Respiratory Training and Educator Course
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COPD Management Module Learning Objectives

  1. The COPD Educator will be able to explain COPD.
  2. The COPD Educator will identify the common signs and symptoms of COPD.
  3. The COPD Educator will be able to explain the natural history of COPD.
  4. The COPD Educator will be able to explain the epidemiology of COPD in terms of:
    1. prevalence
    2. mortality and
    3. impact of the disease.
  5. The COPD Educator will explain the pathophysiology of COPD.
  6. The COPD Educator will be able to explain the environmental factors which play a role in the development of COPD.
  7. The COPD Educator will be able to explain the host factors which play a role in the development of COPD by describing:
    1. definition of alpha-1-antitrypsin (AAT) deficiency;
    2. targeted testing for AAT deficiency;
    3. diagnosis of AAT deficiency;
    4. management of AAT deficiency;
    5. CTS recommendations for AAT deficiency replacement therapy;
    6. other inherited infections;
    7. childhood viral infections; and
    8. bronchial hyperresponsiveness.
  8. The COPD Educator will be able to explain the other factors which may play a role in the development of COPD.
  9. The COPD Educator will be able to:
    1. demonstrate how to take an accurate and effective patient history; and
    2. interpret the pertinent and relevant data from the patient history.
  10. The COPD Educator will be able to describe the relevance of the findings from the physical examination in the COPD assessment.
  11. The COPD Educator will be able to define spirometry in terms of FEV1, FVC and FEV1/FVC.
  12. The COPD Educator will be able to explain the role of quality control in performing spirometry.
  13. The COPD Educator will be able to explain the recommendations for targeted spirometry.
  14. The COPD Educator will be able to explain the importance of early diagnosis.
  15. The COPD Educator will be able to describe the recommendation regarding spirometric findings for the diagnosis of COPD.
  16. The COPD Educator will be able to explain the significance of additional investigations.
  17. The COPD Educator will be able to differentiate COPD from asthma and other lung diseases.
  18. The COPD Educator will be able to:
    1. explain what is meant by follow-up;
    2. explain the goal of follow-up & its importance;
    3. describe factors to consider during follow-up; &
    4. demonstrate how to conduct an effective follow-up visit.
  19. The COPD Educator will be able to explain when to consider referral to a specialist.
  20. The COPD Educator will be able to explain the parameters used to assess COPD severity including impairment, disability and handicap.
  21. The COPD Educator will be able to define severity of airflow obstruction (impairment) in COPD.
  22. The COPD Educator will be able to explain the classification of COPD severity using symptoms (disability).
  23. The COPD Educator will be able to describe health status questionnaires to assess handicap in COPD patients in terms of: their importance, their use, the components and examples. i.e. SGRQ, CRDQ.
  24. The COPD Educator will explain the role of co-morbidities in the assessment of severity.
  25. The COPD Educator will be able to explain the philosophy of the management of COPD.
  26. The COPD Educator will be able to explain the goals of the comprehensive management of COPD.
  27. The COPD Educator will be able to explain the stepwise approach in the comprehensive management of COPD.
  28. The COPD Educator will be able to explain self-management education in terms of:
    1. definition;
    2. educator and patient's role;
    3. components; and
    4. outcomes.
  29. The COPD Educator will be able to explain smoking cessation in terms of:
    1. tobacco addiction;
    2. its necessity;
    3. importance of initiating discussion; and
    4. various strategies available.
  30. The COPD Educator will be able to apply counselling strategies related to quitting smoking.
  31. The COPD Educator will be able to describe the pharmacological aids used in smoking cessation including:
    1. nicotine replacement therapies (NRTs)
    2. bupropion
  32. The COPD Educator will be able explain the goals of pharmacotherapy.
  33. The COPD Educator will be able to identify:
    1. the mechanism of action
    2. generic and brand names
    3. the delivery device
    4. the side effects
    5. the recommendations for therapy for each of the following medications:
      1. inhaled short-acting beta2-agonists
      2. inhaled short-acting anticholinergics
      3. combination inhaled short-acting bronchodilators
      4. inhaled long-acting anticholinergics
      5. inhaled long-acting beta2-agonists
      6. oral bronchodilators
      7. inhaled corticosteroids
      8. combination inhaled corticosteroids and long-acting bronchodilators
      9. oral corticosteroids
  34. The COPD Educator will be able to (for each of the following devices):
    1. demonstrate proper technique
    2. demonstrate proper maintenance
    3. explain indications for use of:
      1. Aerolizer.
      2. Diskus®
      3. HandiHaler®
      4. Metered-dose inhaler (MDI)
      5. Metered-dose with spacer (mouthpiece and mask)
      6. Turbuhaler®
      7. Wet nebulizer.
  35. The COPD Educator will be able to describe the definition of supplemental long-term oxygen therapy (LTOT).
  36. The COPD Educator will be able to explain the clinical benefits of LTOT.
  37. The COPD Educator will be able to describe the indications/eligibility criteria for LTOT.
  38. The COPD Educator will be able to describe the tests required to assess the need for supplemental oxygen.
  39. The COPD Educator will be able to explain the role of arterial blood gases in evaluating chronic obstructive pulmonary disease.
  40. The COPD Educator will be able to identify oxygen equipment available for LTOT in terms of the following.
    1. describe equipment
      1. Cylinders/compressed air
      2. Oxygen conserving devices
      3. Concentrators
      4. Liquid
    2. identify types of disposable equipment in terms of how to use and how to maintain.
    3. discuss choice of equipment appropriate for patient needs and lifestyles.
  41. The COPD Educator will be able to explain the components of an oxygen prescription.
  42. The COPD Educator will be able to describe the education a patient will require for the appropriate use of oxygen as it relates to:
    1. safety factors
    2. how to store equipment
    3. funding eligibility
    4. compliance
    5. adjustments for air travel
    6. portability; and
    7. how to maintain equipment.
  43. The COPD Educator will be able to explain pulmonary rehabilitation in terms of its role.
  44. The COPD Educator will be able to explain pulmonary rehabilitation in terms of its components:
    1. exercise training,
    2. education, &
    3. self-management.
  45. The COPD Educator will be able to explain pulmonary rehabilitation in terms of its benefits.
  46. The COPD Educator will be able to explain pulmonary rehabilitation in terms of its long-term effects/maintenance.
  47. The COPD Educator will be able to explain pulmonary rehabilitation in terms of who to refer to it.
  48. The COPD Educator will be able to explain the role of the 6-minute walk test in evaluating chronic obstructive pulmonary disease.
  49. The COPD Educator will be able to explain pulmonary rehabilitation in terms of accessibility.
  50. The COPD Educator will be able to explain pulmonary rehabilitation in terms of cost-effectiveness.
  51. The COPD Educator will be able to describe acute exacerbations in terms of:
    1. the definition, and
    2. its causes and impact.
  52. The COPD Educator will be able to describe the parameters used to assess acute exacerbations.
  53. The COPD Educator will be able to describe the goals of treatment for AECOPD and the various treatment options.
  54. The COPD Educator will be able to explain each of the following in relation to treatment for AECOPD:
    1. indications for use of antibiotics and antivirals;
    2. the criteria used to determine who would benefit most from antibiotic therapy;
    3. the criteria used to determine which antibiotic is used;
    4. examples of the types of antibiotics used;
    5. the instructions the COPD Educator should give COPD patients regarding proper use of antibiotics.
  55. The COPD Educator will be able to explain noninvasive mechanical (positive pressure) ventilation in terms of:
    1. definition,
    2. objectives and
    3. criteria for management of AECOPD.
  56. The COPD Educator will be able to explain how the following may help to prevent an exacerbation:
    1. smoking cessation
    2. inhaled corticosteroids
    3. annual influenza vaccine
    4. pneumococcal vaccine
    5. importance of early recognition, and
    6. development of self-management skills:
  57. The COPD Educator will be able to explain the role of the following vaccinations:
    1. annual influenza vaccine; and
    2. pneumococcal vaccine.
  58. The COPD Educator will be able to explain:
    1. how the patient determines warning signs that indicate worsening COPD; and
    2. how the warning signs determine the action to be taken by the patient.
  59. The COPD Educator will be able to demonstrate techniques to control breathlessness including:
    1. pursed-lip breathing at rest and with exertion; and
    2. resting positions.
  60. The COPD Educator will be able to apply methods that enable the patient to minimize fatigue and to adapt activity to energy level.
  61. The COPD Educator will be able to recognize the psychosocial issues of COPD by:
    1. explaining the emotional consequences of COPD;
    2. explaining the anxiety-dyspnea cycle;
    3. selecting and applying appropriate coping strategies; and
    4. identifying possible barriers to the execution of self-management strategies.
  62. The COPD Educator will be able to explain nutrition in terms of:
    1. the causes of muscle wasting and weight loss (body depletion);
    2. the consequences of body depletion; and
    3. strategies for maintaining adequate nutrition.
  63. The COPD Educator will be able to explain good sleep hygiene in terms of:
    1. the potential causes for poor sleep; and
    2. strategies to improve sleep habits.
  64. The COPD Educator will be able to explain sexuality in terms of:
    1. the role of intimacy in living with COPD;
    2. reasons for stopping/limiting sexual activity;
    3. strategies to maintain an intimate relationship; and
    4. techniques to reduce SOB during intercourse.
  65. The COPD Educator will be able to apply the PLISSIT model to address sexuality with clients with COPD.
  66. The COPD Educator will be able to explain oxygen and travel in terms of:
    1. the precautions for air and ground travel;
    2. the effects of change in altitude on oxygenation; and
    3. the pre-planning strategies to ensure safe travel.
  67. The COPD Educator will be able to explain leisure in terms of:
    1. its importance; and
    2. how to determine appropriate leisure activities to sustain well-being.
  68. The COPD Educator will be able to describe end-stage COPD and palliative care.
  69. The COPD Educator will be able to explain the goals & benefits of end-of-life discussions.
  70. The COPD Educator will be able to facilitate education of the patient & caregivers regarding:
    1. prognosis;
    2. therapeutic options; and
    3. community resources available.
  71. The COPD Educator will be able to identify team members for appropriate referrals.
  72. The COPD Educator will be able to explain current CTS recommendations about end-of-life issues.
  73. The COPD Educator will be able to explain:
    1. Lung volume reduction surgery (LVRS) and
    2. lung transplants in terms of:
      1. definition
      2. criteria
      3. contraindications
      4. benefits achieved (including impact on lung function)
      5. risks
      6. cost considerations
      7. availability
      8. survival
  74. The COPD Educator will refer to the current Canadian COPD guidelines regarding future therapies.

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