Nurses have consistently shown a positive contribution in
delivering the hospital-at-home and early discharge schemes for
COPD. 25,26 Under these schemes, patients with acute exacerbations
are cared for at home by a specialist respiratory nurse with the
support of a hospital-based multidisciplinary team. These
interventions are particularly important considering that COPD
exacerbations are one of the most common causes of hospital
admission and are responsible for an increased demand of hospital
beds. Two systematic reviews evaluating the efficacy of hospital-athome care in patients with acute COPD exacerbations have shown
that treatment of these patients at home resulted in a numerically
reduced or unchanged mortality rate when compared with hospital
inpatient care. 25,26 This suggests that patients with acute
exacerbations can be safely and successfully treated at home with
support from respiratory nurses. In addition, discharge support and
follow-up interventions, based on visits by nurses aimed atreinforcing education and promoting compliance with therapy, have
been shown to be useful in shortening hospital stay