Table 4.
Delivery of individual elements of the admissions bundle at level 2 comparator and implementation sites
| Admissions bundle | ||||
| Bundle element | Delivery | Comparator sites, n (%) | Implementation sites, n (%) | P value |
| 1. Correct diagnosis of AECOPD. | ||||
| 1a. Chest X-ray result within 4 hours. | Yes | 443 (76.8) | 454 (83.9) | 0.003 |
| 1b. ECG result within 4 hours. | Yes | 473 (74.8) | 656 (83.5) | <0.001 |
| 1a and 1b | Yes | 350 (59.9) | 382 (66.4) | 0.022 |
| 2. Recognise and respond to respiratory acidosis within 3 hours of diagnosis. | ||||
| 2a. Arterial blood gas within 1 hour if oxygen sats less than 94% on air or controlled oxygen. | Yes | 403 (75.6) | 467 (73.8) | 0.473 |
| 2b. When pH is less than 7.35, assess suitability for Non-invasive ventilation (NIV) and implement within 3 hours of admission. | Yes | 345 (94.5) | 492 (98.0) | 0.006 |
| 2a and 2b | Yes | 193 (57.4) | 283 (61.9) | 0.203 |
| 3. Recognition of hypoxia and correct oxygen prescription within 30 min of admission with target range of 88%–92%. | ||||
| Yes | 197 (32.5) | 395 (51.7) | <0.001 | |
| 4. Correct prescription of medication for AECOPD at admission. | ||||
| 4a. Steroids prescribed and administered within 4 hours of admission when necessary. | Yes | 479 (80.6) | 496 (70.2) | <0.001 |
| 4b. Antibiotics prescribed and administered within 4 hours of admission when necessary. | Yes | 445 (73.4) | 535 (74.6) | 0.624 |
| 4c. Nebulisers prescribed and administered within 1 hour of admission when necessary. | Yes | 327 (52.2) | 315 (43.5) | 0.002 |
| 4a, 4b and 4c | Yes | 214 (35.8) | 207 (29.5) | 0.015 |
| 5. Review by respiratory specialist (specialist nurse, doctor or physiotherapist) within 24 hours. | ||||
| Yes | 100 (17.4) | 274 (39.3) | <0.001 | |
AECOPD, acute exacerbation of chronic obstructive pulmonary disease.