Category: NURS-FPX4030

Capella 4030 Assessment 4 Remote Collaboration and Evidence Based Care Name Capella university NURS-FPX 4030 Making Evidence-Based Decisions Prof. Name Date Remote Collaboration and Evidence-Based Care Salutations! I, _________, welcome to today’s presentation on collaboration and evidence-based care in remote care settings. This presentation focuses on a patient scenario related to gender dysphoria, where we will establish an evidence-based care plan to integrate healthcare services and reduce health disparities. Firstly, let me share a patient care scenario to offer a brief background of the presentation.  Background Scenario  A 25-year-old transgender male living in an underserved area with limited healthcare access was diagnosed with gender dysphoria following a behavioral health assessment. The patient articulated interest in receiving hormonal and surgical management for the health condition. Dr. Smith, who is the patient’s primary care provider, initiated a remote collaboration with a multidisciplinary team, including mental health experts, endocrinologists, surgeons, and registered nurses. The team supports the patient’s preferred treatment modalities; however, they accentuate the need for a more in-depth evaluation to confirm the diagnosis and exclude other conditions before deciding on the best hormonal and surgical treatment options.  Evidence-based Care Plan Proposal  An evidence-based is proposed to improve the safety and outcomes for the patient in this scenario, encompassing a multidisciplinary approach that prioritizes comprehensive assessment, patient-centered care, and coordinated follow-up.  The care plan begins with a comprehensive psychiatric evaluation (CPE) to confirm the diagnosis of gender dysphoria and exclude other conditions that might present similarly. Levine (2024) mentions that this in-depth evaluation helps ensure that the patient receives appropriate, individualized treatment, such as hormone therapy or surgery, while addressing any co-occurring mental health issues. This assessment evaluates the patient’s mental health history, current psychological state, and any symptoms of psychiatric disorders, ensuring a holistic approach to care.  After confirming the diagnosis, we aim to develop a personalized hormone replacement therapy (HRT) plan. Hormonal therapy involves administering hormones, such as testosterone or estrogen, to align the patient’s physical characteristics with their gender identity (Maung, 2024). This plan would be initiated and monitored by the endocrinologist, with regular check-ins to assess the patient’s response and adjust dosages as necessary.  Capella 4030 Assessment 4 Remote Collaboration and Evidence Based Care Simultaneously, the plan includes discussing surgical options in detail with the patient. It is crucial to assess the patient’s readiness for gender-affirming surgeries and ensure the patient understands the risks, benefits, and expected outcomes of each procedure (Amengual et al., 2022). This education is also integral to following ethical and legal requirements. Finally, the plan aims to include patient-centered support and education. Given the patient’s rural location and limited access to healthcare, telehealth services will be integrated into the care plan to provide ongoing support, education, and follow-up care. Telehealth can facilitate regular mental health counseling, HRT monitoring, and post-surgical care, ensuring the patient receives continuous care despite geographic barriers. Additionally, telehealth enables connecting patients with local transgender support groups to offer emotional support and help mitigate societal stigma and discrimination (Stoehr et al., 2021). Need for Further Information  Additional information could have been valuable in several areas in establishing a more patient-centered and precise care plan. First, more detailed data on the patient’s mental health history and any co-existing mental health conditions would help in tailoring the psychological support provided. Additionally, insight into the patient’s social support system, including family acceptance and community resources, would help in addressing potential psychosocial challenges. Finally, knowledge of local healthcare resources and the availability of telehealth infrastructure in the patient’s area would assist in planning effective follow-up care and support services (Stoehr et al., 2021). Evidence-Based Practice Model This evidence-based care plan is grounded in an evidence-based practice (EBP) model called the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model. It is a systematic approach designed to integrate the best available evidence into nursing practice to improve patient outcomes. The model emphasizes three key components: Practice Question, Evidence, and Translation (PET) (Dusin et al., 2023). In developing the care plan for gender dysphoria, the JHNEBP model was instrumental in ensuring that the plan was rooted in the best available evidence and aligned with patient-centered care principles.  The process began with formulating a specific practice question (Dusin et al., 2023). The question for this care plan was: How can we improve the safety and outcomes for a transgender male patient seeking gender-affirming care in a rural setting?  This question guided the subsequent evidence search, focusing on studies, clinical guidelines, and expert consensus on managing gender dysphoria, especially in rural or underserved populations (evidence phase).  Finally, in the translation phase, the evidence was applied to develop a multidisciplinary care plan that included detailed steps for assessment, treatment, and follow-up, additionally emphasizing the integration of telehealth services to overcome geographic barriers, ensuring continuity of care and patient safety (Stoehr et al., 2021). Assessing the Benefits to Patient Outcomes According to Churruca et al. (2021), monitoring patient-reported outcomes through surveys and questionnaires assists in evaluating the effectiveness of care and the benefits that it leaves on patients’ well-being. Measuring several metrics, such as the patient’s mental and physical well-being, satisfaction with care, adherence to treatment and medication plans, and availability of adequate healthcare services, will be crucial for assessing the benefits of our EBP care plan. Continuous monitoring and adjustment based on these evaluations would ensure the plan remains responsive to the patient’s evolving needs and contributes to optimal outcomes. Evaluation of Evidence for Making Care Plan The evidence-based care plan utilized several literature studies and clinical guidelines to ensure the plan is deeply rooted in research. Yet, the most relevant evidence collected for the care plan was Levine (2024), which discusses the importance of a comprehensive psychiatric evaluation (CPE) in diagnosing gender dysphoria. This evidence supports the intervention decided by the multidisciplinary team, which is crucial to accurately confirm the diagnosis before initiating any treatment. This literature study emphasizes addressing co-occurring mental health issues and ensuring individualized treatment, highlighting the foundational role of a thorough evaluation in providing effective and

Capella 4030 Assessment 3 Picot Questions and An Evidence Based Approach Name Capella university NURS-FPX 4030 Making Evidence-Based Decisions Prof. Name Date PICO (T) Questions and an Evidence-Based Approach Stroke is a leading cause of disability and mortality worldwide, making it a critical focus for healthcare interventions. To improve patient outcomes through evidence-based practice, it is essential to gather credible, relevant, and trustworthy evidence for integration into clinical practices. Thus, a structured approach to clinical inquiry, such as the PICOT framework, will be beneficial. PICOT stands for Patient/Population, Intervention, Comparison, Outcome, and Time, and it helps formulate research questions that guide evidence-based practice (Hosseini et al., 2023). In this assessment, we apply this framework to inquire about the benefits of telehealth services in improving medication adherence among stroke patients, eventually enhancing patient outcomes.  Practice Issue to be Explored and PICO(T) Inquiry Patients encountering stroke are at high risk of developing medication non-adherence, leading to exacerbations, relapses, and poor disease control (Zeng et al., 2021). Thus, it has become a significant medical practice issue where providers strive to ensure that patients maintain medication adherence and engage in self-management practices to control further attacks. In the growing healthcare landscape and increasing disease burden, traditional in-person follow-up visits are insufficient for continuous monitoring, especially in elderly patients who face mobility challenges or other barriers to accessing care. Therefore, this paper explores the use of telehealth services to improve outcomes in this vulnerable population. In patients who have suffered a cerebrovascular attack (stroke) (Population), does the use of telehealth for monitoring and follow-up (Intervention), compared to in-person follow-up visits (Comparison), improve medication adherence and disease control (Outcome)?  Benefit of Using the PICO(T) Framework  Exploring this practice issue through the PICOT approach allows for a structured and focused investigation that can lead to evidence-based interventions. The PICOT framework breaks down the research question into specific components, making it easier to identify relevant evidence and compare the effectiveness of different interventions (Hosseini et al., 2023). By applying this approach, healthcare providers can systematically evaluate the importance of evidence-based interventions in managing post-stroke patients. Ultimately, this can inform clinical guidelines and improve patient outcomes by promoting strategies that are proven to be effective in controlling the disease and reducing the risk of recurrence. Sources of Evidence and Rationale/Criteria Several online sources, including databases, journals, and websites, are capable of answering the PICOT question regarding the effectiveness of telehealth services versus in-person follow-up for medication adherence and disease control in stroke patients.  Databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed.  Journals: Journal of Telemedicine and Telecare and the Journal of Stroke and Cerebrovascular Diseases.  Authoritative Website: The American Stroke Association (ASA).  The Rationale for Selecting These Sources  The selected sources are capable of answering the PICOT question due to their focus on high-quality, peer-reviewed research and evidence-based guidelines. Additionally, these sources provide information that abides by the CRAAP criteria (currency, relevance, authority, accuracy, and purpose). According to Oermann et al. (2021), among other databases, CINAHL and PubMed are acknowledged for their comprehensive coverage of healthcare-related topics. Therefore, these databases are crucial to accessing literature studies that directly examine the impact of telehealth on chronic disease management, including stroke. Simultaneously, the Journal of Telemedicine and Telecare explicitly focuses on telehealth, making it an invaluable resource for understanding the nuances of remote patient monitoring and follow-up care. Similarly, the Journal of Stroke and Cerebrovascular Diseases provides insights into the latest research on stroke management, ensuring that the information is both current and relevant. Finally, the authoritative website of ASA offers reliable guidelines, which are essential for supporting clinical decisions based on the latest evidence (American Stroke Association, n.d.). These sources collectively provide a robust foundation for exploring the efficacy of telehealth in improving post-stroke outcomes, directly addressing the PICOT question. Findings from the Literature  Several scholarly studies support the PICOT inquiry by elaborating on the effectiveness of telehealth and remote monitoring applications compared to standard in-person visits in improving medication adherence, addressing disparities, and enhancing health outcomes for post-stroke patients.  A literature review by Choi et al. (2023) concludes that telemedicine and mobile health applications are beneficial for stroke patients with minimal medication adherence. The study showed a substantial improvement of 37% compared to the control group with usual care. These interventions not only improve medication compliance but are also proven to reduce blood pressure and remain a cost-effective stroke management strategy.  Another literature review shows that compared to the patients who received the usual care, the individuals who were treated using mHealth technology had a better understanding of medication use and adherence. However, this study further mentions the effectiveness of instant messaging features compared to telephonic call intervention in significantly augmenting adherence rates (Zeng et al., 2021).  Sharrief et al. (2023) discuss how telehealth services address healthcare disparities for stroke patients. According to this study, these post-discharge telehealth visits reduce care barriers, such as transportation issues associated with in-person visits. Moreover, these services are crucial for preventing stroke readmissions by guaranteeing adherence to medication and treatment plans. Finally, these interventions also promote easy and accessible follow-up care, ensuring timely interventions.  Capella 4030 Assessment 3 Picot Questions and An Evidence Based Approach Among the sources mentioned, the most credible are the literature reviews by Choi et al. (2023) and Zeng et al. (2021). These peer-reviewed articles are rigorously examined, ensuring the accuracy, objectivity, and reliability of the research. Choi et al. (2023) are particularly credible due to their comprehensive analysis that demonstrates the efficacy of telemedicine in 37% improvement in medication adherence, underscoring its significance to integration in clinical practice. Similarly, Zeng et al. (2021) also present credible evidence, especially in their comparison of different telehealth modalities (instant messaging versus telephonic calls). This comparison provides precise guidelines for healthcare professionals to optimize telehealth interventions. Decision-Making on PICO Question  Based on these findings, the decision to implement telehealth interventions for monitoring medication adherence and disease control in stroke patients is strongly supported. The study by Choi

Capella 4030 Assessment 2 Determining the Credibility of Evidence and Resources Name Capella university NURS-FPX 4030 Making Evidence-Based Decisions Prof. Name Date Determining the Credibility of Evidence and Resources This analysis highlights the importance of an evidence-based approach to expanding knowledge regarding acute pancreatitis. Moreover, the paper discusses the criteria for determining the credibility of resources, examining different sources of information for their credibility and relevance to the diagnosis. Lastly, the paper examines the importance of integrating credible information into an Evidence-Based Practice (EBP) model, resulting in improved practices and patient outcomes.  Chosen Diagnosis and Evidence-based Approach Acute pancreatitis is described as the inflammation of the pancreas, usually caused by stones in the gallbladder or excessive consumption of alcohol. It is one of the life-threatening gastrointestinal health conditions, accounting for approximately 275,000 hospital admissions in the United States. It is estimated that 20% of patients develop acute pancreatitis, leading to a 20-40% death rate (Li et al., 2021). Due to its harmful complications, including organ failure and elevated mortality rate, an evidence-based approach is crucial in managing patients.  Li et al. (2019) define Evidence-based Practices (EBP) as the utilization of best practices available in evidence to derive decisions and provide adequate care to patients, considering their needs and preferences. Managing acute pancreatitis can benefit from evidence-based guidelines, helping clinicians to make informed decisions regarding diagnosis, treatment, and monitoring. For instance, early fluid resuscitation is a treatment modality supported by the evidence to prevent hypovolemia and maintain organ perfusion in patients with acute pancreatitis (de-Madaria et al., 2022). Such informed decisions are imperative to improve patient outcomes.  Additionally, an evidence-based approach assists in avoiding unnecessary interventions that may exacerbate patients’ conditions or lead to complications. This is highly important in case of acute pancreatitis to prevent life-threatening outcomes. Through this approach, practitioners ensure that patients receive the most effective and safe care based on the latest scientific evidence, reducing morbidity and mortality and improving patient satisfaction (Li et al., 2019).  Criteria to Determine the Credibility of Online Resources The CRAAP test is a well-developed criterion used to determine the credibility and relevance of online resources, such as websites, scholarly papers, and journal articles. According to Esparrago-Kalidas (2021), the CRAAP is a mnemonic for currency, relevance, authority, accuracy, and purpose. The criteria are elaborated below using a specific resource related to acute pancreatitis.  Szatmary, P., Grammatikopoulos, T., Cai, W., Huang, W., Mukherjee, R., Halloran, C., Beyer, G., & Sutton, R. (2022). Acute pancreatitis: Diagnosis and treatment. Drugs, 82(12), 1251–1276. https://doi.org/10.1007/s40265-022-01766-4  According to the CRAAP test, this resource was published in 2022, demonstrating the up-to-date nature of the information. Moreover, the information is relevant to the search topic, presenting the disease description, diagnostic criteria, and treatment modalities. Additionally, the authors are healthcare professionals and experts in pancreatic medicine. The journal (Drugs) is listed in reputable journals, publishing original research and reviews with an impact factor 11.5. The authors have adequately supported their claims with other valuable and credible sources, representing the accuracy of the information. Lastly, the article aims to expand the knowledge of healthcare professionals.  Credible and Relevant Sources of Information Various literature studies provide pertinent information on acute pancreatitis’s prevalence, management, and treatment. Some of the studies are presented below, and their credibility and relevance are evaluated based on the CRAAP criteria.  The study by Li et al. (2021) highlights the prevalence of acute pancreatitis, indicating the disease’s burden worldwide, regionally, and nationally. The article completes the CRAAP criteria by its recent publication (2021). It is relevant for public health professionals to understand the burden and plan effectively for public health initiatives and resource allocation. Furthermore, the study was authored by multiple researchers from reputable institutions. Additionally, it is published in BMC Gastroenterology, a peer-reviewed journal, indicating scholarly rigor and authenticity of information. Finally, the study underwent peer review to ensure accuracy and reliability and to report the burden of acute pancreatitis. Capella 4030 Assessment 2 Determining the Credibility of Evidence and Resources The study by de-Madaria et al. (2022), published in 2022, holds credibility and relevance based on the CRAAP criteria. The article clarifies its relevance by highlighting fluid resuscitation as a cornerstone in managing acute pancreatitis, offering best practices and up-to-date insights. Authority is evident as the study was conducted by a team of renowned healthcare professionals and gastroenterologists and published in a highly esteemed peer-reviewed journal, the New England Journal of Medicine. The study’s accuracy is also supported by rigorous research methods and the oversight of peer review processes to disseminate information regarding fluid resuscitation as a best practice strategy in acute pancreatitis. This resource is the most useful for healthcare professionals as its findings on fluid resuscitation in acute pancreatitis directly inform clinical practice to enhance patient care and outcomes.  Another study that discusses the current treatment strategies for acute pancreatitis is credible based on the CRAAP criteria. The study was published in 2024, providing recent insights into treatment strategies for the disease. Directly elaborating on the recent advancements in treatment approaches, this article holds relevance in contributing valuable information to clinical practice and patient care. Thus making it the most useful resource for healthcare professionals to implement the best evidence-based strategies in their healthcare settings. Moreover, the authors possess expertise in gastroenterology and related fields, adding credibility to their research. The information is published in a reputable peer-reviewed journal (The Journal of Clinical Medicine). Consequently, as a peer-reviewed publication, the study underwent rigorous evaluation, demonstrating the accuracy and reliability of its findings (Song & Lee, 2024).  Integrating Credible Evidence into an EBP Model Integrating credible evidence into an Evidence-Based Practice (EBP) model for acute pancreatitis is crucial for ensuring optimal patient outcomes. This model provides a structured approach for researchers and healthcare practitioners to make informed decisions regarding patient care using credible evidence from rigorous research (Brunt & Morris, 2023). By integrating authentic evidence into an EBP model, healthcare providers can enhance the effectiveness of interventions, minimize the risk of complications, and improve patient satisfaction. This approach fosters

Capella 4030 Assessment 1 Locating Credible Databases and Research Name Capella university NURS-FPX 4030 Making Evidence-Based Decisions Prof. Name Date Locating Credible Databases and Research Acute pancreatitis is a health condition characterized by sudden inflammation of the pancreas. This results from gallstones or excessive alcohol consumption. In the United States, 35-40% of cases are due to gallbladder stones, and 30% of cases result from the excessive use of alcohol (Mohy-ud-din & Morrissey, 2023). Through this analysis, a senior nurse assists a novice nurse in locating credible and relevant evidence related to acute pancreatitis, helping implement evidence-based practices to improve patients’ overall well-being.  Communication and Collaboration Strategies Several communication and collaboration strategies can be utilized while researching evidence-based resources so that novice nurses can search and access sources of information effectively. These strategies include:  Structured Mentorship Programs: Senior nurses can mentor juniors using structured programs. Mentors can encourage novice nurses to research the diagnosis through regular meetings and discussion sessions. Through these sessions and seminars, experienced nurses will provide resources, suggest study materials, and offer insights from their experiences. Mentoring is a valuable strategy in fostering professional competence through guidance and support, leading to professional commitment and strong relationships between experienced and trainee nurses. Ultimately, this will foster a culture of learning and collaboration (Gong et al., 2022).  Research and Education Programs: Senior nurses can introduce novice nurses to programs that build research and education capacities. These are called Research Capacity Building (RCB) initiatives. Through face-to-face sessions and online learning platforms, senior nurses can help juniors to search databases dedicated to healthcare education and research (King et al., 2022). This strategy helps senior nurses empower novice nurses to explore topics like acute pancreatitis independently. This strategy promotes professional competence by encouraging self-directed learning and honing research skills. Furthermore, it strengthens professional relationships as senior nurses demonstrate support and trust in the abilities of novice nurses. Capella 4030 Assessment 1 Locating Credible Databases and Research Peer Learning Groups: According to Pålsson et al. (2022), peer learning is an effective strategy for newly graduated nurses in learning about nursing practices, health conditions, and patient management and transitioning into professional life. Thus, it leads to professional competence among novice nurses. Senior nurses can facilitate peer learning groups where novice nurses collaborate with their peers to explore acute pancreatitis research and resources. Through this strategy, novice nurses benefit from diverse perspectives and collective problem-solving, enhancing their research skills and understanding of the topic. Additionally, peer interactions build strong professional relationships based on shared learning experiences. The Best Places to Access Resources within the Workplace In the current healthcare setting, there are several places that novice nurses can use to access resources related to acute pancreatitis. These include computer labs with an online medical library, Hospital Information Systems and Electronic Health Records (EHRs), and multidisciplinary team meetings and case conferences.  The computer labs in this healthcare setting have various online databases that nurses can access to find pertinent information about acute pancreatitis. These databases include CINAHL, PubMed, Medline, and the Cochrane Library. These online databases provide comprehensive information on diagnosing, treating, and managing various health conditions, including acute pancreatitis (Chandran et al., 2020).  Computers at nurse stations can be utilized to access hospital information systems and electronic health records (EHR). These resources contain valuable patient data, diagnostic imaging reports, laboratory results, and clinical notes related to cases of acute pancreatitis. Additionally, nurses may access integrated EHR systems with clinical decision support tools and clinical pathways to find specific information related to acute pancreatitis, guiding evidence-based diagnostic practices (Yang et al., 2023). Finally, nurses can participate in multidisciplinary team meetings and case conferences to learn the complexities of acute pancreatitis and its management. During these meetings, clinicians, radiologists, surgeons, and other healthcare professionals share their expertise, review diagnostic findings, and formulate comprehensive treatment plans tailored to individual patients (Henriksen et al., 2022). Accessing resources within these collaborative settings allows nurses to benefit from diverse perspectives and collective decision-making, ultimately optimizing patient care and outcomes. Credible Sources, Justification, and Criteria  According to the ranking of most to least valuable resources, this analysis identifies five credible sources of online information related to acute pancreatitis and elaborates the reasons for their selection. PubMed is one of the most reliable and widely used medical databases, with peer-reviewed articles published in reputable journals. Nurses can search PubMed for credible evidence and up-to-date research articles, clinical trials, systematic reviews, and practice guidelines for acute pancreatitis (Ossom Williamson & Minter, 2019). Secondly, the American Pancreatic Association (APA) website provides resources, guidelines, and educational materials focused explicitly on pancreatic diseases, including acute pancreatitis, enhancing the knowledge and understanding of the condition. Information from the APA website integrates the latest evidence related to nursing practice, making it a reliable and helpful resource (American Pancreatic Association, n.d.).  Moreover, nurses can explore the American Gastroenterological Association (AGA) website, which offers guidelines, position statements, and educational materials. Moreover, they have peer-reviewed journals consisting of high-quality research evidence related to GI and liver conditions, including acute pancreatitis. This facilitates informed decision-making and quality care delivery in gastroenterology practice (American Gastroenterological Association, n.d.). Furthermore, the Cochrane Library is a useful resource as it has a collection of databases containing high-quality, independent evidence to inform healthcare decision-making. Cochrane reviews offer a rigorous analysis of available evidence, demonstrating the high quality and credibility of the information. These sources of knowledge aid nurses in evaluating their current practices and guiding future patient care. Lastly, the resources from the National Pancreas Foundation (NPF), a nonprofit organization that supports patients with pancreatic diseases and their caregivers, will increase nurses’ understanding of acute pancreatitis. NPF’s website offers patient education materials, research updates, and resources specific to acute pancreatitis (National Pancreas Foundation, n.d.). By leveraging NPF resources, nurses can provide valuable support and information to patients and families coping with this condition.  Criteria to Determine Credibility, Relevance, and Usefulness of Resources The CRAAP is a test used to evaluate the sources’ credibility and relevance. It scrutinizes sources