Pulmonary Rehabilitation Programs to Patients Suffering from COPD

This article discusses the benefits of pulmonary rehabilitation programs for patients suffering from COPD or breathlessness. It also covers the Health Independence Program at St Vincent's Hospital and the Clinical Practice Guidelines for managing pneumonia. The article provides recommendations for optimal care and treatment of the disease.

Running head: PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM
COPD 1
Pulmonary Rehabilitation Programs to Patients Suffering from COPD
Student’s name
Institutional Affiliation

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 2
Pulmonary Rehabilitation Programs to Patients Suffering from COPD or Patients
Suffering from Breathlessness
1) Background
I worked at the Hospital of St Vincent for my research project. The Hospital of St Vincent’s
remains one of the most reputable tertiary organizations of healthcare in all of Australia. The
facility provides patients services including emergency and critical services, acute medical
services, and diagnostics. Other services include residential care, aged care, allied health, and
rehabilitation. The Department of Health and Human Services introduced the Health
Independence Program in 2008 to bring together the four services, which were previously
performed separately. The services included Residential in Reach under common guidelines,
Hospital Admission Risk Program, Post-Acute Care, and Sub-acute Ambulatory Care. The
primary intention of the HIP is the delivery of improved outcomes for the clients and the team of
support to the healthcare facility for proper management and flow of work. The hospital aims to
deliver coordinated and integrated care to the clients across all hospital settings together with the
community interface. It aims to reduce duplication and fragmentation of services and to ensure
client centered planning of care. The project sees the coming together of clinically discrete and
separate teams offering many home, community, and center based rehabilitation and support.
They offer support to clients and their families of care, with chronic diseases, psychosocial issues
and other complex issues.
Various ways can be employed in the prevention of Pneumonia. One of the primary ways is
through proper vaccination. One is expected to get a flu shot every year to prevent them from
acquiring influenza. Flu is one of the main causes of the disease and therefore preventing flu
infection is the best way to prevent pneumonia. Children under the age of 5 years and senior

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 3
adults more than 65 years are supposed to vaccination against Pneumococcal pneumonia. It is
also recommended that children and adults who have the risk of developing other infections take
the vaccine. Every patient needs to find out from their physicians the kind of treatment correct
for them. Various other infections can be used in the prevention of Pneumonia and other
infections including chicken pox, measles, and pertussis. Proper hygiene practices like the
washing of hands after visiting the toilet are essential in keeping the disease at bay.
greater bearing and effect on smokers’ bodies. The disease normally follows and manifests like
normal flu infections (Boyle, 2017). Patients need to be keen on it as they might think it is
normal flu infection when it is in fact Pneumonia.
The guidelines made through the collaboration of the Australian government departments
and the Australian agencies charged with medical services developed the mechanisms most
especially for the Australians and the US, however largely they are meant to serve internationally
among diabetic patients (McGonigle & Mastrian, 2012). In congruence with the service opinion,
the guideline has until now been a helpful resource for nurses and doctors caring for people with
Pneumonia. Due to the extreme sensitivity of the issue at hand and the rate of need for such a
course, there were several mechanisms put into place to ensure the smooth running and the
eventual success of the of the medical practice guidelines (Merrifield, 2016). The need for
adequate expertise saw the increase and expansion of the expert committee to about 120 heath
care professionals and specialists who volunteered from various health sectors across Australia
and the US (Mukasa, 2015). The move was aimed at bringing additional expertise from a broad
scope of medical practice settings so that the issue could be understood from the various angles
to provide the easiest way to the solutions (Rogowski et al., 2013). There was another addition to

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 4
the committee to include the people suffering from the said disease so that their views and
preferences regarding the necessary recommendations are taken into consideration.
One of the conditions associated with the infections is pneumonia. The paper hence
examines the role of prevention bundles. Regular exercises, well-balanced diet, and plenty of rest
are essential in keeping the body’s immune system intact (Freser et al., 2017). A drug in the
series of Synagis is usually developed and given to children below one year to help their fragile
immune system. Access to antibiotic and vaccines is the main factor that determines the rate of
child mortality in developing countries (Lakea et al., 2017). Some children die due to lack of
access to proper sanitary towels. Sanitary towels have become a convenient way of maintaining
proper hygiene for the girl child (Hertel, 2016). Pneumonia infection may come about as a
component or may come as a section of a larger infection for example HIV/AIDS. Acquiring
HIV positive weakens one’s immune system.
The project undertaken displays the current pathways and services provided by the St
Vincent’s Hospital Melbourne for a program called pulmonary rehabilitation as a part of their
health Independence Program (Khan et al., 2017). Pulmonary rehabilitation is an intervention
and comprehensive program for the people suffering with chronic lung diseases who usually
suffer from the symptoms of breathlessness. Parasites, fungi, and bacteria are the most common
forms of Pneumonia infection (Grant, 2016). The age of the patient may be helpful in developing
a hypothesis for the sake of variation on diagnostics. Different stages of the infection require a
different approach for treatment and diagnosis. Research speaks of conditions acquired through
the hospital environment (Brown et al., 2014). Health care facilities like hospitals face the
challenge of having to offer their services to many patients. A focus on the number of patients at
the same time compromises the quality of health care services output.

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 5
2) AIMS
The primary aims of the activity was to create or design a visual service mapping poster by
gathering information on various services provided to the respiratory patients by the hospital. As
per the research that I have done, both quantitative and qualitative studies worldwide report poor
patient engagement. The main reasons for the low patient acceptance include lack of perceived
benefit from attending the program, unaware of the program benefits, uncertain and challenging
referral process, uncertainty of whose role it is to refer, and difficulties in access of the program
(Freser et al., 2017). Pneumonia being a global disease-affecting people of different calibers,
races, and ethnicities, it would have been much easier to assume that there is an international
participation in the strategies aimed at controlling it (Grant, 2016). However, in the real situation
and ideological framework of bringing up the clinical practice guideline to help in controlling
and managing Pneumonia, just a few organizations had been involved (Khan et al., 2017).
Pneumonia who horrors have been advancing every five years since 1992 has seen many health
practitioners and clinical organizations worried about the appropriate course to take in attempts
to curb its spread, effects, and advancement into other more severe stages (Hertel, 2016). The
Clinical and Scientific Section (C&SS) of the Australian Pneumonia Association is one key
organization that has put its feet onto this course.
3) Methods
Pulmonary Rehabilitation and Breathlessness
Pulmonary Rehabilitation for people affected with breathlessness remains one of the most
rewarding aspects of physiotherapy. However, it remains one of the most neglected facets of the
study. The study is rewarding for the way it provides real improvement and relief for people
entangled in a web of inactivity, helplessness, and low self-esteem. Various scholars complete

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 6
studies about the same issue of health care and health management. The aspect of neglect accrues
from the belief that patients have reached a dead end in their lives and nothing can save them.
Physiotherapists may at times feel helpless when they encounter people who prove to be overly
breathless. Pulmonary rehabilitation helps the patients in reduction of the respiratory symptoms,
increases exercise tolerance, improves their quality of life, and ensure long-term commitment to
physical activity (Apisarnthanarak et al., 2017). Therefore, this poster as per my understanding
acts as a tool in increasing the awareness on pulmonary rehabilitation and thereby increasing the
program uptake. The standard differential diagnosis for adults that present with lower leg edema
is venous disease, adverse reaction to surgery of the ipsilateral limb, lipedema, and lymphedema
(Wallace, 2013). The condition can be confirmed using lymphoscintigram, El-Hara, ultrasound,
or magnetic resonance imaging. Causes of the disease include low levels of albumin, allergic
reactions, obstruction of flow, and critical illnesses. Treatment of edema entails the treatment of
its underlying cause. For examples, allergens can be used in the treatment of allergies as a way of
treating edema (Takahiro Kamada et al., 2017). Edema caused by a block of fluid blockage can
be handled by making the fluid to start flowing again. The treatment of blood clots in the legs
takes the form of use of blood thinners, which streamline the flow of blood. The treatment of
blood tumors blocking the flow of blood takes the way of shrinking the tumor or removing it by
the use of surgery, radiation, or chemotherapy.
The disease has its ultimate origin from the improper functionality of the pancreatic gland
that is charged with the responsibility of producing insulin to help regulate the amounts and rates
of blood sugar in the body system. For a long time the diseases had been assumed to be cut out
for the older people (Boey & Kiss, 2017). However, this narrative has seemed to change with the
disease now known to be present even among children as young as five years of age. The

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 7
condition is very much accustomed with specific symptoms such as frequent urination, increased
rate, and intensity of thirst and most of all the growing rate of hunger among the casualties
(Boyle, 2017). The disease can grow into an acute stage thus causing massive complication if not
treated in time. Using Clinical Practice Guidelines (CPGs) which involves evidence-based
documents that help in facilitating the use of evidence in daily emerging nursing issues, a better
strategy has thereby been proposed to help fight Pneumonia. The facilitation that has received
immense support from the Australian Pneumonia Association has so far been hailed as a
promising front in the management of Pneumonia (Brown et al., 2014). Through the clinical
practice guideline, it is established that there can be an improved diagnosis, prognosis, and
therapeutic recommendation for the care of individual suffering from Pneumonia.
Despite Pneumonia being a common disease among people of all ages and occupations it
is unique in the sense that every patient requires a type care that is consistent with their type of
disease and responds to different care and medication. Gone is the age when the disease was
considered a reserve of the old and obese (Younga et al., 2017). Thanks to new technology and
an enhancement in research about the disease, however, optimal care for Pneumonia is possible.
The following policy looks at the steps that are taken to take care of Pneumonia patients. The
research draws a parallel between the types of Pneumonia and their care, defining in retrospect
the aspect of optimal care for the disease as well as on-going research in Australia and America
about ways of managing the disease better (Battié, 2013). The essay examines the roles of the
different stakeholders in the care and treatment of Pneumonia as well as develops
recommendations for contributions to be made to better the care and treatment of the disease.
Pneumonia is a metabolic disease that associated with high level of sugar in the blood over a
prolonged period.

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 8
Because of the shortness of breath, they find it very difficult to do daily activities such as
walking, cleaning even showering, and dressing (Apisarnthanarak et al., 2017). The research that
I have done shows that the pulmonary rehabilitation program help these people breathe easier by
improving their exercise tolerance and help them in improving quality of life by increasing their
knowledge about their disease and ways to manage it (Battié, 2013). One ought to wash their
hands after blowing their nose, before preparing or eating food and after coming out of the toilet.
Smokers are at greater risk of developing the disease as Tobacco makes the lungs weak and
makes them unable to fight off any kinds of infections (Boey & Kiss, 2017). Smokers are one of
the high-risk groups of people who are considered for the vaccine against Pneumonia as a
preventive measure. Smokers should take the vaccination because the disease is likely to have
RESULTS
Based on the results of the research I designed a poster, which can be helpful for people
with the condition. Health independence program at St Vincent’s Hospital introduced this
program to deliver improved outcomes and to provide help to people suffering with respiratory
diseases. The program is offered center-based, home and at the community centers which makes
it easier for access and as a means to overcome the barriers for uptake of the program (Shekelle,
2013). Risks associated with Deep Vein Thrombosis include inheritance of a blood clotting
disorder, long periods of bed rest for instance in the event of a hospital stay or when paralyzed.
Surgery or injury and pregnancy can lead to the disease (Soones et al., 2017). The use of pills of
oral contraception or birth control and therapy for hormone replacement are two risks that can
lead to the disease. Cancer, smoking, and obesity are other reasons why people develop the
condition. People above the age of 60 are at a higher risk of contracting the disease compared to
those below the age.

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 9
The studies were as such important in developing and supporting each recommendation
of the strategies of the medical procedures. Diabetic people being diverse and heterogeneous
group regarding race, age, sex and even social status, it is necessary that the treatment measures
be made on individual patient’s capacities (Soones et al., 2017). Through the proposed
guidelines, decisions are to be made dependent on the available evidence about the condition to
be treated except in therapeutic conditions in which decisions are made depending on the
relationship between the patient and the caregiver (Souverein et al., 2017). The proposed
guideline any treatment as such must be evidence based to help outweigh the possible benefits or
harm that a process may cause. It is also recommended that under severe circumstances the
patient opinions should not be counted upon in decision making unless the situation requires the
patient's consent for a process to be commenced.
Australian Disease Control Center places the number of people affected with Pneumonia
in the Australia at an annual rate of 900,000 people. Up to 30% of all reported cased of the
condition die within the first month of diagnosis of the disease. The estimate brings the number
of people who die of the state of 100,000 people every year. The primary significance of the
matter lies in the fact that many of the patients who suffer the disease do so unaware, of what the
issue is until it is too late. The condition calls for research into how it can best be detected before
it becomes a danger to the patients’ lives. Management of the Pneumonia condition is based on a
method of the diagnostic algorithm. History of the state and physical examination of the patient
are non-specific most of the time, and this limits their values in the clinical process of
investigation. Majority of patients with Pneumonia lack the symptoms that to explain their
condition. Few clinical tests can be used to increase the probability of testing for the state.
Swellings on the legs and the things can be determined by measuring the circumference of the

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 10
thighs and the legs. Collateral superficial dilated veins and Oedema might be found on the
affected side of the leg or the thigh. The nurse should look out for tenderness on the path of the
deep veins. The inner anterior thigh experiences compression along the groin all the way to the
adductor canal.
Other patients develop the condition due to a family history of the same (Souverein et al.,
2017). Signs of the disease include rapid breath, feelings of light-headedness or fainting and
chest pain when coughing or taking a deep breath. Various complications accrue from DVT.
They include heart failure, pulmonary embolism, and Post-thrombotic syndrome. Standard tests
for ruling out DVT include Venography, D-dimer test, or an Ultrasound.
The period of pregnancy causes various significant hemodynamic and metabolic alterations in
the body. The body needs to be in a position to accommodate the growing fetus. At times, the
body might fail to adapt to the new changes, and this might lead to complications in the woman’s
health and wellbeing (Thomas A. Hooven & Polin, 2017). Complications that accrue from such
phenomenon are referred to as hypertensive pregnancy disorders. They include preeclampsia,
hypertension, preterm birth, and Gestational Pneumonia. Peripheral Artery Disease is one such
complication (Merrifield, 2016). The disease entails the blockage of blood vessels in the legs.
Physicians can save the woman’s life if the complication is detected early. Early detection
prevents the risk of acquiring a heart attack or stroke (Rogowski et al., 2013). A pregnant woman
needs all the help she can get to remain healthy especially during pregnancy.
Discussion
The main aim of the project is to display a poster on the pulmonary rehabilitation
services, which aids in increased understanding of the services provided by the hospital and in
turn helping the patients and referrers to get maximum awareness on uptake of the program.

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 11
Although it is well established that pulmonary rehabilitation has many beneficial effects, but
only very few people uptake the program and fewer complete it (McGonigle & Mastrian, 2012).
By examining the kinds of vaccines available, one can know the chances they have left.
Programs aimed at fighting Pneumonia remain underfunded despite the great threat the disease
poses (Younga et al., 2017). After the germs that cause Pneumonia enter the lungs, they fill the
lungs with fluid, and the lungs become inflated. Inflation of the lungs makes it difficult to
breathe and hence prevents oxygen from reaching the bloodstream (Virginia Saba &
McCormick, 2015). When the blood lacks enough oxygen, the body loses its ability to perform
simple functions. The type of treatment depends on the type of Pneumonia one catches.
Antibiotics are used to treat bacterial Pneumonia. Antiviral medicines are used to treat viral
Pneumonia (Speck et al., 2016). Antibiotics may also be prescribed to prevent the patient from
the risk of contracting secondary infections. Examination of the patient involves chest x-rays and
blood tests to ascertain the level of infection.
A committee of experts was appointed to help in driving the workability of the proposed
practice through a strategic plan purpose to see its assimilation into the system in its fullness and
as such, there were three-year volunteering experts from the different countries tasked with this
goal. As much as several preparations had been in the underway awaiting the implementation of
the clinical procedures, some setbacks could still be witnessed jostling the progressiveness of the
system. Cost is one significant issue still facing the full implementation of the proposed
guideline with very many health practitioners and the patients fearing the costliness of the whole
procedures. Due to the duration is taken to treat the disease or even manage its effects, health
professionals have concluded that there is a substantial cost increase in correlation with the
prevalence of the disease increase over time.

PULMONARY REHABILITATION TO PATIENTS SUFFERING FROM COPD 12
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