Acute Exacerbations in Chronic Respiratory Illness

Acute Exacerbations in Chronic Respiratory Illness

The problem under consideration is the prevention of hospital readmission rates for acute exacerbations in children with chronic respiratory illnesses. The potential solution to this issue is providing additional education for patients and their parents with the aim of their better awareness of potential complications (Banks, 2013). The nursing focused plan consists of a change model overview, evidence of the problem, a plan for implementation, and a conclusion. The plan of evaluating the outcomes and reporting the results are also included. Acute Exacerbations in Chronic Respiratory Illness


Change Model Overview

The ACE Star model is designed for a better understanding of the character and peculiarities of the knowledge used in a variety of situations of evidence-based practice (EBP) (“The ACE Star model,” n.d.). The benefit of this model is that it arranges both traditional and new ideas of care enhancement into one common system and creates a framework that promotes the systematization of EBP approaches and operations. The ACE Star model comprises five elements: “discovery research,” “evidence summary,” “translation to guidelines,” “practice integration,” and “process, outcome evaluation” (“The ACE Star model,” n.d.). Nurses should use this model as a guide to facilitate change since it contains every aspect of the successful management of clinical problems. Acute Exacerbations in Chronic Respiratory Illness

Define the Scope of the EBP

The practice issue is the prevention of hospital readmission rates for acute exacerbations in children with chronic respiratory illness. According to the statistics, as many as 18% of children suffering from chronic respiratory illnesses are admitted to hospitals (Hall, Chang, & O’Grady, 2016). Because of inappropriate knowledge about the management of complications, patients are frequently readmitted soon after leaving a hospital. The problem impacts the families of children ill with chronic respiratory illnesses because they are not able to return to a normal lifestyle due to frequent readmissions. Their parents also need to spend extra time and money on treatment. On a broader scale, the problem impacts the whole healthcare system because of extra resources wasted and the burden posed on healthcare workers. Acute Exacerbations in Chronic Respiratory Illness


Apart from the leader of the team, the project will engage several stakeholders:

  • a psychologist;
  • a pharmacist;
  • a physical therapist;
  • a charge nurse;
  • three nurses.

Determine Responsibility of Team Members

Although the functions of the stakeholders are different, each of them will play a key role in reaching the success of a project. The psychologist will arrange consultations with the patients and their parents to explain the social and psychological peculiarities of children’s health conditions. Also, this specialist will encourage the participants to obtain knowledge and apply it in practice in order to reduce the readmission rate and arrange the most comfortable conditions for the children who have chronic respiratory illnesses. Acute Exacerbations in Chronic Respiratory Illness

The pharmacist and physical therapist will choose the most appropriate treatment and physical exercises for the children. The charge nurse will be responsible for the coordination between all the stakeholders. Nurses will check whether the recommendations of specialists are being followed and will provide additional help if needed.


There is much evidence of the prospects of the plan’s success in the research literature. Hall et al. (2013) outline the clinical practice guidelines in their intervention protocol on hospital readmission prevention plan. Perotin et al. (2013) and Wark, Tooze, Powell, and Parsons (2013) suggest quality improvement data based on the research of the infections’ impact on the health conditions of patients with chronic obstructive pulmonary disease. Wark et al. (2013) also emphasize that infections may increase the risk of readmission. The strength of the current research is that it will use the evidence from other sources as well as an education plan to decrease the rate of readmissions and arrange the most comfortable conditions for patients and their families. Acute Exacerbations in Chronic Respiratory Illness

Summarize the Evidence

In their article, Hall et al. (2016) suggest the adoption of personified caseworker-assigned discharge plans for patients having chronic conditions. Additionally, the authors outline the activities that might be performed by caseworkers to enhance patient condition and outcomes. Hall et al. (2016) provide a discharge plan with suggestions from relevant healthcare institutions. The outcomes that the authors plan to measure in their final paper are the frequency and rate of readmissions, the percentage of unscheduled doctor visits, the cost-effectiveness of the measures suggested, and the post-discharge mortality rate. The evidence-based interventions suggested by Hall et al. (2016) include the following:

  • the enhancement of communication between patients and service providers,
  • the realization of the existing types of hospital services with the aim of improving the level of care;
  • the coordination of care provided at the hospital and at home;
  • the improvement of health education. Acute Exacerbations in Chronic Respiratory Illness

Develop Recommendations for Change Based on Evidence

Based on the evidence, the recommendation is to arrange the educational program for children and their parents with the help of which they will know how to manage the children’s health condition better. The program will eliminate the readmission rate and improve the patients’ health outcomes. Acute Exacerbations in Chronic Respiratory Illness