Avoiding Hospital Admission in COPD: Impact of a Specialist Nursing Team

Running head: ADULT NURSING
ADULT NURSING
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Introduction:
The assignment focuses on the evidence based practice in nursing and the purpose of the
paper is to critique a selected original research paper.
One of the most common causes of hospitalization and death in the world is Chronic
Obstructive Pulmonary Diseases or COPD (López‐Campos, Tan and Soriano 2016). The adverse
effect of the disease has become a huge threat to the health status of the population and increases
the burden of the health care industry in the population (Rice, et al. 2014). It has been found that
the prevalence of COPD in UK is 1.5% (Adeloye et al. 2015). Thus, it is important to provide
adequate focus on the acute management of COPD in an effective manner in order to reduce the
rate of hospitalization in the population, provide safety to the patient and improve the quality of
life (Naik et al. 2014). In this regards the domain 2 of National Health Service or NHS provides
effective guidelines in order to develop the quality of life (Department of health 2018). This
paper will analyse a relevant article and relate the evidence with the domain 2 of NHS. The
chosen article for the paper is Avoiding hospital admission in COPD: impact of a specialist
nursing team (Cox et al. 2017).
Discussion:
Evidence-based practice:
The evidence-based practice in nursing is considered as the interdisciplinary approach to
the nursing practice that has been introduced in the year 1992 (Hall and Roussel 2016). The
evidence-based practice refers to the use of most recent best practice recommendations in order
to take decision related to the patient care (Baker and Tickle-Degnen 2014). The evidence-based

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practice includes three basic principles. The first principle is identify the best available evidence
based on research regarding the treatment process in order to make decision whether the
treatment process is relevant for the patient or not. Clinical examination in order to identify
health condition, risk factors and benefits of the treatment for individual is the second principle.
The third principle indicates considering the preference and values of the patient regarding the
treatment process (Babcock and Thonus 2018). The process is not only for supporting the
decision making but also for using knowledge, skills and experience of health professional in
order to provide effective service to the patient considering the social support and financial
condition as well (Hamer and Collinson 2014). Such evidence-based practice is important in
order to provide effective care service that aims to develop the health condition of the patient,
improve the quality of life and achieve expected outcomes (Liamputtong 2013). Such process
helps the patient to access most effective treatment that is based on evidence (Melnyk et al.
2014). The evidence-based practice helps to promote the attitude of inquiry in nursing practice
(DiCenso, Guyatt and Ciliska 2014). Such process helps the health professionals to ensure that
the treatment process used by them is informed by the most recent evidence. The use of
evidence-based practice helps to use the health resources in an effective manner (Schmidt and
Brown 2014). Hence, evidence based practice play an important role in order to provide patient
centred care and ensure patient safety.
Rationale for choosing NHS domain 2:
The NHS domain 2 provides guidelines for enhancing the quality of life for the patient
that are affected with the long term disease conditions. The domain provides one over reaching
indicator, two guidelines related to health for improving the quality of life for the people that are
suffering from long term health conditions and six areas of improvement. The domain provides

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effective improvement areas for the condition of unplanned hospital admission in case of chronic
ambulatory care, diabetes, asthma and epilepsy. The indicators in the NHS framework reflect the
changes that are needed in order to enhance the quality of life. The domain also indicates that
implementation of principle of equality is also important in order to provide appropriate benefits
to all suffering from long term conditions. Recent trends, current practice related to the long term
condition and areas of improvement are also mentioned in the domain. Such explanation is
helpful in case of managing COPD patients as it is also a long term health condition (Rycroft et
al. 2012). The areas of improvement provided by the domain would help the health professionals
in understanding the way to improve the acute assessment process in order to reduce the rate of
hospitalization due to COPD (Department of health 2018). Thus, it can be said that the chosen
domain of NHS outcomes framework is relevant to the field of clinical practice.
Rationale of choosing the article:
Cox et al. (2017) has provided relevant information related to the use of acute assessment
in order to reduce the hospital admission due to COPD. The research has focused to the
evaluation of the safety factor and effectiveness of acute respiratory assessment by specialist
nurse in order to reduce the unnecessary hospitalization of COPD patients. According to the
study the most common cause of COPD is smoking. Among the population of 724000, the
percentage of smokers is estimated as 19.1%. Thus, increase in the rate of hospitalization due to
COPD has been found. Most of the health care organization use the guidelines provided by the
British Thoracic Society that includes admission avoidance rules (brit-thoracic.org.uk 2018).
However, it has been found that the guideline is not effective, thus the implementation of ARAS
has been recommended thus. The study has effectively obtained that the skills of respiratory
nurse specialist has been contributed effectively in acute assessment of COPD patients by using