Graduation Semester and Year
Fall 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Patti Parker
Abstract
Background: Chronic obstructive pulmonary disease (COPD) exacerbations contribute to avoidable acute care use, diminished quality of life, and substantial healthcare costs. This quality improvement project evaluated an eight-week COPD exacerbation prevention bundle in a Texas internal medicine clinic.
Methods: The project included adults aged 50 years and older with a history of acute COPD exacerbation and prior hospitalization. Sixty patients comprised the specified project population. The bundle incorporated structured follow-up, use of COPD self-management and action plans, vaccination assessment and education, and individualized smoking-cessation support.
Results: Outcomes were evaluated descriptively by comparing the May 18 through July 12, 2026, implementation period with the corresponding 2025 period. Acute exacerbations decreased from 18 to 7, a 61.1% reduction. Six hospitalizations occurred in the 2025 comparison period; one hospitalization occurred during implementation and was documented as related to a fall with no evidence of COPD exacerbation. Vaccination counts improved across all five targeted vaccines, with the largest increase observed for respiratory syncytial virus vaccination, from 26 to 54 of 60 patients. Among eight baseline smokers, four reduced tobacco use by half, two began smoking cessation, and two had no change; nicotine replacement was used for two patients and bupropion for one. No scheduled visit or progress call was missed.
Conclusion: Findings supported the feasibility of a structured COPD prevention bundle and suggested clinically meaningful improvement in exacerbation-related outcomes in this practice setting.
Keywords
Chronic obstructive pulmonary disease, COPD, Acute exacerbation, Hospitalization, Quality improvement, Vaccination, Smoking cessation
Disciplines
Family Practice Nursing | Geriatric Nursing | Public Health and Community Nursing
License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Gonzalez, Sasha, "Reducing Exacerbation in Patients with Chronic Obstructive Pulmonary Disease to Decrease Hospital Admission Rates" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 31.
https://mavmatrix.uta.edu/nursing_dnpprojects2/31
Included in
Family Practice Nursing Commons, Geriatric Nursing Commons, Public Health and Community Nursing Commons