Category: NURS-FPX4025

Capella FPX 4025 Assessment 4 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date Presenting Your PICO(T) Process Findings to Your Professional Peers The Chronic Obstructive Pulmonary Disease (COPD) diminishes lung performance and produces life quality reductions and higher health service requirements. Smoking functions as the main risk element for COPD, yet stopping tobacco use remains the best approach to prevent disease advancement while enhancing patient results. The challenge to stop smoking exists because people face addiction and psychological distress in combination with their need for proper support networks (Choi et al., 2021). This assessment evaluates whether structured smoking cessation programs work better than standard counseling for assisting COPD patients to stop smoking while improving their lung function during a six-month follow-up period. Diagnosis: Outcomes, Risks, and Complications The COPD forces patients to deal with ongoing air passage blockages while causing breathing problems. The main cause of this disease stems from extended contact with irritants and smokers represent its principal cause. A total of fourteen million Americans suffer from COPD. The symptoms of COPD include persistent cough in addition to shortness of breath, wheezing noises, and frequent infections of the respiratory system. COPD causes patients to lose pulmonary function, so their daily activities become limited, and their quality of life changes negatively (Boers et al., 2023). COPD runs its course differently based on disease extent and treatment effectiveness. Proper intervention is needed to prevent patients from showing declining lung function because they face increased hospital visits because of exacerbations in addition to worse health outcomes. COPD triggers both cardiovascular ailments and the development of osteoporosis together with muscular deterioration and depressive symptoms. COPD becomes more dangerous in patients who lack healthcare services while also showing poor disease control and who maintain their smoking behaviors. The advanced stage of COPD ends in respiratory failure, which leads healthcare providers to give long-term oxygen therapy or utilize mechanical ventilation devices (American Lung Association [ALA], 2024). The continued smoking behavior of someone diagnosed with COPD results in accelerated lung function deterioration and more medical facility stays and increases the possibility of death. Evidence-based treatment combined with smoking cessation enables patients to control disease progression and enhance their health quality. Structured smoking cessation programs establish themselves as vital components in COPD management because they help patients understand existing risks. Research Question Using PICO(T) Criteria To determine the most effective intervention for smoking cessation among COPD patients, a structured research question was formulated using the PICO(T) framework. The research question is: In adult patients diagnosed with COPD (P), how does a structured smoking cessation program incorporating behavioral counseling and pharmacotherapy (I) compared to standard smoking cessation counseling (C) affect the smoking cessation rates and pulmonary function (O) within six months (T)? The Population (P) is adult patients diagnosed with COPD. This population was chosen because COPD is strongly linked to smoking, and cessation is essential in disease management. The Intervention (I) is a structured smoking cessation program incorporating behavioral counseling and pharmacotherapy, such as Nicotine Replacement Therapy (NRT), varenicline, or bupropion. Multi-component interventions improve quit rates compared to single interventions (Onwuzo et al., 2024). For Comparison (C) standard smoking cessation counseling typically involves brief advice or educational materials from healthcare professionals. The Outcomes (O) are measured from sustained smoking cessation rates and improved pulmonary function. Measuring these outcomes provides insight into the intervention’s effectiveness. The time (T) for this intervention is six months. Sustained abstinence beyond this period predicts long-term cessation success. This structured question facilitates a targeted investigation into the effectiveness of smoking-cessation interventions in COPD management, enabling evidence-based practice improvements. Summary of Evidence from Peer-Reviewed Sources A thorough evaluation of research articles established the essential investigations concerning smoking cessation interventions among COPD patients. The researchers used reliable studies with appropriate relevance and robust methodology to find evidence-based guidelines for practical implementation. The study conducted by Wang et al. (2024) investigated how COPD patients responded to smoking cessation through meta-analysis research. The research group assessed 11 trials containing data from over 13000 participants to show how lung function improved by 6.72% FEV1% while both the 6-MWT distance extended by 64.46 meters together with mortality being 25% lower (RR = 0.75). This study gains high credibility because it consolidates findings from various high-quality trials, improving bias reduction and operational applicability. Han et al. (2023) conducted a Randomized Controlled Trial (RCT) to analyze the outcomes of structured smoking cessation treatments that integrated cognitive behavioral therapy with pharmaceutical treatments. Standard counseling yielded fewer quit success rates than structured intervention programs for smoking cessation. RCTs function as the top methodology in clinical research because they provide strong results that also apply to various situations. Fu et al. (2022) examined how the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model can be utilized for COPD patient smoking cessation. The research findings demonstrate that routine clinical practice needs evidence-based interventions for better pulmonary outcomes while controlling disease progression. The research shows credibility through its provision of an organized methodology to implement research findings within clinical environments. According to Hu and fellow researchers, the rate of successful smoking abstinence reached 27.6% after six months in their study (2021). Studies confirm that the selected period addresses successful smoking cessation evaluation and demonstrates why structured cessation interventions produce lasting results. Strong evidence from these varied resources demonstrates that structured programs for smoking cessation represent the most beneficial method to enhance both COPD patients’ quit success rates and their pulmonary conditions. Answer to the PICO(T) Question Based on Evidence Analysis The evidence consistently supports the superiority of structured smoking cessation programs over standard counseling for COPD patients. Wang et al. (2024) demonstrate that smoking cessation significantly improves lung function and reduces mortality risk, reinforcing the necessity of effective cessation strategies. Han et al. (2023) confirm that structured interventions combining behavioral support and pharmacotherapy yield higher quit rates than standard approaches. Fu et al. (2022) highlight the importance of evidence-based practice models in ensuring the successful implementation of cessation programs in clinical settings. Finally, Hu

Capella FPX 4025 Assessment 3 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date Applying the PICO(T) Process Recurrent urinary tract infections (rUTIs) are a common and distressing health issue, particularly among women (Foy et al., 2023). This paper addresses a clinical problem related to rUTIs by formulating a focused PICO(T) question and reviewing current evidence. Emphasis is placed on outcomes, risks, and healthcare disparities to inform best practices and support evidence-based, patient-centered interventions for prevention and care. Diagnostic Summary and Health Disparities Many women suffer greatly from UTIs, and these illnesses can affect the health and well-being of individuals, as well as society as a whole. Most outcomes occur due to re-infection from pathogenic bacteria such as E. coli, which can settle and continually irritate the urinary organs. Some causes of rUTIs include sexual activity, shifts in hormone levels, obstruction or stagnation in the urinary tract, poor personal hygiene, and certain methods of birth control. Women may experience worsening health problems, as well as develop antibiotic resistance and complications with their kidneys if they continue to have recurrent urinary tract infections. People living in disadvantaged communities experience higher rates of recurrent UTIs owing to their limited access to medical care, financial resources and social support networks. Women living in underserved communities or representing marginalized groups are often challenged to receive the help they need for managing their rUTIs in a timely manner. Lack of access to care, inadequate insurance, low health knowledge and inaccurate discussions with doctors all contribute to a later diagnosis and greater chances of recurrence of the illness (Chan et al., 2024). Inappropriate use of antibiotics and failure to practice preventive strategies worsen the symptoms and increase the likelihood of complications experienced by members of this high-risk group. Enumerating strategies to address these issues necessitates concerted educational efforts, expansion of healthcare resources, and efforts to adapt care to diverse cultural contexts. Applying these measures can greatly enhance the treatment and prognosis for chronic diseases while also reducing the likelihood of future flare-ups. Formulating the PICO(T) Question To address the recurring nature of UTIs in women, a PICO(T) question was developed:“In adult women with a history of recurrent UTIs, does participation in nurse-led educational and behavioral interventions, compared to standard care alone, reduce the frequency of UTIs and antibiotic use over six months?”This question aligns with the PICO(T) framework: Population (P): Adult women with recurrent UTIs Intervention (I): Nurse-led educational and behavioral strategies Comparison (C): Usual care without added intervention Outcome (O): Reduced UTI recurrence and decreased antibiotic reliance Timeframe (T): Six months This clinical question addresses a persistent healthcare concern and forms a structured basis for evidence-based practice aimed at enhancing patient outcomes and reducing long-term complications. Evidence Retrieval Approach An extensive literature review was performed to locate studies that evaluated nurse-led education and behavioral programs to prevent repeat UTIs among women. Three databases were chosen for the search because they feature reviewed scientific articles from the medical and nursing fields. Key search terms included: Recurrent UTIs, prevention, nurse-led interventions, educational programs, behavioral strategies, the use of antibiotics, and standard care. Operators like “AND” and “OR” were utilized to narrow down the research results. Each study was assessed using the CRAAP analysis criteria. Additional analysis was conducted to evaluate each study for its design, author credentials, and the reputation of its source journal. This search method prioritized those studies that were most significant, reliable, and relevant to healthcare professionals when making decisions for the best patient care. Evidence Synthesis and Clinical Implications UTIs are among the most frequent bacterial illnesses worldwide and play an important role in global healthcare. Research has recently shown that access to UTI diagnosis, treatment, and patient outcomes can vary among different communities. Research conducted from 2019 to 2021 at Cooper University Hospital and reported in Moazamian et al. (2025) assessed UTI outcomes for patients. Patients living in areas of greater socioeconomic adversity had poorer outcomes, reflected by higher rates of both 30-day and 90-day readmissions. Socioeconomic status has a widespread influence on patients managing and recovering from UTIs. A paper published in the International Journal for Equity in Health examined antibiotic resistance among UTIs treated in outpatient settings in 2024. The study revealed that more individuals with lower socioeconomic status were affected by antibiotic-resistant bacteria, which can worsen management and lead to frequent UTI relapses (Chan et al., 2024). Foy et al. (2023) published in the Journal of Urology, Respiratory Diseases in 2023, examined how often patients with UTIs received virtual care during the COVID-19 outbreak. Study results showed that older adults and people from lower economic groups were less likely to access virtual care for their UTIs, putting them at risk of delayed treatment that could worsen their health. These studies emphasize the urgent need for intentional strategies to reduce these inequalities in addressing UTI treatment. A range of approaches can be employed to address these disparities. These include increasing access to care, implementing initiatives to minimize antibiotic resistance, and enhancing telehealth options to promote equal access to treatment. Analysis of Evidence The studies demonstrate that differences in UTI outcomes exist due to factors such as socioeconomic status, access to healthcare, and antibiotic resistance. The studies suggest that factors such as economic status heavily influence the success of UTI treatment and increase the likelihood of additional hospitalizations, repeated infections, and subsequent delays in medical attention for underprivileged individuals. Moazamian et al. (2025)’s findings indicate that poverty and other economic factors are closely linked to patients’ increased odds of UTI-related readmissions within 30 and 90 days after discharge. Chan et al. (2024) showed that patients from low-income households were more vulnerable to antibiotic-resistant bacteria, which jeopardized the success of UTI treatment and raised the risk of subsequent infections. Foy et al. (2023) show how underrepresented words and topics in Women’s Wellness content topics reflect broader subject matter gaps. Finally, these results support efforts to enhance equitable healthcare practice by improving remote care availability, ensuring responsible antibiotic use, and safeguarding high-risk communities. Part

Capella FPX 4025 Assessment 2 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date Applying an EBP Model Evidence-Based Practice (EBP) is crucial for nursing, patient care being evidence-driven by the best available research. Chronic Obstructive Pulmonary Disease (COPD) heavily affects the quality of life for many patients, especially in relation to smoking-related symptoms and bad medication adherence. This paper uses the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model with smoking cessation in COPD patients. It will discuss the problem, outline the model’s process, and examine reliable evidence to enhance the results for patients. Issue Associated with the Diagnosis COPD is a chronic and progressive lung disease that involves airflow limitation and results in dyspnea, chronic cough, and reduced exercise performance. One of the main problems with COPD is smoking cessation because continued tobacco smoking can make the disease worsen and symptoms become more severe. Principe et al. (2024) explore that smoking cessation has numerous benefits, but many COPD smokers have difficulty stopping smoking due to nicotine addiction and the emotional burden of smoking, as well as a lack of support. A newly conducted meta-analysis verified that individuals who smoke possess a 4.01-fold increased likelihood of acquiring COPD (Principe et al., 2024). Evidence-based practice (EBP) is the key to tackling smoking cessation in COPD patients as it combines the best evidence it has at the moment with clinical expertise and patient preference. Han et al. (2023) highlight that medical professionals use structured smoking cessation programs that combine behavioral counseling with medical interventions and pulmonary rehabilitation to achieve better patient cessation outcomes and clinical results. This study shows that combining nicotine replacement therapy with cognitive-behavioral interventions was significantly enhanced compared to simple advice alone to quit.   Applying the JHNEBP model, nurses can systematically evaluate and translate into practice the most effective smoking cessation techniques for COPD patients. By taking this approach, interventions are founded on sound evidence rather than unwritten practices that can not be effective. Plus, using EBP fosters patient brooked care, providing patients with education and liberty to accomplish adherence with smoking come plans. In the long run, dealing with this by means of an EBP approach enhances disease management, reduces hospitalizations, and results in a superior quality of life for COPD patients (Jiang et al., 2024). EBP Model and Its Steps The JHNEBP model provides a systematic way for nurses to incorporate research findings into practice. This model is relevant for treating smoking cessation in COPD patients as it is based on a structured, evidence-based approach to decision-making tailored to the needs of the individual patient. Practice Question Evidence Translation (PET) is the three parts of the model. The first part is determining a well-defined, focused clinical question using the PICO (Population, Intervention, Comparison, Outcome) framework (Brunt & Morris, 2023). The next step is to perform a literature review to identify well conducted research studies, guidelines, and references to experts guidelines on smoking cessation in patients with COPD. Findings from several peer-reviewed journal studies, systematic reviews, and meta-analyses constitute the most compelling evidence. The reliability and usefulness of each resource are critically evaluated so that the most relevant and current data informs practice decisions. The goal is to implement the investigating-based intervention in the practical setting of the clinic. This includes designing smoking cessation interdisciplinary programs implementing behavioral counseling, pharmacotherapy, and pulmonary rehabilitation, as well as monitoring patient outcomes and adherence. Implementation challenges, including patient motivation and resource availability, are handled by education and support methods (Coleman et al., 2022). The JHNEBP Model is appropriate for this issue because it offers a directive, step-by-step strategy of incorporating research into nursing practice, leading to effective, patient-centered smoking cessation measures in managing COPD. Application of the JHNEBP Model to Evidence Search The JHNEBP model was used to determine evidence-supported interventions for smoking cessation treatments in patients with COPD. The research framework employs PET methodology for conducting effective searches of relevant evidence. The practice question began with PICO format focusing on COPD patients (P) who receive structured smoking cessation programs versus standard advice (C) to achieve better outcomes, including cessation success rates and disease control (O). The framework served to optimize search parameters for achieving relevant results (Williams et al., 2022). A complete investigation of research publications occurred through combined searches in PubMed, CINAHL, and Cochrane Library framework to find articles about COPD smoking cessation. The research used COPD together with smoking cessation and both nicotine replacement therapy and behavioral counseling and pulmonary rehabilitation as essential search terms. The analysis process included a detailed evaluation of chosen studies to assess credibility together with relevance and applicability, as this step ensured clinical decisions relied on strong evidence. The evidence search involved multiple difficulties that arose. The large quantity of available literature about smoking cessation rendered it challenging to locate research dedicated to COPD alone. Most articles implemented universal smoking cessation plans without acknowledging the physiological or behavioral characteristics of COPD patients. The competing information across research studies made it difficult to find the most powerful intervention because investigators needed to analyze research methods and demographic groups and extended results. Full-text article access proved difficult, requiring readers to work with abstracts, system reviews, and institutional access to get comprehensive data. The JHNEBP Model delivered successful results by developing better search techniques and studying evidence to choose the most relevant and dependable findings for implementation in practice. Credibility and Relevance of Resources The study resources from Principe et al. (2024), Han et al. (2023), and Jiang et al. (2024) deliver powerful evidence-based data about smoking cessation approaches for patients with COPD. Such evaluation based on the CRAAP criteria allows healthcare practitioners to determine both the reliability and practice relevance of these sources for EBP. Principe et al. (2024) analyzed multiple studies through a meta-analysis, which produced strong research on smoking risks leading to COPD development. A meta-analysis combining various studies’ information increases research power while minimizing prejudice. This resource holds great value because of both its recent publication and precise

Capella FPX 4025 Assessment 1 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date Analyzing a Research Paper Reference Cherbi, M., Lairez, O., Baudry, G., Gautier, P., Roubille, F., & Delmas, C. (2025). Early initiation of sodium–glucose cotransporter 2 inhibitors in acute heart failure: A systematic review and meta‐analysis. Journal of the American Heart Association, 14(8), e039105. DOI: https://doi.org/10.1161/JAHA.124.039105 Published Date: April 7, 2025            Article Review Criteria Review Study Type Quantitative study based on systematic review and meta-analysis. It included randomized controlled trials (RCTs). The study is based on quantitative analysis of numerical findings from RCTs.  Level of Evidence The systematic and meta-analysis of RCT study represents the highest level of the evidence pyramid, “level 1”. Methodology The systematic and meta-analysis of the RCT-based study followed the systematic approach and the PRISMA checklist for searching articles. The study performed an extensive database research across PubMed, EMBASE, and Cochrane Central Register of Controlled Trials. The study has well-defined Inclusion and Exclusion criteria; The exclusion criteria were strict, such as RCTs involving individuals with moderate and chronic heart failure who did not have an abrupt exacerbation requiring unexpected admission were excluded. Pooled analysis was performed to assess confidence intervals and odds ratios (ORs) for statistical assessment. DerSimonian and Laird’s Random-Effects Model was used to account for variability in treatment, and a sensitivity analysis was conducted to validate findings. Credibility Factors The research complies with the PRISMA checklist and employs advanced analytical and statistical strategies. To avoid bias, a robust sensitivity analysis for confirming results or a Cochrane risk of bias tool is used. The study is credible, as it was printed in the reputable journal “Journal of the American Heart Association.” The authors are from the related medical field and belong to authoritative institutions. Importance of Selected Diagnosis It provides evidence-based recommendations to manage Acute Heart Failure (AHF) concerns. It discusses the effectiveness of Sodium-glucose cotransporter 2 inhibitors (SGLT2is) such as dapagliflozin in managing AHF-related concerns. It also discusses the safety and efficacy of SGLT2 inhibitors in avoiding complications after AHF by lowering all-cause mortalities and re-admissions. Application in Workplace/Patient Population The research’s findings in the AHF care provision provide crucial details about viable therapy for lowering death rates and readmissions. The study’s findings apply to various medical contexts and demonstrate generalizability. The research emphasizes the usefulness of SGLT2is in AHF treatment to improve patient safety. These findings help to establish SGLT2 inhibitors’ standing in the AHF medical care, which could enhance outcomes for diverse patients by reducing complications. The study showed that starting this medication administration before release resulted in an even bigger gain in survival. These findings support the beginning of SGLT2i as promptly as feasible in AHF patients. Sentinel U Patient Case Study Patient Name: Robert Johnson Diagnosis of Clinical Concern: AHF worsening due to excessive fluid levels, Respiratory difficulty, severe I/O, and abnormal lab findings  Current Treatment: Administering IV Lasix, digoxin, and potassium supplements  Care Regimen: Patient needs continual monitoring of the heart and fluid. Summary of Findings The study reviews the medical advantages of SGLT2is for AHF care. The authors state that many unique particular treatments have been tried in AHF settings without producing substantial enhancements and, in fact, with unsatisfactory results in terms of death rates. The initial therapy of AHF included diuretic medication. This study intends to systematically assess the safety and effectiveness of SGLT2is among individuals admitted for AHF. The findings of a meta-analysis of RCTs including 2321 patients hospitalized with AHF revealed that SGLT2i showed significant clinical outcome benefits. They found a reduction in all-cause deaths (OR= 0.72, 95% CI 0.56–0.91), and lowered readmission (OR= 0.74, 95% CI 0.55–0.93). Even when SGLT2is were initiated before discharge, sensitivity analysis supported these benefits, significantly reducing death (OR 0.53). Further, no raised threats of serious negative incidents like acute kidney injury or urinary tract infections among patients taking SGLT2is were observed. These results indicate that the use of SGLT2is in AHF patients will lower mortality, prevent the worsening of heart failure and readmissions, and therefore be a promising adjunct therapy for AHF care. This study is relevant for AHF sufferers like Johnson. To avert acute renal injury, urinary tract infections, complications, and readmissions, Johnson requires ongoing monitoring and specialized therapy. The paper recommends employing SGLT2is for AHF treatment to improve Johnson’s results by avoiding complications and re-hospitalization.  Relevance and Potential Effectiveness of Evidence Cherbi et al. (2025) extensively investigate SGLT2is therapy to manage AHF-related complications. This systematic review meta-analysis provides highly relevant evidence for clinical practice, answering a crucial gap in treating AHF, where mortality and readmission rates are high, but therapeutic advances are limited. The evidence is significant for patients like Johnson, who require extensive fluid and cardiac monitoring. However, their applicability to other patient populations depends on illness severity, complications, and therapy response. The appearance of the article in a reputable journal helps to validate the article’s legitimacy and integrity. To verify that the article contains reliable data, RCTs and statistical evaluations of the efficacy of SGLT2is medication on mortality and readmission rates are performed. The consistency of results across trials and the adoption of rigorous methodology (PRISMA-guided, minimal heterogeneity, sensitivity analysis) contribute to the accuracy of these findings. The article’s findings can be used in clinical settings to provide new therapy choices, particularly for individuals with fluid retention. However, the research does not assess the impact of various doses of SGLT2is and conduct constant follow-ups to grasp its part in AHF management. Safety outcomes revealed no significant harm; the relatively small event rates underline the importance of using this drug for AHF care. This research is critical for personalizing therapy to patients, as improved AHF treatment benefits people like Johnson. If incorporated into medical guidelines, SGLT2is have the potential to transform AHF care by providing cardioprotection and inhibiting fluid retention, rendering them a crucial therapy. Article Link https://pubmed.ncbi.nlm.nih.gov/40194974/ References Cherbi, M., Lairez, O., Baudry, G., Gautier, P., Roubille, F., & Delmas, C. (2025). Early initiation of sodium–glucose cotransporter 2 inhibitors in acute heart failure: A systematic review and meta‐analysis. Journal of the American Heart Association, 14(8), e039105. https://doi.org/10.1161/JAHA.124.039105 Capella FPX 4025