NURS FPX 4025 Assessment 2

Name

Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Applying an EBP Model

Chronic Obstructive Pulmonary Disease (COPD) is a prevalent illness described by airway restriction. The World Health Organization (WHO) identifies that COPD continues to be a leading worldwide cause of death (WHO, 2024). This evidence-based practice (EBP) project identifies the clinical use of nurse-implemented teaching in the self-management of COPD patients. It focuses on individualized teaching interventions in hospital readmission avoidance through exacerbation, informing clinical decision-making. Nurses encourage healthy lifestyles to avoid the appropriate practice of inhalers, first symptoms and pulmonary recovery. Healthcare staff support enhances outcomes and prevents readmission by increasing the public’s sympathy for their disease. 

Issue Associated with the Diagnosis

COPD is the leading reason of expiry worldwide. It is accountable for around 3.6 million expiries in 2021, accounting for nearly 5% of all global mortality (WHO, 2024). COPD is among the 10 principal reasons of demise in America. Approximately 16 million Americans have been diagnosed with COPD, and many more remain undiagnosed (CDC, 2024). Evidence-based studies support nurse-based education in the treatment of COPD. ALHarbi et al. (2022) studied the execution of a staff-driven treatment plan for COPD adults. In this analysis, the effect of inclusive education initiatives on self-care among 60 mild-to-moderate COPD patients was examined.

After three months, the interference unit presented substantial improvements in COPD Self-Management Scale scores, like symptom monitoring, medication adherence and lifestyle changes. The study highlights the efficiency of nurse-driven blended interventions in enhancing COPD care. Zhang et al. (2023), evaluated the influence of a healthcare staff rehabilitation interference on the standard and physical ability in 74 countryside COPD adults.

Following 13 weeks, the interference patient team showed perfection in St. George’s Respiratory Questionnaire (SGRQ) scores and six-minute walking distance, with deterioration of SGRQ scores and loss of 6MWD in the routine group. The nurse intervention involved home-based teaching, exercise guidance, and follow-up supervision, and was efficient in refining helath status. It aids healthcare professionals to provide safe, individualized therapy based on real-world clinical practice evidence.

EBP Model and Its Steps

The Iowa Model of EBP delivers a planned technique for enhancing clinical results that permits it to be operative in the treatment of frequent exacerbations of COPD (Dusin et al., 2023). The model begins with the recognition of a clinical question: the recurrent worsening of COPD in adults with COPD. After the problem is established as an area of priority. Then a multidisciplinary group is formed to examine solutions.

The group collects and evaluates existing research on interventions with a nursing focus. The group tests an intervention involving nurse-delivered education meetings and home follow-up treatment. Results are measured through measures such as exacerbation rates, medication adherence, readmission rates and patient satisfaction. In the event of successful results, the new protocol is integrated into standard care. Constant monitoring and sharing of results protect continued development and enable ongoing learning. The Iowa Model facilitates the incorporation of nurse-initiated education in COPD management. It facilitates sustained quality upgrading in patient care.

NURS FPX 4025 Assessment 2

Identification of the relationship between frequent COPD exacerbations and the need of increased therapeutic care was made possible through clinical evaluation and analysis of patient data. Results indicated that poor self-management, suboptimal inhaler technique and inadequate health literacy were accountable for repeat hospitalizations in COPD patients. A team that included nurse practitioners, respiratory therapists and clinical educators was assembled to investigate evidence-based interventions targeting patient education and self-management. The main aim was to maximize COPD care using nurse-led teaching and support measures based on EBP. Hu et al. (2022), observed the impact of staff-led teaching based on the Knowledge, Attitude, and Practice (KAP) model among older COPD patients.

Results showed that counselling based on KAP improved nursing satisfaction, patient knowledge, self-care, compliance and pulmonary function in comparison to standard nursing. The KAP model improved treatment compliance and quality of life. A practical execution strategy was used to pilot these interventions. Outcome measures include hospital admissions, patient satisfaction and inhaler technique skill. As results showed clinical benefit in patients, the intervention was combined into standard care, with monitoring and provider education to facilitate its success. The Iowa Model gave this process a solid backbone by enabling the identification of problems. It encourages teamwork in planning and aligns outcomes with the present research and clinical objectives.

Application of the Model to Evidence Search

The Iowa Model was applied to assess the efficiency of staff-based intervention in reducing COPD exacerbations among patients with poor symptom control and limited self-management skills. The model supports systematic, evidence-based decision-making, promoting improved symptom monitoring, patient engagement, and adherence to personalized care plans. The issue-driven trigger emerged from clinical observations and patient data. It highlighted frequent exacerbations due to inadequate inhaler technique, low health literacy, and poor follow-up.

These findings emphasized the need to strengthen patient education and apply structured, nurse-led management programs guided by EBP. A multidisciplinary team was assembled to evaluate and implement suitable interventions. A well-structured PICOT question was framed to guide the search: In adults with severe COPD (P), how does a nurse-led education (I), compared to standard discharge education (C), influence hospital readmissions due to exacerbations (O) over 6 months (T)? This PICOT format helped in refining the clinical question, enabling targeted literature searches and informing clinical decisions (Howe et al., 2024).

A structured review was performed by using databases like PubMed, CINAHL, and the Cochrane Library. The keywords and phrases in the search strategy were “COPD,” “nurse-led interventions,” “patient education,” “inhaler training,” “airflow limitation,” and “exacerbation.” The systematic process provided quality clinical trials, peer-reviewed papers, and EBP strategies applicable to the health staff-based interferences in COPD treatment. The process of evaluation encountered major challenges. Two major issues were specifying rigorous quality appraisal criteria for the selection of studies and ensuring the findings were generalizable to COPD adults with features like long-lasting indications.

Credibility and Relevance of Resources

Three key resources highlight the critical role of staff-led interferences in cultivating COPD management. The first study, led by ALHarbi et al. (2022), explored the implementation of staff-driven care for COPD patients. The research evaluated the impacts of a nurse-driven, integrated education initiative on self-management behaviors (SMBs) among 60 individuals with mild-to-moderate COPD. After three months, the group receiving the intervention proved notable improvements in COPD Self-Management Scale outcomes, such as observing signs, obeying to medicine routines and daily routine changes.

The second study by Rassouli et al. (2021), evaluated the impact of telehealth care (TC) on COPD management. Patients in the telecare team displayed a 50% rise in COPD assessment test (CAT) scores associated to standard care (SC) (P = 0.0015). It indicates a reduced progression of the disease. Satisfaction with care improved after TC (P < 0.001). While more moderate exacerbations were detected in the TC group, this likely reflected higher diagnostic sensitivity. The study highlights TC’s potential in improving COPD management and patient satisfaction. The study was published in the Journal of Internal Medicine, a peer-reviewed, high-impact journal, enhancing the credibility of its findings.

Lastly, Wang et al. (2024), examined 9048 COPD patients found that attending health staff was linked with a 16% decrease in death and reduced use of emergency and inpatient services. Individuals in the clinic faction had reduced hazards of death from pneumonia. The clinic reduced emergency department visits by 8%. These findings highlight the positive impact of non-physician experts in COPD care. These findings underscore nurse-led initiatives’ impact in improving COPD management through tailored education, ongoing support, and self-management strategies. All studies were evaluated utilizing the CRAAP criteria (Currency, Relevance, Authority, Accuracy, and Purpose), safeguarding that only valid, recent, and peer-reviewed studies were included. These resources were relevant to COPD care. It reinforces the importance of EBP for nursing educational interventions in COPD management.

Conclusion

The application of the Iowa Model of EBP to the use of staff-driven educational plans for COPD exacerbations demonstrates the analytical role of personalized care in refining patient outcomes. The integration of current research with interdisciplinary collaboration certifies that treatment decisions are grounded in evidence while addressing individual patient characteristics. This EBP initiative exemplifies how systematically applying clinical research can refine COPD management. 

References

ALHarbi, E. R., Wazqar, D. Y., & Sofar, S. M. (2022). A quasi-experimental study of the effect of a comprehensive blended health educational program on self-management practices among patients with chronic obstructive pulmonary disease. Heart & Lung, 56, 133–141. https://doi.org/10.1016/j.hrtlng.2022.07.005

CDC. (2024, June 12). COPD. Chronic Disease Indicators. https://www.cdc.gov/cdi/indicator-definitions/chronic-obstructive-pulmonary-disease.html

NURS FPX 4025 Assessment 2

Dusin, J., Melanson, A., & Lawson, L. (2023). Evidence-based practice models and frameworks in the healthcare setting: A scoping review. British Medical Journal Open, 13(5). https://doi.org/10.1136/bmjopen-2022-071188

Howe, R. (2024). LibGuides: Respiratory Care: Evidence-Based Practice: PICO. Libguides.uthscsa.edu. https://libguides.uthscsa.edu/c.php?g=625986&p=4364976

Hu, W., Li, T., Cao, S., Gu, Y., & Chen, L. (2022). Influence of nurse-led health education on self-management ability, satisfaction, and compliance of elderly patients with chronic obstructive pulmonary disease based on knowledge, belief, and practice model. Computational and Mathematical Methods in Medicine, 2022(1), e1782955. https://doi.org/10.1155/2022/1782955

Rassouli, F., Germann, A., Baty, F., Kohler, M., Stolz, D., Thurnheer, R., Brack, T., Kähler, C., Widmer, S., Tschirren, U., Sievi, N. A., Tamm, M., & Brutsche, M. H. (2021). Telehealth mitigates COPD disease progression compared to standard of care: A randomized controlled crossover trial. Journal of Internal Medicine, 289(3), 404–410. https://doi.org/10.1111/joim.13230

Wang, K., Zhao, S., Yau, S. Z.-M., Wei, Y., Li, Y.-C., Orr, R. W.-C., Lam, I. H.-L., Wu, Y., Wong, E. L.-Y., Hung, C.-T., & Yeoh, E.-K. (2024). Outcomes and hospital service use among patients with COPD in a nurse- and allied health–led clinic. JAMA Health Forum, 5(7), e241575. https://doi.org/10.1001/jamahealthforum.2024.1575

WHO (2024, November 6). Chronic Obstructive Pulmonary Disease (COPD). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(COPD)

NURS FPX 4025 Assessment 2

Zhang, M., Mao, X., Li, F., & Xianyu. (2023). The effects of nurse‐led family pulmonary rehabilitation intervention on quality of life and exercise capacity in rural patients with COPD. Nursing Open, 10(8), 5606–5615. https://doi.org/10.1002/nop2.1804