Non compliant COPD pt

Hey guys,

This week in my cardio placement I have been able to return to the medical ward as it has reopened after being closed by a norovirus outbreak. A patient I was treating approx. 10-12 days before the outbreak was still on the ward and was awaiting placement in a rehabilitation ward.

Initially she presented to hospital with increasing SOB, increased sputum production and reduced exercise tolerance. The pt was diagnosed with an infective exacerbation of her COPD. The chest infection has since resolved and her main problem now is reduced exercise tolerance.

The patient was quite reluctant to ambulate on the ward and would even refuse physiotherapy at times; thus further contributing to the cycle of deconditioning. A number of strategies were tried to convince this patient about the importance of ambulation including:
- earlier D/C
- education RE: ­ immunity thus ¯ risk of future exacerbations & hospital admissions
- maintenance of independence & therefore maintenance/improvement of her quality of life.

To gain optimal benefits it would have been ideal to treat this pt 2 times a day; however she was only compliant with 1 session a day. I was wondering if anyone experienced non-compliant pt’s and what strategies they used to overcome this

Thanks guys