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COPD Assessment and Evaluation

COPD Assessment and Evaluation

Your task is submit your final Project Report. The completed report should be properly presented with a
title page, table of contents, and references where necessary.
For this project, you will have studied the Philips Electronics model of business excellence through speed
and teamwork (BEST). You will find this model described Project Study in the attachment.
You will also have read the following brief but important journal article: TQM and business excellence: is
there really a conflict?
Also, read project proposal, project outline, and project case study all of them in the attachment before
you start to write the project.
Your task is:
1.To assess the BEST model, with particular reference to the importance of teamwork in a company like
Philips Electronics.
2.To evaluate the model against Adebanjo’s proposition that ‘business excellence and quality can and
need to complement each other to provide organisations with the operational and business success they
aspire to and which is necessary for survival in today’s market.’
3.To show how BEST tools and competencies could be applied to the pursuit of business excellence in
your company or another company you think could benefit from using the model.
Chronic Obstructive Pulmonary Disease

This is a serious lung condition that manifests with emphysema coupled with chronic
bronchitis. It is mainly prevalent in patients that are 40 years and above, especially cigarette
smokers (Cherney, 2014, Pg. 50). These patients present with symptoms of coughing, production
of sputum, or breathlessness. Owing to emphysema, the patients frequently experience shortness
of breath, a situation where they have to make an extra effort to inhale sufficient oxygen by
maintaining a high speed of breathing. In emphysema, the lungs of patients can only
accommodate small volumes of air. There is also a notable deficiency in the amount of oxygen
that reaches most body tissues. Old age is a predisposing factor to the disease and more so if
associated with excessive smoking (Hanania, Sharma, & Sharafkhaneh, 2010, Pg. 600). It is
therefore relevant for gerontological care nurses to give special attention to the condition. This
paper not only discusses COPD in details, but also explores further into other secondary

conditions associated with the condition. Selected mechanisms applied by nurses in handling
COPD patients are also explored in detail. Such methods relate to COPD assessment as well as
evaluation. Issues are addressed from the perspective of the nurse as well as from the patient’s

Assessment of COPD Patients

Just like in most other health care set ups, assessment of COPD requires collection patient’s
history, from which an evaluation is made and appropriate medical measures taken. Health
officials are expected to conduct history examinations on their patients and eliminate differential
diagnoses to zero in to the patient’s status with regard to COPD. A complete history collection
usually offer details whether patients or their close relatives have ever been diagnosed with
respiratory abnormalities, and more so emphysema, bronchitis or COPD at large. Childhood lung
infections and atopic illnesses relate directly with the likelihood of COPD diagnoses on patients.
In addition, history collection investigates on the living conditions of the patients, both in the
past as well as in the present. In most cases, environment is a significant player in the aetiology
of not only COPD, but also other common respiratory disorders. Such experiences as livingor
working in dusty places plays are generally a threat to one’s respiratory health (Dweik &
Mazzone, 2015, Pg. 10). When attending COPD patients, knowledge on the patient’s exposure to
such conditions serves to enhance competence among nurses.The best techniques when attending
patients involves nurses’ optimal knowledge on their patients from varied life aspects.

Miller’s Theory

Miller made remarkable contributions in the nursing profession by designing a theory that would
guide nurses when attending aged patients. The theory is still widely applied in most health
institutions in the world today. The theory has been subjected to constant modifications by its

implementers in nursing care. It therefore offers up-to-date guidelines making it very relevant
and appropriate for nurses who attend old people. In the present, Miller’s theory is commonly
termed as “the functional consequences theory of promoting wellness in older adults” (Hunter,
2012, Pg. 37). He theory offers scientifically supported ways of improving the life quality among
the aged populations, in addition to expanding their lifespan. It also relates all aspects of care in
an integrated manner. A relationship is developed between nurses and patients with regard to the
environment. Its incorporation of factors that affect health lure nurses to its application and to
them, the theory just simplifies their day-to-day work. The theory emphasizes on important
matters in the care for the aged, such as the risk factors that accompany aging, diminished body
functionality as a result of old age and the linkage between one’s mind, body and spirit (Hunter,
2012, Pg. 38). In addition to problem identification, the theory suggests on appropriate ways of
handling the challenges. It for instance suggests that care for the aged be directed toward
alleviation of the negativity of functionality, the most predominant consequence of risk
predisposition. The preferable outcomes achieved with the theory see to it that old people retain
their body functionality to the best possible extent.In the care of an old OCPD patient like
Kathleen, Miller’s theory is a first-hand instrument for a nurse. Despite the many challenges in
her life, like being unable to cook for herself, Kathleen can still restore fun in her life with the
application of Miller’s suggestions.

Age-Related Changes in COPD

As a COPD patient ages, like in the case of Kathleen, the ability to maintain wellness is
decreased, patients become more prone to respiratory, cardiovascular, musculoskeletal and
neurological among other disorders. Kathleen experience depression, which prompts her to seek
solace by isolating herself from the community. Such a situation is common with COPD patients

following neurological disorders. Again, the lady is observed to express musculoskeletal
impairments when her mobility is reduced. The most conspicuous effect of COPD on Kathleen is
the impairment of her respiratory system, where she developed shortness of breath as a result of
Consequences of negativity in body functionality are also evident in Kathleen case when she
fails for instance to cook for herself. Malnutrition is a serious problem and would make life more
terrible for the COPD patient. It often results into increased risk to infections (NHS, 2015, Pg.
82). Usually, old people require energy to maintain basic body processes. Other matters of living
affected by diagnosis with COPD among old people include physical life: environmental and
social; as well as psychological life. To overcome problems associated with COPD, nursing care
would involve educating the patients as well as practising the techniques that are suggested to
achieve high results, such as the ones provided in Miller’s theory.
Care for COPD Patients

There has been improved research in the field of aetiology and pathophysiology of COPD
in the last 50 years. There used to be a mistaken belief that little could be done on the progressive
and irreversible nature of COPD. Since COPD is closely related to smoking many patients may
feel as if they are not treated well due to a “self-inflicted illness.” It is this view that has
commonly evoked an unsympathetic response from the patients’ relatives and unfortunately,
some clinicians. Mostly, COPD affects individuals that cannot demand high standards of care
such as the elderly and the poor (Bellamy & Booker, 2011, Pg. 89). Nurses should therefore,
work toward attaining realistic aims of care provision such as slowing down or stopping the
progression of the condition, reducing disability through achieving best possible symptom relief,
and decreasing the number and severity of exacerbations.


The Role of Nurses in Care Provision

Early diagnosis is an essential step to attaining the above- stated objectives. Health
officials also need to carry out regular reviews in order to make sure that necessary interventions
are provided, information and education needs are attained, and signs and symptoms are well
managed. The long-term management illness such as COPD is suited well to nurse-led care, so
long as the nurse is trained well. COPD has a complex diagnosis and management procedure
especially for elderly patients that have co-morbidity. For quality healthcare delivery, nurses
should have high-quality training, continued improvement of professional development and work
as a team with their colleagues.

Progression of COPD

The only effective intervention that has been identified in the slowing down of COPD
progression is smoking cessation. Smoking quickly accelerates the decline of FEV 1 . However,
this can be slowed down to an FEV 1 of anon-susceptible smoker or a non-smoker at any level of
COPD. Early cessation ensures that a patient acquires better outcomes, but it is not too late.
According to Roach, Bronner and Oreffo, healthcare professionals should create
awareness on the subject of smoking cessation at every encounter (Roach, Bronner& Oreffo,
2011, 57). By so doing, they can prompt a smoker that is committed to thinking twice about
smoking and its associated consequences. They may also encourage individuals that could be
contemplating quitting make a serious cessation.
Some pharmacological medicines have also been developed to help patients quit
smoking. Some of these medications include bupropion, varenicline, and nicotine replacement
therapy (Kon, Hansel& Barnes, 2011, Pg. 67). Therefore, clinicians should prescribe these
medications to smokers that want to quit since they may improve their chances of success. There

are some smokers that would like to quit and at the same time require special support. Such
smokers should be referred to specialist services.

Reduction of COPD Symptoms

Breathlessness and a persistent cough are disabling and distressing. The primary clinical
methods of managing these symptoms are;

 Long and short-acting bronchodilators
 Mucolytics
 Pulmonary rehabilitation


These medications only have an effect on FEV 1 in COPD. However, they can also reduce
the tone of bronchomotor, decrease hyperinflation of the respiratory system and improve the
efficiency of respiratory muscles. COPD patients that take bronchodilators breathe efficiently
and more comfortably. They also have an improved tolerance to exercise. The main categories of
bronchodilators used are beta agonist and anticholinergic bronchodilators.


These are drugs that aid in reducing sputum viscosity. As a result, they make it easier for
patients to clear the sputum. Recent studies have shown that mucolytics can also reduce
exacerbation number and improve the symptoms associated with coughing and production of
sputum (Lee-Chiong, 2010, Pg. 362). Carnocisteine and mecysteine are some of the mucolytics
used for long-term management of COPD.

Pulmonary Rehabilitation

Many COPD patients choose to live with breathlessness by shunning exercises. Patients
lose their confidence, self-esteem, feel depressed, and isolate themselves from others. Pulmonary

rehabilitation is aimed at reversing this. Patients should focus mainly on aerobic training so that
they can condition their muscles once more and their endurance to exercise. Continued exercise
also aids in reducing breathlessness. However, for successful pulmonary rehabilitation, patients
should be committed and motivated as well. The patients should also be able to exercise as this
will co-morbid cardiovascular related diseases and musculoskeletal problems that prevent the
patients from exercising accordingly.

Reducing Exacerbations

According to MacNee, ZuWallack & Keenan, patients should be educated on self-
management in order to reduce the worsening of exacerbations (MacNee, ZuWallack & Keenan,
2009, Pg. 134). Patients should also be provided with clearly written advice and also taught
about when they should seek medical attention. Nurses should also ask patients about the number
of exacerbations they experience afterwhich they will prescribe long-acting bronchodilators to
those that have frequent exacerbations.


Tremendous progress has been achieved in comprehending the management of COPD.
However, COPD is still a considerable burden on some patients and the caregivers but its
prospects are quite promising (Bernhardt & Kasko, 2011, Pg. 36). COPD has been has been
branded the “Cinderella” disease of the respiratory system, but the chances of “Cinderella”
approaching the ball are improving.



Bellamy, D., & Booker, R. (2011). Chronic obstructive pulmonary disease in primary care: All
you need to know to manage COPD in your practice.
Bernhardt, N. E., & Kasko, A. M. (2011). Nutrition for middle aged and elderly. New York:
Nova Biomedical Books.
Bernhardt, N. E., & Kasko, A. M. (2011). Nutrition for middle aged and elderly. New York:
Nova Biomedical Books.
Cherney, K. (2014, September 16). COPD: What’s Age Got to Do with It?

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