Occupational Therapy for Chronic Obstructive Pulmonary Disease (COPD) in an Acute Setting
Kelly Stasiulewicz, OTDS
Huntington University Doctor of Occupational Therapy Program
KEY REFERENCESAndersen, I. C., Thomsen, T. G., Bruun, P., Bødtger, U., & Hounsgaard, L. (2017). The experience of being a participant in one’s own care at discharge and at home, following a severe acute exacerbation in chronic obstructive pulmonary
disease: A longitudinal study. International Journal of Qualitative Studies on Health and Well-Being, 12, 1372994. http://doi.org/10.1080/17482631.2017.1371994
Barrecheguren, M., & Bourbeau, J. (2018). Self-management strategies in chronic obstructive pulmonary disease: A first step toward personalized medicine. Curr Opin Pulm Med, 24, 191-198.
Chan, S. C. C. (2004). Chronic obstructive pulmonary disease and engagement in occupation. American Journal of Occupational Therapy, 58, 408-415.
Nakken, N., Janssen, D. J. A., van den Bogaart, E. H. A., van Vliet, M., de Vries, G. J., Bootsma, G. P., Gronenschild, M. H. M., Delbressine, J. M. L., Muris, J. W. M., Wouters, E. F. M., & Spruit, M. A. (2017). Patient versus proxy-reported
problematic activities of daily life in patients with COPD. Respirology, 22, 307-314. http://doi.org/10.1111/resp.12915
Walker, B. A., & Breckner, H. (2016). An open-access review to determine best evidence-based practice for COPD. The Open Journal of Occupational Therapy, 4(2), 1-22. http://doi.org/10.15453/2168-6408.1199
Project Description & SitesThe purpose of this capstone project was to address the lived experience of occupational therapy
intervention for COPD patients at Riverside Methodist Hospital (RMH) in Columbus, Ohio. In acute care
settings, patients tend to have short stays, at which time occupational therapy primarily focuses on
discharge planning and interventions that address basic activities of daily living. Therefore, it is important
to address the needs of the patient to ensure patients outcomes and reduce risk of readmission following
discharge. This capstone experience consisted of direct patient care to individuals with COPD,
examination of documentation and the interprofessional approach to care and discharge, and
examination of evidence-based practice. The project was completed with the aim of improving the COPD
patient experience of occupational therapy to improve patient outcomes and compile recommendations
for care of COPD patients in an acute setting. The findings were compiled utilizing current evidence-
based practice, patient interviews, direct patient care, interprofessional observations, and medical
records to assist in improving acute care occupational therapy provision and reduce readmission rates
for those with COPD.
Area of Focus: Clinical Practice & Program and Policy Development
Sites: Riverside Methodist Hospital & Grant Medical Center
vOutcome Measure #1: Student will gain advanced knowledge in the patient’s experience of
occupational therapy in acute care.
Ø Learning Objective #1: Student will gain advanced knowledge in the COPD population through
observation/treatment of a minimum of 20 patients with COPD throughout their stay at RMH.
vOutcome Measure #2: Student will gain advanced knowledge in COPD treatment techniques and
interventions.
Ø Learning Objective #2: Student will gain advanced knowledge in evidence-based practice for COPD patients
throughout their continuum of care.
Ø Learning Objective #3: Student will examine patient IADL participation in tasks associated with risk of
readmission.
vOutcome Measure #3: Student will identify potential areas of need and risks of readmission within
patients with COPD.
Ø Learning Objective #4: Student will gather patient barriers to daily occupations during clinical practice to
determine COPD patient indicators and patterns to assist in streamlining provided services.
Ø Learning Objective #5: Student will complete a minimum of 40 hours examining the multidisciplinary team
approach to patient care.
Individuals diagnosed with chronic obstructive pulmonary disease (COPD) have been found to be at an
increased risk for hospital readmission(s) and may have particular factors contributing to readmission
and negative outcomes. The high prevalence of readmissions and the severity of the disease itself
indicates a need for healthcare professionals to improve patient care to ensure the best outcomes for
individuals diagnosed with COPD. Walker & Breckner (2016) stated “COPD is an incurable disease but
can be managed through lifestyle adaptations and modifications” (pg.1). The characteristics of COPD
including exacerbations and increased dyspnea with activity tends to lead individuals with COPD to
experience fear, loss of confidence in their ability to perform ADLs, and feelings of loneliness as a result
of the limited mobility that comes along with the disease progression (Chan, 2004; Nakken et al., 2017).
It has been found that enabling self-management is an important aspect of treatment for individuals with
chronic diseases, including COPD. According to Barrecheguren & Bourbeau (2018), “self-management
is in which patients acquire the necessary skills to manage and cope on a day-to-day basis with their
disease, assume greater responsibility for healthcare decision, adopt and maintain behaviors that
improve their wellbeing” (pg. 191).
Project Mission Statement:To identify patient needs and experiences of COPD patient intervention in the acute care setting.
Project Vision Statement:To provide patients at Riverside Methodist Hospital an enriched and effective occupational therapy
experience with the aims of improving occupational engagement and participation following discharge.
Mission & Vision Statements
Literature Review
Project Completion and Outcomes
DeliverablesvDocumentation and personal reflection of patient occupational
therapy sessions observed or completed by student at Riverside
Methodist Hospital to assist in determining patient patterns and/or
indicators for readmissions amongst the COPD population.
vCompilation of evidence-based practice of COPD patients to be
utilized by hospital occupational therapy staff and provide a quick
resource to assist in implementation of current best practice.
vReport of findings and recommendations of occupational therapy
practice in acute settings for COPD patients, including potential
COPD patient indicators for readmission.
Future Implications for OTvIncreasing self-management skills for patients with COPD as a way of placing responsibility back on
the patient to be an active participant in their own day to day healthcare.
vUse of the Canadian Occupational Performance Measure (COPM) to gain patient perspective on
occupational engagement and satisfaction.
vWriting and viewing therapeutic goals through an adaptation/modification lens as a way to guide
occupational therapy treatment in line with the progressive, chronic nature of COPD.
vEnsuring carryover of self-management strategies following discharge through appropriate
discharge recommendations and potential occupational therapy involvement in pulmonary rehab.