Table 4

Delivery of individual elements of the admissions bundle at level 2 comparator and implementation sites

Admissions bundle
Bundle elementDeliveryComparator sites,n (%)Implementation sites, n (%)P value
1. Correct diagnosis of AECOPD.
 1a. Chest X-ray result within 4 hours.Yes443 (76.8)454 (83.9)0.003
 1b. ECG result within 4 hours.Yes473 (74.8)656 (83.5)<0.001
 1a and 1bYes350 (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.Yes403 (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.Yes345 (94.5)492 (98.0)0.006
 2a and 2bYes193 (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%.
Yes197 (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.Yes479 (80.6)496 (70.2)<0.001
 4b. Antibiotics prescribed and administered within 4 hours of admission when necessary.Yes445 (73.4)535 (74.6)0.624
 4c. Nebulisers prescribed and administered within 1 hour of admission when necessary.Yes327 (52.2)315 (43.5)0.002
 4a, 4b and 4cYes214 (35.8)207 (29.5)0.015
5. Review by respiratory specialist (specialist nurse, doctor or physiotherapist) within 24 hours.
Yes100 (17.4)274 (39.3)<0.001
  • AECOPD, acute exacerbation of chronic obstructive pulmonary disease.