Capella 4025 Assessment 2

Name

Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Applying an Evidence-Based Practice (EBP) Model

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory illness that presents significant global health challenges due to its high mortality and morbidity rates. According to the World Health Organization (WHO, 2024), COPD remains one of the leading causes of death globally. This Evidence-Based Practice (EBP) project emphasizes the integration of nurse-led educational interventions to support the self-management of individuals diagnosed with COPD. By focusing on personalized teaching strategies, this approach seeks to prevent hospital readmissions due to disease exacerbation. Nurses play a central role in delivering patient-centered education, reinforcing proper inhaler use, identifying early symptoms, and promoting pulmonary rehabilitation. Furthermore, educating patients fosters empowerment, enhances adherence to treatment, and ultimately improves quality of life. Effective nurse-patient engagement ensures that individuals understand the trajectory of their condition and actively participate in managing their health.

The importance of such interventions is grounded in clinical studies that highlight the benefits of structured education. For instance, ALHarbi et al. (2022) demonstrated improved self-management behaviors in patients following a comprehensive nurse-led educational program. Zhang et al. (2023) also confirmed that rural patients who received home-based pulmonary rehabilitation experienced measurable gains in physical function and quality of life over 13 weeks. These outcomes affirm the effectiveness of nurse-led initiatives and illustrate how real-world clinical strategies can enhance patient care.

Issue Associated with the Diagnosis

COPD contributes significantly to global and national mortality statistics. In 2021, COPD was responsible for approximately 3.6 million deaths worldwide, equating to about 5% of all global deaths (WHO, 2024). In the United States alone, an estimated 16 million individuals live with a confirmed diagnosis, although the actual burden is believed to be higher due to underdiagnosis (CDC, 2024).

Clinical trials support educational interventions as a crucial component of COPD care. A study by ALHarbi et al. (2022) involved 60 patients with mild-to-moderate COPD who participated in a comprehensive nurse-driven educational program. After three months, participants demonstrated significant improvement in self-management areas such as symptom recognition, medication adherence, and lifestyle adaptation. Similarly, Zhang et al. (2023) examined the impact of a nurse-led family pulmonary rehabilitation program on 74 rural patients with COPD. Their findings revealed enhanced outcomes in quality of life and walking capacity.

These studies underscore the value of nurse-led education in managing chronic illness. They also highlight how structured programs can be tailored to meet the diverse needs of individuals in different settings.

Table 1: Summary of Key Studies on Nurse-led COPD Interventions

Study	Intervention Type	Sample Size	Key Outcomes
ALHarbi et al. (2022)	Blended education program	60	Improved symptom monitoring, medication adherence
Zhang et al. (2023)	Home-based pulmonary rehab	74	Increased walking distance, better quality of life scores
Rassouli et al. (2021)	Telehealth care	60+	Increased CAT scores, improved satisfaction, better detection
Wang et al. (2024)	Allied health-led clinic intervention	9048	16% reduced mortality, 8% reduction in ER visits

These studies collectively emphasize that properly trained health professionals, especially nurses, play a critical role in shaping positive outcomes for COPD patients through education, monitoring, and support.

EBP Model and Its Steps

The Iowa Model of Evidence-Based Practice serves as a strategic guide to implementing quality improvement in healthcare, especially for conditions like COPD that require long-term management. The model begins by identifying a pressing clinical issue—in this case, recurrent exacerbations among COPD patients. Following this, a multidisciplinary team, comprising nurse practitioners, respiratory therapists, and educators, is formed to evaluate and implement interventions (Dusin et al., 2023).

Evidence was gathered from reliable databases to identify successful educational approaches. One key step involved framing a well-structured PICOT question: 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 question guided the literature search and helped align clinical strategies with the best available evidence (Howe, 2024).

Table 2: Application of the Iowa Model Steps in COPD Care

Iowa Model Step	Application in COPD EBP Implementation
Identify problem	Frequent exacerbations and readmissions among COPD patients
Form a team	Nurses, respiratory therapists, educators
Review evidence	Systematic search in PubMed, CINAHL, Cochrane
Pilot intervention	Nurse-led education and follow-up
Evaluate outcomes	Readmission rates, symptom control, patient satisfaction
Sustain change	Incorporation into standard care with continued monitoring

Additionally, Hu et al. (2022) explored nurse-led education based on the Knowledge, Attitude, and Practice (KAP) framework. They found that older COPD patients receiving this model-based instruction experienced improved self-care, treatment compliance, and pulmonary function compared to those receiving standard care. The KAP approach added a psychological dimension by fostering belief-based behavioral changes.

Challenges during the evidence appraisal process included ensuring that findings were applicable to diverse populations and maintaining high methodological standards in study selection. Nonetheless, this structured model enabled successful integration of EBP into routine COPD management by aligning clinical priorities with research evidence and patient needs.

Credibility and Relevance of Resources

The credibility of the supporting studies was assessed using the CRAAP criteria (Currency, Relevance, Authority, Accuracy, Purpose). All selected research articles were published within the last five years in peer-reviewed journals, demonstrating strong methodological rigor and relevance to clinical practice.

ALHarbi et al. (2022) provided a strong foundation for nurse-led education, while Rassouli et al. (2021) introduced the promising utility of telehealth, showing a 50% improvement in COPD Assessment Test (CAT) scores and increased care satisfaction. The third source by Wang et al. (2024), which analyzed data from over 9000 patients, revealed that nurse and allied-health-led clinics significantly lowered mortality rates and emergency department usage.

These findings collectively illustrate the transformational role of nursing interventions in chronic disease management. Not only do these approaches yield measurable improvements in clinical outcomes, but they also enhance patients’ quality of life through accessible, tailored support systems. As healthcare systems face increasing strain, such evidence-based, nurse-led approaches offer scalable, sustainable solutions.

Conclusion

The use of the Iowa Model to guide nurse-led educational initiatives in COPD management demonstrates the power of structured, evidence-based approaches in improving clinical outcomes. By aligning interdisciplinary collaboration with research evidence, the model ensures that care is both effective and patient-centered. This EBP project highlights how real-time application of research can yield tangible improvements in symptom control, reduce hospital readmissions, and elevate the standard of care for COPD patients.

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

Capella 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

Capella 4025 Assessment 2

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)

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