Category: BSN

Capella FPX 4035 Assessment 2 Name Capella university NURS-FPX4035 Enhancing Patient Safety and Quality of Care Prof. Name Date Root-Cause Analysis and Safety Improvement Plan Understanding the Incident A sentinel event is a critical patient safety issue that occurs unexpectedly and is not directly tied to a patient’s existing condition or illness. Such incidents often have profound effects on patients, their families, and healthcare staff. The primary purpose of a root-cause analysis (RCA) is to uncover both immediate and systemic failures contributing to these events to implement corrective strategies and prevent recurrence. In one such incident at an Emergency Department (ED), a patient in septic shock experienced delayed treatment due to an incomplete handoff between nursing staff. The outgoing nurse failed to convey essential clinical details, compounded by inadequate documentation. As a result, the patient’s condition worsened, requiring prolonged hospitalization and additional interventions. The emotional toll on the patient and family, as well as the professional strain on staff, highlighted the need for stronger communication protocols and systems improvements. Analyzing Contributing Factors Root Causes and Contributing Elements Human Elements: Nurse fatigue, communication breakdowns, and inadequate training in structured handoff practices played a major role. Overreliance on verbal exchanges without written backup increased risk. Systemic Challenges: The chaotic ED environment, absence of digital tools for handoff, and understaffing created barriers to effective communication. Organizational Culture: A weak culture of safety, lack of leadership reinforcement for handoff protocols, and limited routine audits exacerbated inconsistencies. Cultural Influences: Language differences and varying communication norms among multicultural staff may have also interfered with message clarity. Deviation from Standards There were significant lapses in following established procedures, notably the SBAR (Situation, Background, Assessment, Recommendation) framework. The outgoing nurse’s verbal report lacked completeness, and no checks or clarifications were made by the incoming nurse. Documentation was also insufficient, omitting vital assessments and care plans. Roles, Communication, and Environment Personnel Involved The event primarily involved the outgoing and incoming nurses, along with a physician who made new medication orders that were not communicated properly. Supervisors such as the charge nurse failed to ensure adherence to standard handoff procedures, and leadership lacked oversight in enforcing training and auditing practices. Communication Breakdown There was a clear communication gap between the nurses and the physician. Vital updates on patient condition and treatment changes were missed. Additionally, the patient was not adequately informed about their revised care plan, reducing their ability to engage meaningfully in their treatment. Contributing Environment and Staffing The physical layout of the facility—with distant nursing stations and frequent equipment malfunctions—created additional challenges. Staffing shortages overwhelmed available nurses, leading to skipped protocols. While staff competency was generally acceptable, gaps in targeted training for handoffs and updates on medication protocols were evident. Organizational and Monitoring Shortfalls Policy Failures Even though policies for handoffs and medication administration existed, they were not followed. Their complexity and limited accessibility made consistent application difficult, leading to variance in practice. Monitoring Gaps The patient’s vital signs were not tracked consistently during critical hours, delaying responses to deterioration. Alarm fatigue also contributed, with important alerts being missed amidst frequent non-critical ones. Recommendations and Safety Enhancements Lessons and Improvement To prevent recurrence, systemic upgrades are necessary. This includes standardizing communication tools, reinforcing training, and fostering a culture where staff feel comfortable speaking up. Implementation of electronic systems to track handoffs and patient monitoring can also reduce human error. Patient Safety Measures Introduce risk mitigation strategies like automated alerts for vital signs, regular simulation training, and robust alarm systems. Create a non-punitive feedback mechanism encouraging open reporting of errors to support learning and continuous quality improvement. Certainly! Below is the rephrased content in paragraph format, followed by a row and column table version with three-level headings retained. Both formats include APA-formatted references at the end. Root Cause(s) and Contributing Factors An in-depth analysis of the sentinel event revealed several underlying causes and contributing factors. One of the principal root causes was the failure in communication among healthcare team members. This lapse led to incorrect interpretation of the patient’s condition and delayed appropriate intervention. Categorized under Human Factor – Communication (HF-C), this failure represents a fundamental weakness in team coordination. Another significant root cause was insufficient training related to newly updated protocols and equipment usage, which falls under Human Factor – Training (HF-T). This deficiency prevented staff from recognizing and responding effectively to changes in patient status. A third contributing factor was equipment malfunction, which led to unrecognized warning signs and subsequently delayed clinical responses. This issue is associated with Environment/Equipment (E). Additionally, staff fatigue, linked to poorly structured schedules, affected cognitive performance and situational awareness, a problem that aligns with Human Factor – Fatigue/Scheduling (HF-F/S). Moreover, breaches in established safety protocols and the presence of organizational barriers, such as ineffective communication systems, further exacerbated the incident. These challenges reflect issues in both Rules/Policies/Procedures (R) and Barriers (B) that need systematic rectification. Application of Evidence-Based Strategies To address the aforementioned safety concerns, several evidence-based strategies should be implemented. First, structured communication tools such as SBAR (Situation, Background, Assessment, Recommendation) have demonstrated effectiveness in improving handoff procedures and reducing communication errors. A study conducted at Tabanan Hospital indicated that SBAR implementation significantly enhanced nursing performance and patient safety during transitions of care (Mulfiyanti & Satriana, 2022). Secondly, the implementation of continuous professional development, including simulation-based and scenario-specific training, can bridge competency gaps. Research has highlighted that a majority of medical equipment alerts are false, underscoring the need for regular in-service education on equipment usage and alarm interpretation to mitigate alarm fatigue (Shaoru et al., 2023). Lastly, incorporating routine safety audits and feedback mechanisms can identify and resolve system-level gaps. Root-cause analysis and data-driven evaluations have proven effective in reinforcing safety culture and reducing the recurrence of sentinel events (Argyropoulos et al., 2024). These evidence-based approaches, when systematically applied, create a culture of continuous learning and improvement. Safety Improvement Plan Planned Actions for Each Root Cause/Contributing Factor For the communication failures, standardized SBAR communication will be mandated during all patient handoffs to ensure clarity and consistency. To resolve training deficits, a comprehensive education plan will

Capella FPX 4035 Assessment 1 Name Capella university NURS-FPX4035 Enhancing Patient Safety and Quality of Care Prof. Name Date Enhancing Quality and Safety There are many safety problems in healthcare and diagnostic errors are considered critical since they cause delays in care, additional treatments and more deaths than needed. If a medical diagnosis is obtained incorrectly, missed or comes late, it is because of challenges with thinking, teamwork or how systems are organized. Such errors influence a patient’s happiness, trust in medicine, mindset and general safety (Toker, 2025). The paper concentrates on how diagnostic errors create safety concerns for patients, analyzes what causes them and looks at the solutions offered by evidence and by nurses and other health team members.  Factors Leading to Diagnostic Errors in Healthcare Many healthcare problems linked to diagnostic errors are overlooked and not reported. Every year nearly 12 million adults in the United States are affected by diagnostic errors and in one out of three cases, the results can be serious or fatal (Gleason et al., 2020). Errors of this kind can be very troubling in fast-moving places like emergency departments and hospital units, where the decisions people have to make are often urgent and difficult. Common reasons for misdiagnosis include thinking mistakes, not having all the needed medical information, poor patient record-taking and breakdowns between healthcare staff. In some cases, clinicians can become “anchored” to their first assumption and find it hard to adjust when new information arrives. When there is not enough time to think and do everything, critical thinking and clinical reasoning are compromised. Issues at the systems level such as separated Electronic Health Records (EHRs) and different protocols for diagnosing, add extra difficulty to these challenges (Runyon et al., 2022). When doctors and nurses at Riverside Community Hospital team up to take care of difficult conditions, blurred messages and missed diagnosis checks often contribute to mistakes. If test results are not handled properly or information changes hands incorrectly during a nurse’s shift, it result in a delayed or missed diagnosis. Problems with diagnosis weaken confidence in healthcare services, result in delayed treatment, raise healthcare expenses and increase the risk of malpractice. Being aware of what causes mistakes helps design useful interventions and build a culture in healthcare that helps with accurate and prompt diagnoses (Gleason et al., 2020). Evidence-Based and Best-Practice Solutions to Reduce Diagnostic Errors It is important to approach diagnostic errors using clinical best practices, by fixing systems and involving teams from different medical professions. Timely and accurate diagnosis is seen by literature from the Institute of Medicine (IOM), now the National Academy of Medicine and the Agency for Healthcare Research and Quality (AHRQ) as a major part of providing high-quality care. Better accuracy in diagnosis needs to form the base of patient safety and suggests ways to improve joint work, educate teams and apply upgraded health information technology. The Quality and Safety Education for Nurses (QSEN) initiative is one of the most respected frameworks and features six essential competencies, amongst them patient-centered care, teamwork and collaboration, evidence-based practice and safety (AHRQ, 2024). QSEN hopes that nurses practice expressing themselves thoughtfully and use SBAR (Situation, Background, Assessment, Recommendation) along with other standardized tools to improve how they communicate about patients in handoffs and consults. Clinical decision support systems (CDSS) are considered a sound best-practice intervention. With CDSS connected to their electronic health records, clinicians instantly get prompts, diagnostic lists and alarms to help them think about various diagnoses and avoid relying on personal assumptions. CDSS helped lower diagnostic disagreements in large clinical environments by 15%. Also, taking time-outs for the team to reconsider what they found can prevent errors from resulting in harm (Harada et al., 2021). Giving everyone a chance to think allows for better shared choices. Part of a nurse’s role is to look after the patient, inform others of important test results and join in on team discussions about diagnosis. Using these evidence-based approaches, healthcare organizations can improve how they diagnose, reduce serious incidents and support better patient outcomes with less need for costly corrections. Nurse-Driven Strategies to Increase Safety and Reduce Costs Coordinating care which results in safer patients and lower healthcare costs, mainly depends on nurses. They participate in activities that reduce errors, help maintain a patient’s care and teach and support patients. Taking care of patient transitions is proven to be very impactful. Nurses always use SBAR when handing off important details during admission, discharge or transfers between departments. Because of this, chances of missing or delaying a diagnosis are significantly reduced. Helping people understand their condition is also very important. Nurses guide patients and their families on signs and symptoms to report, taking their medication and what to do after they go home. Learning about their conditions helps patients start taking care of themselves, cutting down on new hospitalizations and mistakes in diagnosis. Partnership among various professional fields is just as valuable. Nurses link doctors, specialists, pharmacists and the rest of the care team. By attending multidisciplinary rounds and case conferences, they give advice based on what they observe at the patient’s bedside. With this approach, it is less likely important information will be missed. Keeping medical records accurate and up-to-date supports both safe and inexpensive treatment (Flaubert, 2021). By clearly documenting all assessments, actions and responses from patients in the medical record, nurses help maintain continuity and accountability needed for good diagnosis and quality assurance. As a result, safety increases and costs go down because there are less chance of errors in diagnosis, fewer unnecessary tests are performed and malpractice related to misdiagnosis is less likely. Stakeholders Involved in Safety Enhancement Caring for patient safety is the job of many individuals, who all play important roles in discovering threats, taking steps to prevent harm and improving how care is given. Nurses on the inside are essential, regularly keeping an eye on patients, looking out for risks to their safety and applying solutions to stop delays in diagnosis. Part of a

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

Capella FPX 4015 Assessment 5 Name Capella university NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care Prof. Name Date Comprehensive Head-to-Toe Assessment Introduction and Initial Observations Good day, Ms. Jackson. My name is __, and I will be conducting a full head-to-toe assessment to evaluate your overall physical and emotional health. The purpose of this evaluation is to detect any potential health concerns and tailor a care plan specific to your needs. If at any point during the process you experience discomfort or need a break, please let me know immediately. On initial observation, your posture suggests mild fatigue, and there appears to be some emotional tension based on your facial expressions and body language. To assess your mental clarity, I’ll ask you a few questions: Can you please tell me your full name, the current date, and your present location? Thank you. Additionally, I’d like to inquire about your emotional well-being—have you recently experienced trouble sleeping, mood fluctuations, or persistent anxiety or sadness? It’s important to address emotional and mental health alongside physical well-being so we can create a supportive and effective care plan. Neurological and Cardiovascular Assessment We’ll begin with a brief neurological examination. Your pupils are equal in size and react appropriately to light stimuli, which is a positive sign of neurological function. Your extraocular movements were assessed by tracking my finger, and your eye movements appeared coordinated and smooth. I then evaluated your reflexes with a patellar tap, which yielded a normal response. Your grip strength is balanced on both sides, and your coordination appears intact when performing the finger-to-nose test followed by reaching toward my hand. Moving forward to the cardiovascular evaluation, I auscultated your heart sounds, which were regular and clear. Your pulse rhythm was steady. Upon measuring your blood pressure, the reading was 145/90 mmHg, which is mildly elevated. This may be related to recent stress, dietary habits, or underlying health conditions. Your peripheral circulation, evaluated through capillary refill time, is within normal limits. Respiratory, Abdominal, and Musculoskeletal Assessment The respiratory assessment involved listening to lung sounds at various locations on your chest and back. The breath sounds were clear, without wheezes, rales, or crackles, indicating healthy pulmonary function. I then palpated your abdomen, which was soft and non-tender, with no detectable masses. Your bowel sounds were active and regular, suggesting normal gastrointestinal activity. In evaluating your musculoskeletal system, you demonstrated full joint range of motion when asked to move your arms in circles. Your leg strength was symmetrical when pressing against resistance. A brief skin examination revealed healthy, intact skin without signs of lesions, edema, or rashes. Your nails also appeared healthy, with no abnormalities such as discoloration or brittleness. Table: Comprehensive Head-to-Toe Assessment Findings Assessment Category Findings Comments Mental Status Oriented to person, place, and time. No signs of confusion; emotional distress noted. Neurological Pupils equal/reactive; smooth eye tracking; intact reflexes; good strength. Neurological findings within normal limits. Cardiovascular BP: 145/90 mmHg; heart sounds clear; regular pulse. Slight hypertension possibly linked to stress or diet. Respiratory Breath sounds clear in all lung fields. Respiratory system appears healthy. Abdominal Abdomen soft, non-tender; normal bowel activity. No GI concerns noted. Musculoskeletal and Skin Joint movement normal; symmetrical leg strength; skin intact. No dermatological or musculoskeletal issues observed. Discussion of Diagnosis and Findings Following the comprehensive assessment, it appears that Ms. Jackson may be experiencing symptoms commonly associated with anxiety and depression. Fatigue, difficulty concentrating, disturbed sleep, and feelings of hopelessness are all indicative of underlying mental health conditions. As the CDC (2023) highlights, conditions such as anxiety and depression can significantly affect one’s physical health, often presenting with symptoms like muscle tightness, restlessness, and mood instability. Ms. Jackson also expressed feelings of low motivation, sadness, and emotional overwhelm—symptoms that may align with major depressive disorder. These emotional health conditions are treatable and should be addressed with the same level of attention as chronic conditions such as hypertension (CDC, 2023). It’s important that we proceed with a tailored treatment strategy that may include therapy, lifestyle modifications, and possibly pharmacological support, all of which can improve her quality of life. Ms. Jackson, do you have any concerns or questions regarding today’s findings? Your comfort and understanding are essential as we move forward. References Calvi, A., et al. (2021). Antidepressant drugs effects on blood pressure. Frontiers in Cardiovascular Medicine, 8(8). https://doi.org/10.3389/fcvm.2021.704281 Centers for Disease Control and Prevention (CDC). (2023). Mental health conditions: Depression and anxiety. https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html Chu, A., & Wadhwa, R. (2023). Selective serotonin reuptake inhibitors. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554406/ Cleveland Clinic. (2022). Neurotransmitters. https://my.clevelandclinic.org/health/articles/22513-neurotransmitters Capella FPX 4015 Assessment 5 Ghodeshwar, G. K., et al. (2023). Impact of lifestyle modifications on cardiovascular health. Cureus, 15(7). https://doi.org/10.7759/cureus.42616 Nakao, M., et al. (2021). Cognitive-behavioral therapy for mental health and stress. BioPsychoSocial Medicine, 15(1), 1–4. https://doi.org/10.1186/s13030-021-00219-w

Capella FPX 4015 Assessment 4 Name Capella university NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care Prof. Name Date Caring for Special Populations: Educational Presentation Overview of Homelessness and Health Care Barriers Individuals experiencing homelessness form a high-risk population confronted by multiple health disparities rooted in economic hardship and insufficient social networks. This educational presentation explores the complex health issues unique to the homeless community, including barriers to preventative services. It also sheds light on the cultural nuances and social determinants influencing their healthcare outcomes. Nurses serve a pivotal role by advocating for equitable, empathetic care that acknowledges individual backgrounds. Through education, active community partnerships, and cultural understanding, nurses can help reduce healthcare inequities faced by this marginalized group. Understanding the Healthcare Needs of People Experiencing Homelessness Epidemiology and Health Vulnerabilities Homelessness continues to be a critical public health concern in the United States. As of 2024, approximately 771,480 individuals were reported as homeless, translating to 23 per 10,000 people (De Sousa & Henry, 2024). This diverse group includes chronically homeless adults, families with children, military veterans, and unaccompanied youth. They often suffer from multiple health conditions, such as cardiovascular diseases, respiratory illnesses, diabetes, and untreated infections. Furthermore, mental health disorders, substance abuse, and trauma are commonly observed, compounded by unstable housing, poor hygiene facilities, and food insecurity (Padgett, 2020). The absence of a permanent address often prevents access to health insurance, follow-up care, and necessary medications. Distrust of healthcare providers, stigma, and logistical hurdles also discourage them from seeking medical attention. As a result, they frequently prioritize immediate survival needs over chronic disease management. Nurses can respond more effectively by embracing trauma-informed care that prioritizes respect, safety, and compassion (Brais & Riva, 2024). Effective care should be culturally responsive and tailored to the lived realities of this group. Cultural Beliefs and Healthcare Perspectives Survival-Driven Values and Spiritual Coping Homeless individuals often share survival-centered values, regardless of their race, religion, or background. Securing basic needs such as shelter, safety, and food generally takes precedence over preventive health measures (Zhao, 2022). Due to repeated experiences of neglect or discrimination, many people without housing lack trust in the medical system and delay seeking care. Spirituality or religious practices often serve as critical coping tools, helping individuals deal with trauma and adversity (Fitzpatrick, 2020). Cultural norms—such as dress, dietary preferences, or communication styles—may also affect how homeless individuals interact with healthcare providers. Respecting autonomy, treating patients with dignity, and allowing for shared decision-making are key to fostering trust (Miller et al., 2024). True cultural competence in this context involves understanding both the individual’s culture and their experience of homelessness. Health Disparities and Systemic Challenges Social Determinants and Gaps in Access Environmental and societal factors significantly contribute to the health inequities faced by homeless populations. Key social determinants include poverty, lack of education, limited job opportunities, inadequate nutrition, and unstable housing (Lee et al., 2023). These barriers complicate chronic disease management and limit access to timely, quality care. Homeless individuals are disproportionately affected by physical illnesses, psychiatric conditions such as PTSD and schizophrenia, and co-occurring substance use disorders. Due to a lack of insurance, transportation, or primary care access, many rely on emergency services, which are both inefficient and costly. Preventive services like vaccinations and screenings are often out of reach. Language and cultural barriers can further hinder care for children in homeless families. As such, there is a pressing need for trauma-sensitive, practical, and equitable nursing strategies that address these disparities with empathy and understanding (Zhao, 2022). Strategies for Culturally Competent Nursing Practice Implementing Trauma-Informed Care and Community Partnerships Culturally competent care for homeless individuals includes recognizing past traumas and offering dignity-centered, nonjudgmental support. Many have experienced domestic abuse, systemic racism, or street violence. Nurses must acknowledge these histories and provide consistent, respectful care that values the person’s autonomy (Brais & Riva, 2024). This builds trust and promotes engagement with health services. Partnering with shelters, mosques, churches, or community centers can create culturally safe environments where patients feel supported emotionally and spiritually (Fitzpatrick, 2020). These collaborations improve outreach and continuity of care, especially for marginalized or religiously observant individuals. Case-Based Applications of Competent Care Real-World Examples In Southern Oregon, a specialized care initiative targeted the homeless population through a culturally responsive, trauma-informed model (OHSU School of Nursing, n.d.). Nurses received training to manage tri-morbidity—mental illness, substance use, and chronic diseases—and provided care in familiar environments, reducing anxiety and increasing compliance. Another case involved a Somali refugee suffering from homelessness and asthma. Due to her religious attire and prayer needs, she previously avoided clinics. A nurse learned about her spiritual customs and coordinated care that accommodated prayer times and cultural norms. A local mosque assisted with temporary housing, leading to improved medication adherence and follow-up visits (Fang et al., 2023). These examples underscore how integrating cultural awareness into care can foster healing and trust. Educational Resources for Nurses Enhancing Cultural Sensitivity and Clinical Skills To build their skills, nurses can access resources such as the National Health Care for the Homeless Council (NHCHC), which offers toolkits and training in trauma-informed care and cultural competency (NHCHC, n.d.). The Substance Abuse and Mental Health Services Administration (SAMHSA) also provides evidence-based resources focusing on co-occurring disorders and homelessness (SAMHSA, n.d.). Engaging in local outreach efforts and ongoing education in ethics, cultural humility, and health disparities further strengthens nursing competencies. Hands-on experiences are essential for delivering care that respects the unique narratives of individuals living without housing. Conclusion Meeting the healthcare needs of homeless individuals requires a blend of cultural humility, trauma-informed care, and system-level advocacy. Nurses can play a transformative role by removing barriers, embracing diverse perspectives, and tailoring care to each patient’s lived experiences. Long-term solutions involve promoting trust, accessibility, and dignity in healthcare delivery. Continued professional learning, interagency collaboration, and a focus on social justice remain essential to improving outcomes for this vulnerable population. References Brais, H., & Riva, M. (2024). Towards a “trauma-informed spaces of care” model: The example of services for

Capella FPX 4015 Assessment 2 Name Capella university NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care Prof. Name Date Enhancing Holistic Nursing Practice through the 3Ps In the evolving landscape of modern healthcare, ensuring high-quality, patient-centered, and safe nursing care demands the integration of scientific expertise with a holistic philosophy. Holistic nursing advocates for attending to the patient as a complete being—encompassing mental, physical, emotional, and spiritual health. Incorporating the foundational 3Ps—pathophysiology, pharmacology, and physical assessment—equips nurses to develop individualized and evidence-informed care strategies. With a deeper grasp of disease processes, appropriate medication management, and comprehensive assessments, nurses are empowered to address the layered and diverse needs of their patients. The subsequent sections illustrate how these core domains interact to reinforce sound clinical decisions and foster better health outcomes. Holistic Nursing Care and Its Importance According to the American Holistic Nurses Association (n.d.), holistic nursing is a practice that promotes healing the person as a whole, emphasizing the integration of self, spirit, and environment. Florence Nightingale initially advocated these values, viewing health as harmony among body, mind, and environment. Holistic nursing highlights active listening, cultural respect, therapeutic engagement, and empathetic collaboration. This care model promotes improved symptom relief, emotional comfort, and patient empowerment while encouraging patient participation in care plans (Ambushe et al., 2023). Moreover, it enhances adherence to treatments by aligning care with patients’ cultural beliefs and values. For nurses, embracing a holistic philosophy can reduce job fatigue, enhance self-awareness, and increase professional satisfaction through reflective practice and compassion-driven care (Prescott et al., 2024). Ultimately, this approach fosters healing on multiple levels and contributes to improved care quality. Understanding Pathophysiology in Nursing Pathophysiology explores how disease and injury alter normal physiological functions. Nurses with a solid understanding of pathophysiology can detect early warning signs, anticipate complications, and tailor care to match disease progression (Colsch et al., 2020). This knowledge enables holistic assessments, identifying how conditions like congestive heart failure (CHF) manifest not just physically—through edema or fatigue—but also psychologically and socially (Malik et al., 2023). For example, understanding glucose metabolism helps nurses educate diabetic patients about dietary habits and the risks of neuropathy or kidney dysfunction. Through this knowledge, nurses contribute meaningfully to interdisciplinary care, advocate for patients, and improve health literacy—key components of holistic practice. Applying Pharmacology for Holistic Care Pharmacology is vital in nursing to ensure the safe and effective administration of medications. A strong pharmacological foundation helps nurses evaluate therapeutic benefits, anticipate adverse reactions, and adjust care plans according to the individual’s health status and social context (Taasen et al., 2024). For instance, administering opioids for pain involves understanding pharmacodynamics and pharmacokinetics while addressing psychological concerns like addiction or societal stigma. Similarly, managing antihypertensive medications requires understanding vascular effects, promoting adherence, and considering cultural beliefs about pharmaceuticals. Nurses skilled in pharmacology support patient education and promote autonomy, especially in managing chronic conditions. When integrated into a holistic model, pharmacology ensures that medications not only meet clinical objectives but also support the patient’s lifestyle and values. Role of Physical Assessment in Nursing Care Physical assessment is a foundational skill in nursing that enables the systematic collection and interpretation of clinical data. Techniques such as palpation, auscultation, inspection, and percussion offer vital insights into patients’ physiological and emotional states (Fontenot et al., 2022). For example, a nurse caring for a dyspneic patient may evaluate respiratory rate, breath sounds, and oxygen saturation. These findings guide clinical actions like administering oxygen or adjusting medications (Zimmerman & Williams, 2023). Assessments also play a role in evaluating treatment effectiveness, such as checking post-operative sites for infection or complications. A thorough assessment enables prompt intervention, contributes to accurate diagnoses, and supports the development of a patient-specific care plan—cornerstones of holistic and safe nursing practice. Clinical Integration of the 3Ps Example 1: Managing Congestive Heart Failure (CHF) In an acute care environment, a nurse managing a CHF patient integrates knowledge from all three domains. Pathophysiology helps the nurse understand decreased cardiac function and fluid buildup (Malik et al., 2023). A physical exam might reveal symptoms like edema, crackles, or sudden weight gain. Armed with pharmacology expertise, the nurse can administer diuretics and ACE inhibitors safely, monitoring for side effects. Patient education on diet, medications, and fluid restrictions is tailored to the individual, resulting in reduced hospital readmissions and enhanced quality of life (Ding & Wang, 2020). Example 2: Diabetes Care in Primary Settings In a primary care setting, nurses managing type 2 diabetes patients must understand the physiological underpinnings of insulin resistance and its complications (Galicia-Garcia et al., 2020). Through assessment, nurses can detect signs of hyperglycemia or neuropathy. Medication administration is guided by pharmacological principles, including side effect monitoring. Patient education encompasses diet, glucose monitoring, and medication timing—empowering patients to self-manage. Combining these strategies reduces disease progression and complications, reinforcing patient autonomy and comprehensive care. Conclusion Holistic nursing care involves more than treating symptoms—it embodies an integrated, person-centered approach rooted in science and empathy. Nurses well-versed in pathophysiology, pharmacology, and physical assessment are equipped to deliver individualized and safe care. When combined, these disciplines not only inform nursing practice but also support patient empowerment, safety, and well-being. This integration allows for clinical excellence while honoring the uniqueness of each patient’s experience. References Ambushe, S. A., Awoke, N., Demissie, B. W., & Tekalign, T. (2023). Holistic nursing care practice and associated factors among nurses in public hospitals of Wolaita zone, South Ethiopia. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01517-0 American Holistic Nurses Association. (n.d.). What we do. Ahna.org. https://www.ahna.org/About-Us/What-is-Holistic-Nursing Colsch, R., Lehman, S., & Tolcser, K. (2020). State of pathophysiology in undergraduate nursing education: A systematic review. Journal of Nursing Education and Practice, 11(3), 11. https://doi.org/10.5430/jnep.v11n3p11 Capella FPX 4015 Assessment 2 Ding, L., & Wang, X. (2020). Effects of holistic nursing on chronic pulmonary heart disease complicated with heart failure. Revista Argentina de Clínica Psicológica, 29(4), 122–126. https://doi.org/10.24205/03276716.2020.814 Fontenot, N. M., Hamlin, S. K., Hooker, S. J., Vazquez, T., & Chen, H. (2022). Physical assessment competencies for nurses: A quality improvement initiative. Nursing Forum, 57(4), 710–716. https://doi.org/10.1111/nuf.12725 Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A.,

Capella FPX 4015 Assessment 3 Name Capella university NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care Prof. Name Date Concept Map: The 3Ps and Mental Health Management Overview of Major Depressive Disorder (MDD) Major Depressive Disorder (MDD) is a significant mental health condition that interferes with an individual’s ability to function in daily life. It frequently coexists with physical illnesses, such as cardiovascular conditions, thereby complicating treatment outcomes and increasing the risk of mortality (Cui et al., 2024). Effective management of MDD necessitates a holistic strategy encompassing psychological, physiological, and pharmacological interventions—collectively described as the “3Ps.” This concept map is employed to apply the 3Ps framework to a real-life case study to promote a comprehensive, individualized care plan. Case Study: Ivy Jackson The featured case involves Ivy Jackson, a 63-year-old woman presenting with classic symptoms of MDD. After a divorce three weeks ago, Ivy began experiencing fatigue, insomnia, emotional distress, and unintended weight loss. While she does not report suicidal thoughts, her daily functioning is compromised due to anxiety and poor dietary habits. Ivy’s history of hypertension and familial predisposition to both depression and high blood pressure contribute to her mental and physical health challenges. A preliminary diagnosis of MDD has been made based on her symptoms and background, highlighting the multidimensional nature of her condition. Clinical Overview Mental Health Diagnosis Ivy has been diagnosed with Major Depressive Disorder (MDD), a complex psychiatric condition that necessitates a detailed biopsychosocial assessment to understand contributing factors and inform treatment. Pathophysiological Mechanisms MDD is associated with neurochemical imbalances in serotonin, norepinephrine, and dopamine levels, which regulate emotions and cognition. Disruptions in these neurotransmitters—often triggered by stressful life events like trauma or loss—can lead to structural brain changes, particularly in the prefrontal cortex, impacting mood and decision-making (Cui et al., 2024). Identified Risk Factors Ivy’s condition is influenced by her genetic vulnerability, demonstrated through a family history of depressive and hypertensive disorders. Her postmenopausal state and limited social network further amplify her risk and symptomatology (Bond et al., 2022). Pharmacologic Treatment She is currently taking escitalopram to regulate serotonin levels, a key strategy in alleviating depressive symptoms. Additionally, mirtazapine is prescribed to aid in sleep and reduce anxiety, creating a synergistic effect for more comprehensive symptom control (Murphy et al., 2021). Diagnostic Assessments A multidimensional diagnostic process was followed, including a comprehensive interview, PHQ-9 depression screening, and a psychiatric physical evaluation to differentiate MDD from other medical conditions (Cui et al., 2024). Physical and Emotional Assessment Ivy displays various depressive symptoms such as frequent crying, social withdrawal, insomnia, and poor nutritional intake. The absence of social support exacerbates her emotional distress, promoting further isolation and diminishing her overall functioning (Bond et al., 2022). Nursing Focus Nursing Diagnosis Ivy’s emotional distress following her divorce has led to maladaptive responses, including fatigue and sleep disturbances. Her physical symptoms, including poor nutrition and weight loss, contribute to her nonadherence to medications, exacerbating her depressive state and decreasing her quality of life. Recommended Nursing Interventions To support Ivy’s recovery, cognitive behavioral therapy (CBT) is advised to help restructure negative thoughts. Regular monitoring of medication compliance, patient education, and referrals to social work for community support are also essential. These strategies aim to foster empowerment and functional reintegration. Potential Complications Untreated MDD can evolve into a chronic condition, heightening the risk of suicidal ideation, cognitive deficits, and deepened social withdrawal. Early intervention is key to preventing further health decline and preserving Ivy’s quality of life (Cui et al., 2024). Conclusion MDD profoundly affects both psychological and physical well-being. By incorporating the 3Ps model—psychological, physical, and pharmacological elements—into treatment planning, a more personalized and effective care strategy is achieved. Ivy’s case exemplifies the need for this integrative model to ensure comprehensive recovery and enhance life quality. Concept Map – The 3Ps and MDD Management Heading Content Summary Mental Health Diagnosis Major Depressive Disorder (MDD), confirmed by clinical evaluation, PHQ-9 screening, and patient history. Pathophysiology Involves neurotransmitter imbalances (serotonin, norepinephrine, dopamine) and structural brain changes, especially in the prefrontal cortex (Cui et al., 2024). Risk Factors Genetic predisposition (family history), postmenopausal status, recent emotional trauma, and lack of social support (Bond et al., 2022). Pharmacology Escitalopram (SSRI) to regulate mood; mirtazapine for sleep and anxiety. Combination improves symptom management (Murphy et al., 2021). Diagnostic Procedures PHQ-9 screening, psychiatric interview, and full physical examination to exclude other health issues (Cui et al., 2024). Physical Assessment Symptoms include fatigue, insomnia, crying, social withdrawal, and poor appetite. Lacks social engagement and support (Bond et al., 2022). Nursing Diagnosis Emotional breakdown due to life stressors causing ineffective coping, fatigue, and nutritional deficiencies impacting recovery. Nursing Interventions CBT for thought restructuring, medication compliance education, follow-ups, and social support referrals to improve coping and function. Complications Chronic depression, cognitive decline, suicidal ideation, and further physical and social deterioration if left unaddressed (Cui et al., 2024). Conclusion Utilizing the 3Ps model allows for a holistic and effective care plan, improving quality of life and treatment outcomes for patients like Ivy Jackson. References Bond, A. E., Bandel, S. L., Rodriguez, T. R., Anestis, J. C., & Anestis, M. D. (2022). Mental health treatment seeking and history of suicidal thoughts among suicide decedents by mechanism, 2003-2018. JAMA Network Open, 5(3), e222101. https://doi.org/10.1001/jamanetworkopen.2022.2101 Bruijniks, S. J. E., Meeter, M., Lemmens, L. H. J. M., Peeters, F., Cuijpers, P., & Huibers, M. J. H. (2021). Temporal and specific pathways of change in Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) for depression. Behaviour Research and Therapy, 151, 104010. https://doi.org/10.1016/j.brat.2021.104010 Capella FPX 4015 Assessment 2 Cui, L., Li, S., Wang, S., Wu, X., Liu, Y., Yu, W., Wang, Y., Tang, Y., Xia, M., & Li, B. (2024). Major Depressive disorder: Hypothesis, mechanism, prevention and treatment. Signal Transduction and Targeted Therapy, 9(1). https://doi.org/10.1038/s41392-024-01738-y Murphy, S., Capitao, L., Giles, S., Cowen, P., Stringaris, A., & Harmer, C. (2021). The knowns and unknowns of SSRI treatment in young people with depression and anxiety: Efficacy, predictors, and mechanisms of action. The Lancet Psychiatry, 8(9), 824–835. https://doi.org/10.1016/S2215-0366(21)00154-1