Optimizing care of your patients with COPD

Abstract

Chronic obstructive pulmonary disease (COPD) is now the third-leading cause of death in the US. The primary risk factor for COPD is smoking. COPD is underdiagnosed, and spirometry, the main method for its diagnosis, is underutilized. Nurses can play an essential role in improving patient outcomes, in part by helping to apply clinical guidelines for care. Management of COPD consists of reduction of risk factor exposure (for example, smoking cessation), influenza vaccination, pharmacotherapy, and pulmonary rehabilitation. Comorbidities may pose a special challenge in patients with COPD and they may compete with COPD for attention during office visits. Of particular note with regard to pharmacotherapy is the choice of delivery system. Handheld inhalers form the mainstay of treatment of COPD; however, some patients have difficulty using inhalers because of an inability to generate sufficient inspiratory flow, impaired manual dexterity, or cognitive impairment that leads to difficulties in following instructions concerning how to use the inhaler. In such patients, nebulization may be an effective alternative. In this review, we provide a list of best practices that can assist nurses in the optimal care of patients with COPD.