Introduction
Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory condition marked by chronic symptoms and frequent exacerbations.
Smart devices enable continuous monitoring heart rate and oxygen saturation. It provides real-time data so that health care providers can conduct timely interventions to reduce admission. Also, it arouses patients' awareness to enhance their self-management on COPD.
Besides, breathing exercises for COPD patients can improve respiratory muscle performance and reduce dyspnea result in improving their life quality.
Thus, NTEC COST conducted a pilot of using continuous SaO2 monitoring device on COPD patient to detect early sign of exacerbation and educated patient breathing and coughing training since November 2021.
Objectives
1. To review patients SpO2 pattern to facilitate nursing intervention
2. To reduce hospital admission rate due to COPD exacerbation
3. To educate patient to perform breathing and coughing training
Methodology
COPD patients with Abbreviated Mental Test(AMT) ≥6, were invited. CAT score were assessed as baseline and evaluated at last monitoring day. Patients wore O2 ring (ring-like continuous SpO2 monitoring device) at least 3 days. Nurses analysed the correlation between patient activities and SpO2 pattern from smart phone. Medical and nursing interventions provided according to the result.
Besides, patient start breathing and coughing training with Pearl 8 if required. Nurse can check the record when home visit.
Result
From Nov 21 till Mar 25, 94 patients were recruited in the project. 59 among 94 patients conducted breathing and coughing training with "Pearl 8" device. They includes 83 males and 11 females. Mean age was 78.6. 29 patients had no admission due to COPD exacerbation within 1 year before recruited. Whereas 16 patients were admitted more than 2 times due to COPD exacerbation within 1 year before recruited.
Intervention included puff regime adjustment, breathing and coughing training and ad hoc medical consultation had been taken as indicated. Average pre and post CAT score were 17.1 (range:2-34) and 12. 9 (range: 1-32) respectively. It reduced 24.6%. 13 patients (13.8%) were admitted due to COPD exacerbation. 3 of them had history of frequency admission≥3 in a year.
Conclusion
Smart device provided continuous SpO2 monitoring and training logs for COPD patients during their daily activities, which provided useful information for nurses in identifying patient issues and facilitating prompt interventions. It is recommended the use of wearable sensors for ongoing measurements to assess clinical relevance in community care settings.
