”