NURS FPX 4025 Assessment 5
NURS FPX 4025 Assessment 5 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date
NURS FPX 4025 Assessment 5 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date
NURS FPX 4025 Assessment 4 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date
NURS FPX 4025 Assessment 3 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date Assessment 3: Understanding COPD and Smoking Cessation Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease that severely affects breathing and quality of life. Smoking is the primary risk factor contributing to COPD, and continued smoking accelerates disease progression. Despite the well-documented benefits of smoking cessation, many individuals struggle to quit due to nicotine addiction, psychological stress, and limited access to support systems. COPD remains a significant public health concern in the United States, impacting approximately 16 million adults (Centers for Disease Control and Prevention [CDC], 2024). Quitting smoking not only slows disease progression but also improves overall lung function and reduces the risk of hospitalizations. However, due to various barriers, many COPD patients find it challenging to quit smoking successfully. This assessment evaluates the effectiveness of structured smoking cessation programs compared to standard counseling in assisting COPD patients in achieving long-term smoking abstinence and improving their lung health over six months. Diagnosis and Challenges COPD manifests through persistent symptoms such as chronic coughing, breathlessness, and frequent respiratory infections. If left unmanaged, it can lead to severe complications, including hospitalizations, cardiovascular diseases, and respiratory failure. Smoking cessation remains the most effective intervention for slowing disease progression, yet many patients face challenges such as nicotine dependence, emotional stress, and lack of healthcare access (American Lung Association [ALA], 2024). Socioeconomic factors also play a crucial role, as individuals from low-income backgrounds or those residing in remote areas may struggle to access smoking cessation resources. Additionally, limited financial means may prevent some patients from affording essential COPD medications, such as inhalers or nicotine replacement therapies. Healthcare providers, particularly nurses, are instrumental in bridging these gaps by educating patients, providing support, and implementing evidence-based smoking cessation strategies (Wang et al., 2024). By addressing these challenges, structured programs can enhance smoking cessation rates and improve disease management. Research Question and PICO(T) Framework Understanding the most effective smoking cessation approach for COPD patients requires a structured research question. The PICO(T) framework is a useful tool for formulating a focused research question: 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), impact smoking cessation rates and pulmonary function (O) within six months (T)? A breakdown of the PICO(T) components is provided in the table below: PICO(T) Criteria Description Population (P) Adult patients diagnosed with COPD, for whom smoking cessation is critical for disease management. Intervention (I) A structured smoking cessation program incorporating behavioral counseling and pharmacotherapy (e.g., nicotine replacement therapy [NRT], varenicline, or bupropion), which has shown higher success rates than single interventions (Fu et al., 2022). Comparison (C) Standard smoking cessation counseling, typically consisting of brief counseling sessions or educational materials. Outcome (O) Sustained smoking cessation and improved pulmonary function over six months. Time (T) A six-month period, as research indicates that abstinence beyond this timeframe leads to long-term cessation success (Hu et al., 2021). This research question aims to identify the most effective smoking cessation strategies for COPD patients, providing insights into best practices for disease management and improved patient outcomes. Evidence and Literature Review A comprehensive literature review was conducted to gather evidence on smoking cessation programs for COPD patients. Databases such as PubMed, CINAHL, Cochrane Library, and Google Scholar were searched using keywords including “COPD,” “smoking cessation,” “nicotine replacement therapy,” “behavioral counseling,” and “pharmacotherapy.” Boolean operators were used to refine the search, ensuring a focus on studies specifically addressing smoking cessation in COPD patients. The CRAAP criteria (Currency, Relevance, Authority, Accuracy, and Purpose) were applied to assess the credibility of sources. Peer-reviewed articles, systematic reviews, and meta-analyses from reputable organizations such as the CDC and ALA were prioritized. Three key studies highlight the effectiveness of smoking cessation interventions. Wang et al. (2024) conducted a meta-analysis showing that quitting smoking significantly improved lung function (FEV1% increase of 6.72), walking ability (6-MWT increased by 64.46), and oxygen levels (1.96 higher). Han et al. (2023) found that structured programs incorporating cognitive-behavioral therapy and pharmacotherapy resulted in higher quit rates than standard counseling. Fu et al. (2022) emphasized the importance of using evidence-based practice models, such as the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, to enhance smoking cessation interventions. Collectively, these studies support the effectiveness of structured smoking cessation programs in improving patient outcomes. NURS FPX 4025 Assessment 3 Study Findings Wang et al. (2024) Smoking cessation led to improved lung function (FEV1% increased by 6.72), increased walking ability (6-MWT by 64.46), and higher oxygen levels (1.96 increase). Han et al. (2023) A structured smoking cessation program incorporating cognitive-behavioral therapy and pharmacotherapy led to higher quit rates compared to standard counseling. Fu et al. (2022) The use of evidence-based practice models, such as JHNEBP, improves smoking cessation outcomes and slows COPD progression. Conclusion Smoking cessation is vital for COPD patients as it significantly improves lung health and overall quality of life. Structured smoking cessation programs that include behavioral counseling and pharmacotherapy have demonstrated greater success rates than standard counseling. These programs provide essential support, helping patients overcome barriers to quitting smoking and reducing COPD-related complications. Nurses and healthcare providers play a crucial role in implementing these programs and guiding patients through the cessation process. By adopting evidence-based smoking cessation interventions, healthcare systems can enhance patient outcomes and contribute to the long-term management of COPD. References Alupo, P., Baluku, J., Bongomin, F., Siddharthan, T., Katagira, W., Ddungu, A., Hurst, J. R., Boven, van, Worodria, W., & Kirenga, B. J. (2024). Overcoming challenges of managing chronic obstructive pulmonary disease in low- and middle-income countries. Expert Review of Respiratory Medicine. https://doi.org/10.1080/17476348.2024.2398639 American Lung Association (ALA). (2024). Learn about COPD | American Lung Association. Lung.org; American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd Centers for Disease Control and Prevention (CDC). (2024, June 12). COPD. Chronic Disease Indicators. https://www.cdc.gov/cdi/indicator-definitions/chronic-obstructive-pulmonary-disease.html NURS FPX 4025 Assessment 3 Fu, Y., Chapman, E. J., Boland, A. C., & Bennett, M. I. (2022). Evidence-based management approaches for patients with severe
NURS FPX 4025 Assessment 2 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date Applying an Evidence-Based Practice (EBP) Model Evidence-Based Practice (EBP) is an essential approach in nursing, ensuring that patient care is based on the most reliable research. Chronic Obstructive Pulmonary Disease (COPD) significantly affects patients’ quality of life, particularly due to smoking-related complications and poor medication adherence. This discussion explores the use of the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model to enhance smoking cessation efforts for COPD patients. It addresses the challenges associated with the condition, outlines the structured steps of the JHNEBP model, and reviews relevant evidence to improve patient outcomes. Issue Associated with the Diagnosis COPD is a progressive respiratory disease that causes airflow limitation, leading to symptoms such as chronic cough, shortness of breath, and reduced exercise tolerance. One of the biggest challenges in managing COPD is smoking cessation, as continued tobacco use worsens the condition and accelerates disease progression. According to Principe et al. (2024), smoking cessation provides significant health benefits, yet many COPD patients struggle to quit due to nicotine dependence, emotional attachment, and insufficient support systems. Their meta-analysis found that smokers have a 4.01 times higher likelihood of developing COPD than non-smokers. EBP integrates the best research evidence with clinical expertise and patient preferences to address this issue effectively. Han et al. (2023) emphasize that structured smoking cessation programs—including behavioral counseling, pharmacotherapy, and pulmonary rehabilitation—lead to better outcomes compared to basic cessation advice. Evidence suggests that combining nicotine replacement therapy with cognitive-behavioral interventions significantly increases quit rates. By applying the JHNEBP model, nurses can systematically evaluate and implement effective smoking cessation strategies, improving disease management, reducing hospitalizations, and enhancing the overall quality of life for COPD patients (Jiang et al., 2024). EBP Model and Its Steps The JHNEBP model offers a structured process for integrating research findings into clinical practice, particularly in smoking cessation interventions for COPD patients. This model consists of three primary steps: Practice Question, Evidence Translation, and Implementation (PET). Practice Question: This step involves defining a clear clinical question using the PICO (Population, Intervention, Comparison, Outcome) framework. This structured approach helps healthcare professionals identify key concerns and develop targeted interventions for COPD patients struggling with smoking cessation (Brunt & Morris, 2023). Evidence Translation: The second step involves conducting a comprehensive literature review to gather relevant studies, clinical guidelines, and expert recommendations on smoking cessation strategies. Each source is critically appraised for reliability and applicability to ensure that clinical decisions are informed by high-quality evidence (Coleman et al., 2022). Implementation: In the final step, evidence-based interventions are applied in the clinical setting. This may include the development of interdisciplinary smoking cessation programs that incorporate behavioral counseling, pharmacotherapy, and pulmonary rehabilitation. The effectiveness of these interventions is continuously monitored, addressing challenges such as patient motivation and limited resources through education and support (Jiang et al., 2024). By following the JHNEBP model, healthcare providers can systematically implement smoking cessation programs that are both evidence-based and patient-centered. Application of the JHNEBP Model to Evidence Search The JHNEBP model was used to identify evidence-based interventions for smoking cessation in COPD patients. The PET framework guided the evidence search, focusing on COPD patients (P) undergoing structured smoking cessation programs (I) compared to those receiving standard cessation advice (C) to assess improvements in smoking cessation rates and disease management (O). This search was conducted across key medical databases such as PubMed, CINAHL, and the Cochrane Library, utilizing search terms like COPD, smoking cessation, nicotine replacement therapy, behavioral counseling, and pulmonary rehabilitation. Each selected study was critically analyzed for credibility and relevance, ensuring the most reliable evidence guided clinical decision-making. Despite challenges such as the overwhelming volume of literature and limited research focusing specifically on COPD-related smoking cessation, the JHNEBP model facilitated a systematic and targeted approach. This method ensured that the most relevant studies were identified for practical implementation in clinical settings. Credibility and Relevance of Resources Several studies, including those by Principe et al. (2024), Han et al. (2023), and Jiang et al. (2024), provide strong evidence on smoking cessation interventions for COPD patients. These resources were evaluated using the CRAAP (Currency, Relevance, Authority, Accuracy, and Purpose) criteria to determine their credibility and applicability to EBP. Principe et al. (2024) conducted a meta-analysis that synthesized data from multiple studies, offering compelling evidence on smoking-related risks and cessation benefits. Han et al. (2023) examined structured smoking cessation programs, highlighting the effectiveness of combining behavioral counseling with pharmacotherapy. Additionally, Jiang et al. (2024) explored the role of nurses in implementing smoking cessation interventions, reinforcing the importance of the JHNEBP model in improving COPD patient care. The credibility and relevance of these studies make them critical resources for guiding evidence-based smoking cessation strategies in clinical practice. Conclusion The application of the JHNEBP model ensures that smoking cessation interventions for COPD patients are based on high-quality, evidence-based practices. By leveraging credible research, nurses can develop structured smoking cessation programs that improve patient outcomes, slow disease progression, and support long-term COPD management. This systematic approach enhances the effectiveness of smoking cessation efforts, ultimately leading to better health outcomes for individuals with COPD. Table: EBP Model and Its Application Step Description References Practice Question Define a clear clinical question using the PICO framework to focus on COPD-related smoking cessation. Brunt & Morris, 2023 Evidence Translation Conduct a thorough literature review to identify relevant studies, guidelines, and expert opinions. Coleman et al., 2022; Williams et al., 2022 Implementation Apply the findings in practice through structured programs, monitor patient outcomes, and provide support. Jiang et al., 2024 References Brunt, B. A., & Morris, M. M. (2023, March 4). Nursing professional development evidence-based practice. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK589676/ Coleman, S. R. M., Menson, K. E., Kaminsky, D. A., & Gaalema, D. E. (2022). Smoking cessation interventions for patients with chronic obstructive pulmonary disease: A narrative review with implications for pulmonary rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention, 43(4). https://doi.org/10.1097/HCR.0000000000000764 Han, M. K., Fu, Y., Ji, Q., Duan, X., & Fang, X. (2023). The effectiveness of theory-based smoking cessation interventions
NURS FPX 4025 Assessment 1 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date Evaluation of the Article The study by Assaf et al. (2022) is a quantitative, cross-sectional analysis that investigates the quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD). This research design gathers data at a single point in time, allowing for the identification of associations rather than causal relationships. While the study provides moderate-level evidence on the factors influencing QoL in COPD patients, further research, particularly randomized controlled trials (RCTs), would be required to establish cause-and-effect relationships. The credibility of the article is strengthened by its publication in F1000Research, a peer-reviewed journal with an open-review process, ensuring transparency. The authors are affiliated with reputable academic and healthcare institutions, and the study follows ethical research standards by utilizing validated tools in its methodology. Moreover, the article references authoritative sources such as the World Health Organization (WHO) and the American Thoracic Society (ATS), reinforcing its reliability and academic rigor. NURS FPX 4025 Assessment 1 The study’s key findings indicate that smoking, dyspnea, and psychological distress negatively impact the quality of life of COPD patients. The research underscores the importance of pulmonary rehabilitation, smoking cessation programs, and medication adherence in improving patient outcomes. These insights are particularly relevant to healthcare settings where smoking rates are high and support the implementation of integrated care models for COPD management. The findings also apply to the case of Mr. James Carter in the Sentinel U simulation, whose dyspnea and chronic cough result from a 40-pack-a-year smoking history and poor treatment adherence. The article provides a strong evidence base for designing interventions aimed at improving Mr. Carter’s quality of life. Table: Evaluation of the Article Criteria Details Study Design & Level of Evidence Quantitative, cross-sectional study. Collects data at a single point in time, useful for identifying associations but not causality. Provides moderate-level evidence. Credibility Factors Published in F1000Research, a peer-reviewed journal with an open-review process. Authors are affiliated with reputable institutions. The study follows ethical guidelines and uses validated tools. Cites authoritative sources like WHO and ATS. Key Findings & Implications Smoking, dyspnea, and psychological distress significantly impact the QoL of COPD patients. Highlights the importance of pulmonary rehabilitation, smoking cessation programs, and medication adherence for better patient outcomes. Supports integrated care models. Summary of Findings Assaf et al. (2022) explored the quality of life (QoL) in COPD patients, identifying several key factors that influence their well-being, including dyspnea, chronic cough, smoking history, and psychological distress. The study emphasizes the importance of evidence-based interventions, such as pulmonary rehabilitation, smoking cessation, and medication adherence, in improving COPD management. These findings align closely with the case of Mr. James Carter in the Sentinel U simulation, as his symptoms mirror those seen in COPD patients, primarily due to a long history of smoking and poor treatment adherence. The study provides strong support for integrating structured interventions, such as pulmonary rehabilitation programs and smoking cessation efforts, into COPD care to enhance patient outcomes. Credibility & Usefulness The article was published in F1000Research, a peer-reviewed journal, ensuring credibility through an open-review process and expert validation. The authors have affiliations with reputable institutions specializing in pulmonary diseases, adding to the study’s reliability. Using a structured quantitative approach, the research applies validated questionnaires and statistical analysis, making its findings robust. Furthermore, referencing authoritative sources such as WHO and ATS strengthens the article’s trustworthiness. Although cross-sectional studies do not establish causation, this research offers valuable insights into COPD management. In particular, it provides guidance on effective interventions for Mr. Carter, such as pulmonary rehabilitation and smoking cessation programs, which could significantly improve his quality of life and disease management. NURS FPX 4025 Assessment 1 Article Link: https://doi.org/10.12688/f1000research.121783.1 References Assaf, E. A., Badarneh, A., Saifan, A., & Al-Yateem, N. (2022). Chronic obstructive pulmonary disease patients’ quality of life and its related factors: A cross-sectional study of the Jordanian population. F1000Research, 11, 581. https://doi.org/10.12688/f1000research.121783.1
