Synthesis of nursing roles in developing COPD clinic service systems in community hospitals : A review based on the COPD Service Plan framework

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a major public health problem in Thailand. The morbidity and mortality rates are increasing continuously, affecting patients' quality of life and burdening the healthcare system. The Ministry of Public Health has therefore established the COPD Service Plan as a guideline for the systematic development of the healthcare system. It has five main goals: reducing mortality, reducing hospital readmissions, improving patient quality of life, developing healthcare network, and developing personnel potential. This article aims to review and synthesize the role of nurses in developing the COPD clinic service system in community hospitals using the 3P framework: Purpose, Process, and Performance. The review results indicate that the role of nurses in the care process for COPD patients is at the heart of clinic operations. It consists of patient assessment and screening using standardized tools to classify disease severity; planning for continuous care and follow-up by applying case management and home visit concepts; pulmonary rehabilitation and health behavior promotion to increase respiratory efficiency; coordinating the healthcare network between community hospitals, subdistrict health promoting hospitals, and communities to ensure continuity of care; and developing the service system and personnel potential through training, development of clinical practice guidelines, and evaluation of nursing service quality. These processes are directly linked to the outcome of the COPD Service Plan, which is reducing mortality. Reduce hospital readmissions and improve patient quality of life. Policy recommendations from the review indicate the need to support resources, tools, information systems, and develop the competencies of nurses to have expertise in respiratory diseases in order to be able to drive the operation of chronic obstructive pulmonary disease clinics in community hospitals effectively, comprehensively, and sustainably, in line with the policy of developing the health service system of Thailand.