Chronic Obstructive Pulmonary Disease (COPD)

For this Part One of your Project, write a paper in APA format and address:
COPD is the targeted disease and population for the topic of this paper.
Present the scope of this issue in the general population and on the health care system.
Why there should there be a formal case management program.
Potential benefits to implementing a systematic case management plan (economics, quality
of life/care, social disruption, etc.).
Why nursing should coordinate this plan of care.
The other team members–who should be included and why

Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease has been defined by the Global Initiative for Chronic and
Obstructive lung Disease (Vestbo, 2013) as:

a common preventable and treatable disease, is characterized by persistent airflow
limitation that is usually progressive and associated with an enhanced chronic
inflammatory response in the airways and the lungs to noxious particles or gases.
Exacerbations and comorbidities contribute to the overall severity in individual patients

It is associated with either chronic bronchitis (with bacterial infection and more sputum
produced) or emphysema (lung damage & hyperinflation). Its main cause is smoking (20-25% of
those who smoke more than 20 cigarettes for at least 10 years develop COPD. Other factors are
massive air pollution and genetic link.

COPD diagnosis is rarely among those under 35 years old, accompanied with increasing
shortness of breath, productive cough, and confirmed with spirometry. In spirometry, airway
obstruction of FEVi/FVC <0.7 occurs; this limits the amount of air inspired. Exacerbation is a


mark of an advanced COPD, and requires immediate intervention. Increase in difficult breathing
is characteristically ongoing through months and years. Xray (hyperinflation), FBC and
oxymetry (<92%) further confirms the diagnosis (Bourne, 2012).

Managing COPD involves a holistic approach. Stopping Cigarette smoking has been shown to be
helpful. If enhances quality of life and reduces both hospital admissions and advancement of the
condition. Other modalities include oxygen therapy and use of drugs (bronchodilators,
theophyllines and mucolytics) for managing breathlessness; involving in exercise, pulmonary
rehabilitation, and antibiotics. Use of inhalant steroids prevent execrations. Surgery is sometimes
applicable for lung damage in advanced COPD. Palliative/ hospice care is indicated for advanced
stage as well (Vestbo, 2013).
COPD in the scope of the general population and on the health care system
COPD’s impact is significant. Not only is it the fourth greatest killer (Bourne, 2012), it was
estimated to have affected 329 million people (4.8% of total population) globally. Compared to
2004 tally, which was 64 million people, that was a notable rise in prevalence. More men than
women are affected.
In terms of cost, COPD is responsible for 6% of Europe’s health care expenditure- that is about
38.6 billion Euros. In the US, about 50 billion is pumped into the condition, most of it for
exacerbation management.
COPD comes with a social burden. It is estimated that it will be the 7 th greatest cause for DALYs
(Disability Adjusted Life year- the amount of years lost due to premature death of disability) by
2030 (Vestbo, 2013).


Why there should there be a formal nurse case management program
COPD patients require follow up care. Since it’s a chronic condition, case management works
well as it facilitates concentrated effort of the registered nurse for optimal outcome in the long
This program will streamline the case management of the COPD patients. It provides a clear
guideline on management along a continuum, promotes teamwork & co ordination, allows for
proper resource allocation and facilitate effective follow up.
Potential benefits to implementing a systematic case management plan.
Systematic case management has the benefit of resource efficiency. Planned and well co-
ordinate material purchase is distributed according to the areas with need, thus avoiding wastage.
Quality of health care is improved; manpower (that is, healthcare workers) is appropriately
allotted to specific clients/ patients in the long run. This ensures continuity of care. A systemic
case management plan integrates the involvement of other healthcare worker as part of the team.
Their multidisciplinary contribution to a case of interest brings out better way of managing the
Why nursing should coordinate this plan of care
The primary nurse is involved intricately in the patient’s life professionally. Though the social
workers are also involved alongside the nurse in meeting the needs of the patient, the case study
nurse mainly forms the link between the patient and the health care system. The doctor
diagnoses, prescribes and demonstrates the use of inhaler, for example, but it’s the nurse who
through her various roles (‘advocate,’ counselor, educator, etc), as well as implement the follow
up and education over the long term.


The other team members–who should be included and why
Other members need to be part of this tem, because comprehensive care will only be complete
with their positive contribution. The patient- because he is the key personality. He needs to feel
like part of the team for him to co operate. The social worker- he identifies and acts on any social
related issue that affects the patient’s health. The physician- his role in diagnosis and treatment is
crucial. The nurse- co-ordinates and is intricately involved in holistic care of patient.


Bourne, S. (2012). Clinical Review Copd. Gp, 19-21.

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