Category: BSN

NURS FPX 4045 Assessment 1 Nursing Informatics in Health Care Name Capella university NURS-FPX4045 Nursing Informatics: Managing Health Information and Technology Prof. Name Date Nursing Informatics in Health Care Integrating a Clinical Decision Support System (CDSS) into healthcare organizations is essential for enhancing patient outcomes and safety. CDSS technology significantly contributes to improving diagnostic accuracy, refining treatment protocols, and supporting clinical decisions (Laraichi et al., 2024). The implementation of this system requires skilled Nurse Informaticists (NI), who play a vital role in minimizing clinical errors, delivering real-time medication alerts, and ensuring overall patient safety. In nursing practice, informatics merges nursing science with information technology to improve the delivery of healthcare. Nurse Informaticists are equipped with both clinical and technological expertise and serve as intermediaries between IT systems and clinical practice (Nashwan et al., 2025). They oversee the implementation of tools like CDSS, train healthcare personnel, and develop strategies for data-informed decision-making. Notably, Dr. Virginia Saba contributed to this field by developing the Clinical Care Classification (CCC) system to enhance documentation precision (Lopez et al., 2023). NIs ensure that CDSS platforms are designed for user-friendliness and meet clinical needs, boosting decision accuracy and reducing errors. Leading health organizations such as the Cleveland Clinic and Mayo Clinic have adopted nursing informatics to enhance clinical performance. Cleveland Clinic uses nursing informatics to streamline Electronic Health Records (EHRs), while Mayo Clinic uses CDSS to tailor care for patients with Acute Kidney Injury (Mayo Clinic, 2024). These systems assist in predicting risk factors and offering timely, evidence-based recommendations. The presence of Nurse Informaticists in these settings ensures that CDSS is integrated smoothly, aligning patient care strategies with technology and enhancing clinical outcomes. Nurse Informaticists and Healthcare Collaboration Nurse Informaticists act as liaisons between technology developers and healthcare professionals. They collaborate across disciplines—nurses, physicians, and IT experts—to develop systems that are clinically relevant and functionally efficient (Laraichi et al., 2024). By applying their dual expertise, they ensure that CDSS tools are effectively integrated into EHRs and that systems meet the dynamic demands of patient care. Their work not only reduces clinical errors but also fosters team collaboration and boosts clinical efficiency. Training is a crucial responsibility of Nurse Informaticists. They educate nurses and other clinical staff on how to use CDSS effectively, ensuring that everyone understands how to access real-time data and apply it to clinical decision-making. According to the American Nurses Association (2024), training initiatives support the adoption of technology and increase staff competency, which translates to safer and more efficient patient care. NI-led implementation also supports change management and increases the acceptance of new tools within clinical environments. The value of full nurse participation in CDSS planning cannot be overstated. When nurses are involved in the creation and execution of clinical systems, workflows improve, and patient outcomes are optimized. Nurses’ insights help ensure that the CDSS supports practical clinical operations while reducing overhead costs. According to Zhai et al. (2022), nurse engagement is vital in every stage of implementation to ensure clinical relevance and acceptance of the tools. Moreover, such integration enhances efficiency and leads to significant cost savings. Opportunities, Challenges, and Recommendations Nurse Informaticists bring transformative opportunities to health organizations through the implementation of CDSS, including the standardization of care and the enhancement of patient safety. These professionals help streamline care workflows and ensure real-time, data-driven decisions (Laraichi et al., 2024). For instance, CDSS use has reduced unnecessary testing costs, such as an annual \$300,000 saving on vitamin D testing (Lewkowicz et al., 2020). Moreover, NIs are key in maintaining data integrity, ensuring HIPAA compliance, and executing data encryption and multifactor authentication to protect sensitive patient information (Shojaei et al., 2024). Despite these advantages, challenges persist, including resistance to new technologies and data privacy concerns. These can be addressed through robust staff training and strict data security protocols. NIs conduct system audits and enforce access controls to safeguard patient records. Their collaboration with technologists ensures that tools meet clinical needs and are user-friendly, thereby improving acceptance rates. To conclude, the inclusion of Nurse Informaticists is justified based on their unique ability to integrate CDSS into healthcare systems effectively. Their involvement enhances diagnostic accuracy, patient safety, and data security. Nurse Informaticists serve as catalysts for technological adoption, enabling better outcomes through streamlined clinical workflows, data-driven decision-making, and interdisciplinary collaboration. Table: Summary of Key Concepts Heading Key Focus Areas Examples and Outcomes Nursing Informatics and CDSS – Improve diagnostics – Reduce errors – Real-time alerts CDSS tools used by Cleveland Clinic and Mayo Clinic to enhance patient-specific care and diagnostics NI Roles and Collaboration – Train staff – Optimize EHR – Design user-friendly CDSS NI ensures smooth CDSS-EHR integration, educates teams, ensures clinical relevance Opportunities and Justifications – Cost savings – Privacy and data security – Improved patient care Savings of \$300,000 annually (Lewkowicz et al., 2020); Enhanced HIPAA compliance and care quality References American Nurses Association. (2024). What is nursing informatics and why is it so important. https://www.nursingworld.org/content-hub/resources/nursing-resources/nursing-informatics/ Cleveland Clinic. (2024). Nursing informatics. https://consultqd.clevelandclinic.org/nursing/nursing-informatics Laraichi, O., Daim, T., Alzahrani, S., Hogaboam, L., Bolatan, G. I., & Moughari, M. M. (2024). Technology readiness assessment: Case of clinical decision support systems in healthcare. Technology in Society, 79, 102736. https://doi.org/10.1016/j.techsoc.2024.102736 Lewkowicz, D., Wohlbrandt, A., & Boettinger, E. (2020). Economic impact of clinical decision support interventions based on electronic health records. BMC Health Services Research, 20(1), 871. https://doi.org/10.1186/s12913-020-05688-3 NURS FPX 4045 Assessment 1 Nursing Informatics in Health Care Lopez, K. D., Langford, L. H., Kennedy, R., McCormick, K., Delaney, C. W., Alexander, G., Englebright, J., Carroll, W. M., & Monsen, K. A. (2023). Future advancement of health care through standardized nursing terminologies: Reflections from a Friends of the National Library of Medicine workshop honoring Virginia K. Saba. Journal of the American Medical Informatics Association, 30(11), 1878–1884. https://doi.org/10.1093/jamia/ocad156 Mayo Clinic. (2024). Clinical decision support systems for personalized management of patients with acute kidney injury. https://www.mayoclinic.org/medical-professionals/pulmonary-medicine/news/clinical-decision-support-systems-for-personalized-management-of-patients-with-acute-kidney-injury/mac-20524049 Nashwan, A. J., Cabrega, J. A., Othman, M. I., Khedr, M. A., Osman, Y. M., Ashry, A. M. E., Naif, R., & Mousa, A. A. (2025). The evolving role of nursing informatics in the era

NURS FPX 4035 Assessment 4 Improvement Plan Tool Kit Name Capella university NURS-FPX4035 Enhancing Patient Safety and Quality of Care Prof. Name Date Improvement Plan Tool Kit This toolkit is intended for use by medical professionals and nurses aiming to implement evidence-based safety initiatives that target hospital fall prevention. It incorporates carefully selected clinical and academic resources that outline effective strategies, risk assessment tools, patient education techniques, and technological interventions. Each tool is accompanied by descriptions, implementation guidelines, and relevance to practice, allowing seamless integration into clinical settings. By leveraging these resources, nursing staff can significantly enhance quality and safety outcomes across diverse healthcare environments. The toolkit’s development was driven by search terms including “fall prevention,” “patient safety,” “risk assessment,” “root cause analysis,” and “evidence-based nursing practice.” These terms guided the identification of literature that supports the practical application of fall prevention measures in clinical workflows. As a result, nurses and healthcare leaders can rely on this toolkit to bridge the gap between evidence-based knowledge and daily clinical operations. Resources provided within the toolkit offer practical applications during staff training, patient handoffs, and facility-based fall prevention initiatives. Furthermore, each tool is contextualized for specific clinical environments, such as inpatient care units, home care services, or rehabilitation centers. This comprehensive design allows healthcare professionals to implement fall prevention practices tailored to their unique care settings. Annotated Bibliography Table Category Summary of Key Resource Practice Application Organizational Safety and Fall Prevention Garcia et al. (2021) examined nurses’ views on fall prevention strategies, emphasizing multifactorial programs that combine patient education and environmental modifications. Barriers included time constraints, lack of organizational support, and limited patient involvement. This resource helps nursing leaders design training that addresses staff barriers. It’s most effective during planning and training phases of fall prevention initiatives, and is ideal for customizing staff education to increase engagement with safety protocols. Linnerud et al. (2023) discussed a co-created implementation strategy tailored for home-care services. The study highlights stakeholder participation in developing community-specific fall prevention plans. Nurse managers and QI teams can use this during initial planning phases to foster collaboration. The document supports designing workshops to engage stakeholders and develop sustainable strategies, particularly in home-care environments. Mulfiyanti & Satriana (2022) focused on the SBAR (Situation, Background, Assessment, Recommendation) method’s role in improving nursing handovers and reducing safety incidents like falls. Nurses should use SBAR during handovers, interprofessional communications, and urgent care reporting. The study suggests that SBAR fosters team confidence and minimizes errors in high-risk environments. Environmental Risk Reduction & Safety Assessment Campani et al. (2021) evaluated environmental risk factors contributing to falls among the elderly, offering tools to assess and mitigate hazards such as poor lighting and cluttered spaces. Nurses and discharge planners can apply this tool for home visits and hospital safety checks. It enables healthcare teams to teach environmental safety and identify high-risk settings, aiding in both community and institutional fall prevention planning. Locklear et al. (2024) presented a narrative review of fall epidemiology, emphasizing early risk assessment using tools like the Morse Fall Scale. Their data showed a major reduction in costs due to structured interventions. Nurse leaders can use this for training and patient risk evaluation. The tool supports early identification of fall risks during admissions and ongoing care, and demonstrates cost-effectiveness of proactive measures in acute care settings. Stathopoulos et al. (2021) investigated how overcrowding and poor hospital design contribute to in-patient falls. Results showed that neurology and orthopedic units experienced most incidents, often when staff were not present. This tool supports administrative decisions on staffing and space allocation. Nurse managers and QI teams can use it to analyze incident data and support policy proposals for improved hospital design and staffing levels. Staff Education & Patient-Centered Strategies Albertini et al. (2022) implemented a person-centered model for fall prevention in Brazilian hospitals. They found that staff compliance with fall protocols improved significantly through individualized care and targeted education. Clinical leaders can implement this protocol to promote personalized fall prevention care. The approach emphasizes staff-patient collaboration and is especially valuable in units managing elderly or high-risk patients. References Albertini, A. C. da S., Fernandes, R. P., Püschel, V. A. de A., & Maia, F. de O. M. (2022). Person-centered care approach to prevention and management of falls among adults and aged in a Brazilian hospital: A best practice implementation project. JBI Evidence Implementation, 21(1), 14–24. https://doi.org/10.1097/xeb.0000000000000356 Campani, D., Caristia, S., Amariglio, A., Piscone, S., Ferrara, L. I., Barisone, M., Bortoluzzi, S., Faggiano, F., Dal Molin, A., Silvia Zanetti, E., Caldara, C., Bellora, A., Grantini, L., Lombardi, A., Carimali, C., Miotto, M., Pregnolato, A., & Obbia, P. (2021). Home and environmental hazards modification for fall prevention among the elderly. Public Health Nursing, 38(3), 493–501. https://doi.org/10.1111/phn.12852 Garcia, A., Bjarnadottir, R. (Raga) I., Keenan, G. M., & Macieira, T. G. R. (2021). Nurses’ perceptions of recommended fall prevention strategies. Journal of Nursing Care Quality, Publish Ahead of Print(3). https://doi.org/10.1097/ncq.0000000000000605 Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A.-M., & Morris, M. E. (2020). Hospital falls prevention with patient education: A scoping review. BMC Geriatrics, 20(1), 1–12. https://doi.org/10.1186/s12877-020-01515-w NURS FPX 4035 Assessment 4 Improvement Plan Tool Kit Heng, H., Kiegaldie, D., Shaw, L., Jazayeri, D., Hill, A.-M., & Morris, M. E. (2022). Implementing patient falls education in hospitals: A mixed-methods trial. Healthcare, 10(7), 1298. https://doi.org/10.3390/healthcare10071298 Lakbala, P., Bordbar, N., & Fakhri, Y. (2024). Root cause analysis and strategies for reducing falls among in-patients in healthcare facilities: A narrative review. Health Science Reports, 7(7). https://doi.org/10.1002/hsr2.2216 Linnerud, S., Aimée, L., Graverholt, B., Idland, G., Taraldsen, K., & Brovold, T. (2023). Stakeholder development of an implementation strategy for fall prevention in Norwegian home care – a qualitative co-creation approach. BMC Health Services Research, 23(1). https://doi.org/10.1186/s12913-023-10394-x Locklear, T., Kontos, J., Brock, C. A., Holland, A. B., Hemsath, R., Deal, A., Leonard, S., Steinmetz, C., & Biswas, S. (2024). In-patient falls: Epidemiology, risk assessment, and prevention measures. A narrative review. HCA Healthcare Journal of Medicine, 5(5). https://doi.org/10.36518/2689-0216.1982 Miura, T., & Kanoya, Y. (2025). Fall risk assessment and prevention strategies in nursing homes: A narrative

NURS FPX 4035 Assessment 3 Improvement Plan In-Service Presentation Name Capella university NURS-FPX4035 Enhancing Patient Safety and Quality of Care Prof. Name Date Improvement Plan In-Service Presentation Part 1: Introduction, Agenda, and Goals Welcome, and thank you for joining today’s in-service session. I am [Presenter’s Name], and I will be discussing a critical patient safety issue that affects the quality of care in the emergency department (ED): failures in patient handoff. The aim of this training is to provide nursing and clinical staff with effective tools and strategies to improve handoffs, ultimately enhancing communication and safety outcomes for patients. The agenda for this session centers on resolving the ongoing issue of patient handoff failures within the ED. Inadequate handoffs often lead to injury, suboptimal treatment, longer hospitalizations, increased costs, and even patient mortality (Nawawi & Ibrahim, 2024). This session is designed to strengthen nursing staff’s skills in transferring patient information effectively through evidence-based solutions such as the SBAR (Situation, Background, Assessment, Recommendation) communication tool and bedside handoff protocols. A recent adverse event involving a septic patient highlights the consequences of insufficient handoff communication, where poor documentation and incomplete information sharing delayed treatment and put the patient at risk. Three clear goals guide our initiative. First, we aim to explore the main factors contributing to handoff errors in the ED, including educational gaps, insufficient handoff time, interruptions, lack of standardization, and understaffing. Research shows that poor communication is responsible for approximately 22.1% of adverse nursing outcomes (Kim et al., 2021). Second, the training introduces proven strategies like SBAR and EHR usage to address these errors. Third, we will stress the importance of handoff accuracy and equip staff with the practical skills necessary to reduce safety risks and implement the plan effectively. Expected outcomes include recognizing the root causes of handoff inefficiencies, equipping staff with practical skills to address them, and fostering a consistent, evidence-based approach to patient information transfer. These changes are expected to enhance communication, improve nurse confidence, and reduce healthcare costs while improving patient satisfaction and clinical outcomes (Nawawi & Ibrahim, 2024). Part 2: The Safety Improvement Plan and Organizational Impact Patient handoff challenges in the ED pose a significant threat to patient safety and overall organizational performance. Miscommunication during transitions has been linked to nearly 40.2% of adverse outcomes, with 80.1% of medical errors involving some form of miscommunication (Janagama et al., 2020). These failures may lead to injury, extended hospital stays, increased healthcare costs, and even death. Communication breakdowns alone are estimated to cost U.S. healthcare systems approximately \$12.1 billion annually. Addressing this issue requires a structured improvement plan. The first step involves adopting the SBAR model as a standard communication framework to promote consistency and clarity among healthcare professionals (Kay et al., 2022). Next, the organization should enhance surveillance and alert management systems to prevent oversight of critical changes in patient status. The third phase will include implementing electronic systems like EHR templates and the Electronic Nursing Handover System (ENHS) to facilitate timely and accurate information transfer. These tools minimize memory reliance and support high-quality handovers (Tataei et al., 2023). Finally, ongoing staff training is essential to ensure long-term adherence and competence in these protocols. Regular sessions will sharpen clinical judgment, reduce stress, and foster trust among team members (Nawawi & Ibrahim, 2024). Improving patient handoffs is not only a safety priority but also a financial and operational necessity. Failures in communication can increase organizational liability, reduce patient satisfaction, and affect accreditation. Furthermore, staff morale and productivity are diminished when workflows are disjointed, making standardized handoff procedures a vital element of performance improvement. Effective implementation leads to better teamwork, higher standards of care, and improved patient outcomes. Part 3: The Audience’s Role and Expected Benefits The success of this safety initiative relies heavily on the commitment and collaboration of nurses, clinicians, and administrative staff. Nurses and physicians are the primary agents in patient transfers and shift changes; therefore, their use of structured communication tools such as SBAR is crucial to prevent omissions of critical data. According to Kim et al. (2021), adequate staffing directly correlates with improved care quality, making their role indispensable in patient safety initiatives. Staff engagement in training programs, feedback provision, and multidisciplinary team participation helps sustain standardized protocols. Hospital administrators must support this transition by allocating resources for electronic handoff systems and continuing education. Their leadership enables sustainable implementation by ensuring the availability of time and infrastructure necessary for smooth handoffs. Involving staff as stakeholders ensures a sense of ownership and accountability, increasing the likelihood of successful adoption. Their insights into challenges like time constraints or process inefficiencies can shape realistic, applicable solutions. Moreover, embracing these roles offers substantial benefits. Structured handoff tools like SBAR and EHR templates simplify transitions, reduce miscommunications, and decrease the need for follow-up clarifications (Kay et al., 2022). This not only leads to better patient outcomes but also lowers staff burnout by creating more predictable and manageable workflows. Ultimately, a shared commitment to effective handoffs promotes a culture of safety, teamwork, and continuous improvement. Summary Table Section Key Points Supporting Evidence Introduction & Goals Addressing patient handoff failures in the ED through training, SBAR, and bedside protocols Nawawi & Ibrahim (2024); Kim et al. (2021) Safety Improvement Plan Implement SBAR, surveillance, EHR, and staff training to reduce errors and improve communication Kay et al. (2022); Tataei et al. (2023) Audience Role & Benefits Nurses, physicians, and managers play a vital role in implementing the plan; benefits include fewer errors, better workflow, and improved outcomes Kim et al. (2021); Kay et al. (2022) References Janagama, R., Gardner, L., Allen, A., & Talbert, J. (2020). Communication failures and healthcare costs: Estimating the burden. Journal of Patient Safety, 16(4), 250–257. https://doi.org/10.1097/PTS.0000000000000592 Kay, K., Ramaswamy, R., & Chatterjee, N. (2022). Improving communication in patient handoffs: Adopting the SBAR model in emergency care settings. BMJ Open Quality, 11(1), e001752. https://doi.org/10.1136/bmjoq-2021-001752 NURS FPX 4035 Assessment 3 Improvement Plan In-Service Presentation Kim, M., Park, M., & Kang, K. J. (2021). Factors influencing adverse events in nursing care: The impact of handoff quality. Journal

NURS FPX 4035 Assessment 2 Root-Cause Analysis and Safety Improvement Plan Name Capella university NURS-FPX4035 Enhancing Patient Safety and Quality of Care Prof. Name Date Root-Cause Analysis and Safety Improvement Plan A sentinel event is defined as an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof, not primarily related to the natural progression of a patient’s illness or condition. These events are deeply distressing for both patients and healthcare providers and serve as critical reminders of the importance of robust safety systems. The objective of conducting a thorough root-cause analysis (RCA) is to uncover not only immediate causes but also underlying systemic flaws that may contribute to these adverse outcomes. By identifying these factors, organizations can implement sustainable changes to prevent recurrence and enhance patient safety. Understanding What Happened In this particular case, the sentinel event took place in the Emergency Department (ED), where a miscommunication during a patient handoff led to a delay in treatment. A septic patient’s deteriorating condition was not clearly communicated by the outgoing nurse due to omissions in critical details and insufficient documentation. As a result, the patient’s condition worsened, leading to an extended hospital stay and additional medical interventions. The event affected multiple stakeholders. The patient experienced health deterioration and psychological distress; family members faced emotional stress; and healthcare providers endured increased workloads and potential disciplinary scrutiny. The institution faced regulatory reviews, financial repercussions, and a tarnished reputation. Several factors contributed to this event. Human elements such as fatigue, high workload, and inadequate training led to incomplete verbal handoffs. Systemic flaws, including inefficient workflow and lack of structured electronic tools, compounded the problem. The organizational culture lacked a robust emphasis on safety, leadership oversight, and accountability. Additionally, cultural and language differences among staff affected the clarity of communication. These interconnected factors underscore the importance of addressing both human and structural components in patient safety initiatives. Deviation from Protocols and Breakdown in Communication The standardized SBAR (Situation, Background, Assessment, Recommendation) protocol was not adhered to during the handoff. Critical patient data was omitted, and there was no structured process to verify understanding between staff. Documentation in medical records and nursing notes lacked key details such as pending care needs and medication administration. Consequently, critical interventions were delayed. The event also exposed weaknesses in interdisciplinary and patient-provider communication. Nurses failed to exchange vital updates about new medication orders. The patient was inadequately informed about their evolving care plan, potentially compromising their trust and engagement in treatment. These lapses in communication underscore the need for structured protocols and training. Contributing Factors and Policy Gaps Environmental constraints, such as poorly placed nursing stations and malfunctioning devices, hindered effective information flow. Staffing shortages led to nurse fatigue and decreased attention to protocol adherence. While staff were generally competent, gaps in training—especially around updated handoff procedures—were evident. Policy compliance issues also played a significant role. While protocols existed, they were not effectively communicated or enforced. Many staff members reported difficulty accessing current guidelines, leading to inconsistencies in practice. Vital signs monitoring during critical periods was insufficient. Nurses failed to notice changes in the patient’s condition in real time. Furthermore, alarm fatigue—a common issue in high-volume units—resulted in missed alerts. These system failures compounded the risks already introduced by human and procedural lapses. Learning from the Incident and Enhancing Patient Safety This incident offers several important lessons. Systemic interventions must include strengthening communication strategies, particularly by reinforcing SBAR and bedside handoff procedures. Training should be updated regularly and include simulation of high-risk scenarios to ensure staff are prepared for emergencies. A cultural shift is also needed, with a focus on safety, accountability, and open dialogue. Preventive strategies include upgrading monitoring systems, refining alarm protocols, and introducing checklists for critical transitions. Frequent audits and feedback loops should be implemented to identify risks proactively. A non-punitive reporting culture should be cultivated to encourage transparency and continuous learning. These measures can help mitigate risks and elevate the standard of patient care. Root Cause and Contributing Factors Table Root Cause / Contributing Factor Category Code Breakdown in communication between the care team, leading to misinterpretation of patient condition Human Factor – Communication HF-C Insufficient training on updated protocols, causing staff to miss critical care changes Human Factor – Training HF-T Malfunctioning equipment led to missed warning signs and delayed intervention Environment / Equipment E Staff fatigue due to poor scheduling affected attention and decision-making Human Factor – Fatigue/Scheduling HF-F/S Failure to follow safety protocols resulted in missed interventions Rules / Policies / Procedures R Organizational barriers, including poor communication channels, hindered effective teamwork Barriers B Code Key: HF-C = Human Factor – Communication HF-T = Human Factor – Training HF-F/S = Human Factor – Fatigue/Scheduling E = Environment / Equipment R = Rules / Policies / Procedures B = Barriers Application of Evidence-Based Strategies Addressing sentinel events requires the implementation of evidence-based strategies that target both systemic and human factors. One of the most effective approaches involves the adoption of structured communication tools such as SBAR. Research conducted in the Griyatama Inpatient Room at Tabanan Hospital demonstrated that consistent use of SBAR significantly improves communication effectiveness, particularly during handoffs and emergency transitions (Putra et al., 2022). Improving alarm management systems is also critical. Alarm fatigue is a well-documented contributor to missed interventions, and literature suggests that prioritizing critical alarms and reducing unnecessary alerts can improve staff responsiveness (Cvach, 2012). Incorporating automated alert systems for abnormal vital signs can further reduce oversight and enhance timely interventions. Another key strategy is the implementation of routine simulation training and refresher courses. These sessions reinforce proper handoff procedures, ensure knowledge of updated protocols, and provide staff with hands-on experience in managing complex cases. Encouraging a culture of open reporting, supported by leadership, can transform adverse events into opportunities for learning and systemic improvement. References Cvach, M. (2012). Monitor alarm fatigue: An integrative review. Biomedical Instrumentation & Technology, 46(4), 268–277. https://doi.org/10.2345/0899-8205-46.4.268 Putra, A. A., Wardani, E. Y., & Sari, K. (2022). Implementation of SBAR communication

NURS FPX 4035 Assessment 1 Enhancing Quality and Safety Name Capella university NURS-FPX4035 Enhancing Patient Safety and Quality of Care Prof. Name Date Enhancing Quality and Safety The patient handover process within hospital emergency departments (EDs) is a critical juncture for maintaining quality and safety in healthcare delivery. Transitions of care become particularly vulnerable when communication falters, often leading to errors, delayed treatments, and adverse patient outcomes. The emergency setting is uniquely high-risk due to time constraints, high patient volume, and complex cases. Inefficient or inconsistent handoff protocols further complicate these challenges. This paper explores the implications of ineffective patient handoffs in EDs and evaluates evidence-based communication frameworks that can mitigate risks. It also emphasizes the role of nurses in promoting care coordination and highlights the involvement of essential stakeholders aimed at improving safety and reducing hospital costs. Several factors contribute to elevated patient safety risks in ED handoffs. Ineffective communication combined with time pressure and clinical complexity significantly increases the likelihood of errors. Studies report that communication breakdowns during chaotic emergency care contribute to roughly 80% of severe medical errors during handoffs (Kinney-Sandefur, 2024). Non-compliance with standardized communication protocols and rushed interactions often result in missing or incorrect information transfer. Poor verbal communication and inadequate documentation are core contributors to suboptimal handovers. Moreover, the time-sensitive nature of emergency care exacerbates the problem. Staff often operate under significant pressure to provide timely and accurate interventions, but handover delays and communication issues impact as much as 70% of healthcare outcomes and 50% of handoff-specific events (Atinga et al., 2024). Emergency care frequently involves multifaceted treatments requiring team coordination. When formal handoff procedures are absent, it leads to fragmented care, extended hospital stays, and increased risk of medical errors, adversely affecting both patient outcomes and healthcare costs. Factors Leading to Patient Safety Risk Effective solutions have been identified to address the risks associated with emergency department handoffs. One of the most widely accepted communication frameworks is SBAR (Situation, Background, Assessment, Recommendation). SBAR provides a structured and standardized method of communication that enhances clarity, reduces misunderstandings, and facilitates smooth transitions. Studies show that implementing SBAR improves handover efficiency, healthcare provider satisfaction, and patient safety (Ghosh et al., 2021). Additionally, SBAR usage correlates with cost savings by improving documentation accuracy, streamlining billing, and reducing unnecessary treatment errors. The adoption of electronic health records (EHRs) with integrated handoff templates is another effective strategy. These systems enable real-time updates and consistent access to patient data, eliminating reliance on memory or handwritten notes (Tataei et al., 2023). Furthermore, conducting bedside shift reports encourages patient and family involvement, which improves communication clarity and increases patient satisfaction. These methods not only prevent adverse events but also contribute to shorter hospital stays and reduced litigation. Structured communication during handoffs significantly decreases the likelihood of preventable errors, ultimately optimizing operational efficiency and lowering healthcare expenditures. Nurses play a central role in enhancing communication during patient transitions. As the primary caregivers, they ensure the continuity of care by verifying critical patient information before, during, and after handoffs. Active participation in multidisciplinary rounds enables nurses to collaborate with other healthcare professionals to create cohesive care plans and address gaps that may emerge before patient transfers (Shirley et al., 2024). Their involvement helps prevent miscommunication and reduces the risk of costly medical mistakes. Nurses also reinforce closed-loop communication, ensuring that receiving providers understand and acknowledge the handoff content—critical for reducing avoidable clinical errors and healthcare costs. Stakeholders’ Involvement in Nursing Coordination Patient handoff effectiveness in the emergency department depends on a broad coalition of stakeholders. Physicians rely on accurate and timely handoff information to make clinical decisions, so collaboration between nurses and physicians is vital. Communication errors between these parties can delay treatment, jeopardize patient safety, and raise care costs (Jemal et al., 2021). Pharmacists are another key group, especially in verifying medication orders during transitions. Their coordination with nurses reduces medication-related errors, which account for billions of dollars in wasted spending annually. Hospital administrators are responsible for enforcing standardized handoff protocols, providing technological infrastructure, and offering staff training programs. Their leadership is crucial for empowering frontline healthcare professionals with tools that enable safe and effective patient transitions. Patient safety officers and quality improvement teams also play pivotal roles in analyzing errors and refining hospital policies in alignment with best practices. Including patients and their families in bedside handoffs increases transparency, improves continuity of care, and lowers readmission rates (Bucknall et al., 2020). Nurses, by facilitating communication among these various stakeholders, serve as vital links in the system of care that enhances both safety and financial performance in healthcare institutions. Summary Table of Key Insights Section Key Points Evidence/Support Enhancing Quality and Safety ED handoffs are high-risk due to time pressure, case complexity, and inconsistent communication protocols. 80% of severe errors linked to miscommunication (Kinney-Sandefur, 2024) Factors Leading to Patient Safety Risk SBAR and EHRs standardize communication, reduce costs, and improve outcomes. Bedside reporting involves patients and increases satisfaction. SBAR improves satisfaction and safety (Ghosh et al., 2021); EHRs reduce memory reliance (Tataei et al., 2023) Stakeholders’ Involvement Effective handoffs rely on collaboration among nurses, physicians, pharmacists, administrators, and patients/families to reduce risk and cost. Communication gaps with physicians cause delays (Jemal et al., 2021); Family involvement reduces readmissions (Bucknall et al., 2020) References Atinga, R. A., Gmaligan, M. N., Ayawine, A., & Yambah, J. K. (2024). “It’s the patient that suffers from poor communication”: Analysing communication gaps and associated consequences in handover events from nurses’ experiences. SSM – Qualitative Research in Health, 6, 100482–100482. https://doi.org/10.1016/j.ssmqr.2024.100482 NURS FPX 4035 Assessment 1 Enhancing Quality and Safety Bucknall, T. K., Hutchinson, A. M., Botti, M., McTier, L., Rawson, H., Hitch, D., Hewitt, N., Digby, R., Fossum, M., McMurray, A., Marshall, A. P., Gillespie, B. M., & Chaboyer, W. (2020). Engaging patients and families in communication across transitions of care: An integrative review. Patient Education and Counseling, 103(6), 1104–1117. https://doi.org/10.1016/j.pec.2020.01.017 Ghosh, S., Ramamoorthy, L., & Pottakat, B. (2021). Impact of structured clinical handover protocol on communication and patient satisfaction. Journal of Patient Experience, 8(1), 1–6. https://doi.org/10.1177/2374373521997733

NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers 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

NURS FPX 4025 Assessment 3 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date Assessment 3: Understanding COPD and Smoking Cessation Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease that severely affects breathing and quality of life. Smoking is the primary risk factor contributing to COPD, and continued smoking accelerates disease progression. Despite the well-documented benefits of smoking cessation, many individuals struggle to quit due to nicotine addiction, psychological stress, and limited access to support systems. COPD remains a significant public health concern in the United States, impacting approximately 16 million adults (Centers for Disease Control and Prevention [CDC], 2024). Quitting smoking not only slows disease progression but also improves overall lung function and reduces the risk of hospitalizations. However, due to various barriers, many COPD patients find it challenging to quit smoking successfully. This assessment evaluates the effectiveness of structured smoking cessation programs compared to standard counseling in assisting COPD patients in achieving long-term smoking abstinence and improving their lung health over six months. Diagnosis and Challenges COPD manifests through persistent symptoms such as chronic coughing, breathlessness, and frequent respiratory infections. If left unmanaged, it can lead to severe complications, including hospitalizations, cardiovascular diseases, and respiratory failure. Smoking cessation remains the most effective intervention for slowing disease progression, yet many patients face challenges such as nicotine dependence, emotional stress, and lack of healthcare access (American Lung Association [ALA], 2024). Socioeconomic factors also play a crucial role, as individuals from low-income backgrounds or those residing in remote areas may struggle to access smoking cessation resources. Additionally, limited financial means may prevent some patients from affording essential COPD medications, such as inhalers or nicotine replacement therapies. Healthcare providers, particularly nurses, are instrumental in bridging these gaps by educating patients, providing support, and implementing evidence-based smoking cessation strategies (Wang et al., 2024). By addressing these challenges, structured programs can enhance smoking cessation rates and improve disease management. Research Question and PICO(T) Framework Understanding the most effective smoking cessation approach for COPD patients requires a structured research question. The PICO(T) framework is a useful tool for formulating a focused research question: In adult patients diagnosed with COPD (P), how does a structured smoking cessation program incorporating behavioral counseling and pharmacotherapy (I), compared to standard smoking cessation counseling (C), impact smoking cessation rates and pulmonary function (O) within six months (T)? A breakdown of the PICO(T) components is provided in the table below: PICO(T) Criteria Description Population (P) Adult patients diagnosed with COPD, for whom smoking cessation is critical for disease management. Intervention (I) A structured smoking cessation program incorporating behavioral counseling and pharmacotherapy (e.g., nicotine replacement therapy [NRT], varenicline, or bupropion), which has shown higher success rates than single interventions (Fu et al., 2022). Comparison (C) Standard smoking cessation counseling, typically consisting of brief counseling sessions or educational materials. Outcome (O) Sustained smoking cessation and improved pulmonary function over six months. Time (T) A six-month period, as research indicates that abstinence beyond this timeframe leads to long-term cessation success (Hu et al., 2021). This research question aims to identify the most effective smoking cessation strategies for COPD patients, providing insights into best practices for disease management and improved patient outcomes. Evidence and Literature Review A comprehensive literature review was conducted to gather evidence on smoking cessation programs for COPD patients. Databases such as PubMed, CINAHL, Cochrane Library, and Google Scholar were searched using keywords including “COPD,” “smoking cessation,” “nicotine replacement therapy,” “behavioral counseling,” and “pharmacotherapy.” Boolean operators were used to refine the search, ensuring a focus on studies specifically addressing smoking cessation in COPD patients. The CRAAP criteria (Currency, Relevance, Authority, Accuracy, and Purpose) were applied to assess the credibility of sources. Peer-reviewed articles, systematic reviews, and meta-analyses from reputable organizations such as the CDC and ALA were prioritized. Three key studies highlight the effectiveness of smoking cessation interventions. Wang et al. (2024) conducted a meta-analysis showing that quitting smoking significantly improved lung function (FEV1% increase of 6.72), walking ability (6-MWT increased by 64.46), and oxygen levels (1.96 higher). Han et al. (2023) found that structured programs incorporating cognitive-behavioral therapy and pharmacotherapy resulted in higher quit rates than standard counseling. Fu et al. (2022) emphasized the importance of using evidence-based practice models, such as the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, to enhance smoking cessation interventions. Collectively, these studies support the effectiveness of structured smoking cessation programs in improving patient outcomes. NURS FPX 4025 Assessment 3 Study Findings Wang et al. (2024) Smoking cessation led to improved lung function (FEV1% increased by 6.72), increased walking ability (6-MWT by 64.46), and higher oxygen levels (1.96 increase). Han et al. (2023) A structured smoking cessation program incorporating cognitive-behavioral therapy and pharmacotherapy led to higher quit rates compared to standard counseling. Fu et al. (2022) The use of evidence-based practice models, such as JHNEBP, improves smoking cessation outcomes and slows COPD progression. Conclusion Smoking cessation is vital for COPD patients as it significantly improves lung health and overall quality of life. Structured smoking cessation programs that include behavioral counseling and pharmacotherapy have demonstrated greater success rates than standard counseling. These programs provide essential support, helping patients overcome barriers to quitting smoking and reducing COPD-related complications. Nurses and healthcare providers play a crucial role in implementing these programs and guiding patients through the cessation process. By adopting evidence-based smoking cessation interventions, healthcare systems can enhance patient outcomes and contribute to the long-term management of COPD. References Alupo, P., Baluku, J., Bongomin, F., Siddharthan, T., Katagira, W., Ddungu, A., Hurst, J. R., Boven, van, Worodria, W., & Kirenga, B. J. (2024). Overcoming challenges of managing chronic obstructive pulmonary disease in low- and middle-income countries. Expert Review of Respiratory Medicine. https://doi.org/10.1080/17476348.2024.2398639 American Lung Association (ALA). (2024). Learn about COPD | American Lung Association. Lung.org; American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd Centers for Disease Control and Prevention (CDC). (2024, June 12). COPD. Chronic Disease Indicators. https://www.cdc.gov/cdi/indicator-definitions/chronic-obstructive-pulmonary-disease.html NURS FPX 4025 Assessment 3 Fu, Y., Chapman, E. J., Boland, A. C., & Bennett, M. I. (2022). Evidence-based management approaches for patients with severe

NURS FPX 4025 Assessment 2 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date Applying an Evidence-Based Practice (EBP) Model Evidence-Based Practice (EBP) is an essential approach in nursing, ensuring that patient care is based on the most reliable research. Chronic Obstructive Pulmonary Disease (COPD) significantly affects patients’ quality of life, particularly due to smoking-related complications and poor medication adherence. This discussion explores the use of the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model to enhance smoking cessation efforts for COPD patients. It addresses the challenges associated with the condition, outlines the structured steps of the JHNEBP model, and reviews relevant evidence to improve patient outcomes. Issue Associated with the Diagnosis COPD is a progressive respiratory disease that causes airflow limitation, leading to symptoms such as chronic cough, shortness of breath, and reduced exercise tolerance. One of the biggest challenges in managing COPD is smoking cessation, as continued tobacco use worsens the condition and accelerates disease progression. According to Principe et al. (2024), smoking cessation provides significant health benefits, yet many COPD patients struggle to quit due to nicotine dependence, emotional attachment, and insufficient support systems. Their meta-analysis found that smokers have a 4.01 times higher likelihood of developing COPD than non-smokers. EBP integrates the best research evidence with clinical expertise and patient preferences to address this issue effectively. Han et al. (2023) emphasize that structured smoking cessation programs—including behavioral counseling, pharmacotherapy, and pulmonary rehabilitation—lead to better outcomes compared to basic cessation advice. Evidence suggests that combining nicotine replacement therapy with cognitive-behavioral interventions significantly increases quit rates. By applying the JHNEBP model, nurses can systematically evaluate and implement effective smoking cessation strategies, improving disease management, reducing hospitalizations, and enhancing the overall quality of life for COPD patients (Jiang et al., 2024). EBP Model and Its Steps The JHNEBP model offers a structured process for integrating research findings into clinical practice, particularly in smoking cessation interventions for COPD patients. This model consists of three primary steps: Practice Question, Evidence Translation, and Implementation (PET). Practice Question: This step involves defining a clear clinical question using the PICO (Population, Intervention, Comparison, Outcome) framework. This structured approach helps healthcare professionals identify key concerns and develop targeted interventions for COPD patients struggling with smoking cessation (Brunt & Morris, 2023). Evidence Translation: The second step involves conducting a comprehensive literature review to gather relevant studies, clinical guidelines, and expert recommendations on smoking cessation strategies. Each source is critically appraised for reliability and applicability to ensure that clinical decisions are informed by high-quality evidence (Coleman et al., 2022). Implementation: In the final step, evidence-based interventions are applied in the clinical setting. This may include the development of interdisciplinary smoking cessation programs that incorporate behavioral counseling, pharmacotherapy, and pulmonary rehabilitation. The effectiveness of these interventions is continuously monitored, addressing challenges such as patient motivation and limited resources through education and support (Jiang et al., 2024). By following the JHNEBP model, healthcare providers can systematically implement smoking cessation programs that are both evidence-based and patient-centered. Application of the JHNEBP Model to Evidence Search The JHNEBP model was used to identify evidence-based interventions for smoking cessation in COPD patients. The PET framework guided the evidence search, focusing on COPD patients (P) undergoing structured smoking cessation programs (I) compared to those receiving standard cessation advice (C) to assess improvements in smoking cessation rates and disease management (O). This search was conducted across key medical databases such as PubMed, CINAHL, and the Cochrane Library, utilizing search terms like COPD, smoking cessation, nicotine replacement therapy, behavioral counseling, and pulmonary rehabilitation. Each selected study was critically analyzed for credibility and relevance, ensuring the most reliable evidence guided clinical decision-making. Despite challenges such as the overwhelming volume of literature and limited research focusing specifically on COPD-related smoking cessation, the JHNEBP model facilitated a systematic and targeted approach. This method ensured that the most relevant studies were identified for practical implementation in clinical settings. Credibility and Relevance of Resources Several studies, including those by Principe et al. (2024), Han et al. (2023), and Jiang et al. (2024), provide strong evidence on smoking cessation interventions for COPD patients. These resources were evaluated using the CRAAP (Currency, Relevance, Authority, Accuracy, and Purpose) criteria to determine their credibility and applicability to EBP. Principe et al. (2024) conducted a meta-analysis that synthesized data from multiple studies, offering compelling evidence on smoking-related risks and cessation benefits. Han et al. (2023) examined structured smoking cessation programs, highlighting the effectiveness of combining behavioral counseling with pharmacotherapy. Additionally, Jiang et al. (2024) explored the role of nurses in implementing smoking cessation interventions, reinforcing the importance of the JHNEBP model in improving COPD patient care. The credibility and relevance of these studies make them critical resources for guiding evidence-based smoking cessation strategies in clinical practice. Conclusion The application of the JHNEBP model ensures that smoking cessation interventions for COPD patients are based on high-quality, evidence-based practices. By leveraging credible research, nurses can develop structured smoking cessation programs that improve patient outcomes, slow disease progression, and support long-term COPD management. This systematic approach enhances the effectiveness of smoking cessation efforts, ultimately leading to better health outcomes for individuals with COPD. Table: EBP Model and Its Application Step Description References Practice Question Define a clear clinical question using the PICO framework to focus on COPD-related smoking cessation. Brunt & Morris, 2023 Evidence Translation Conduct a thorough literature review to identify relevant studies, guidelines, and expert opinions. Coleman et al., 2022; Williams et al., 2022 Implementation Apply the findings in practice through structured programs, monitor patient outcomes, and provide support. Jiang et al., 2024 References Brunt, B. A., & Morris, M. M. (2023, March 4). Nursing professional development evidence-based practice. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK589676/ Coleman, S. R. M., Menson, K. E., Kaminsky, D. A., & Gaalema, D. E. (2022). Smoking cessation interventions for patients with chronic obstructive pulmonary disease: A narrative review with implications for pulmonary rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention, 43(4). https://doi.org/10.1097/HCR.0000000000000764 Han, M. K., Fu, Y., Ji, Q., Duan, X., & Fang, X. (2023). The effectiveness of theory-based smoking cessation interventions

NURS FPX 4025 Assessment 1 Name Capella university NURS-FPX4025 Research and Evidence-Based Decision Making Prof. Name Date Evaluation of the Article The study by Assaf et al. (2022) is a quantitative, cross-sectional analysis that investigates the quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD). This research design gathers data at a single point in time, allowing for the identification of associations rather than causal relationships. While the study provides moderate-level evidence on the factors influencing QoL in COPD patients, further research, particularly randomized controlled trials (RCTs), would be required to establish cause-and-effect relationships. The credibility of the article is strengthened by its publication in F1000Research, a peer-reviewed journal with an open-review process, ensuring transparency. The authors are affiliated with reputable academic and healthcare institutions, and the study follows ethical research standards by utilizing validated tools in its methodology. Moreover, the article references authoritative sources such as the World Health Organization (WHO) and the American Thoracic Society (ATS), reinforcing its reliability and academic rigor. NURS FPX 4025 Assessment 1 The study’s key findings indicate that smoking, dyspnea, and psychological distress negatively impact the quality of life of COPD patients. The research underscores the importance of pulmonary rehabilitation, smoking cessation programs, and medication adherence in improving patient outcomes. These insights are particularly relevant to healthcare settings where smoking rates are high and support the implementation of integrated care models for COPD management. The findings also apply to the case of Mr. James Carter in the Sentinel U simulation, whose dyspnea and chronic cough result from a 40-pack-a-year smoking history and poor treatment adherence. The article provides a strong evidence base for designing interventions aimed at improving Mr. Carter’s quality of life. Table: Evaluation of the Article Criteria Details Study Design & Level of Evidence Quantitative, cross-sectional study. Collects data at a single point in time, useful for identifying associations but not causality. Provides moderate-level evidence. Credibility Factors Published in F1000Research, a peer-reviewed journal with an open-review process. Authors are affiliated with reputable institutions. The study follows ethical guidelines and uses validated tools. Cites authoritative sources like WHO and ATS. Key Findings & Implications Smoking, dyspnea, and psychological distress significantly impact the QoL of COPD patients. Highlights the importance of pulmonary rehabilitation, smoking cessation programs, and medication adherence for better patient outcomes. Supports integrated care models. Summary of Findings Assaf et al. (2022) explored the quality of life (QoL) in COPD patients, identifying several key factors that influence their well-being, including dyspnea, chronic cough, smoking history, and psychological distress. The study emphasizes the importance of evidence-based interventions, such as pulmonary rehabilitation, smoking cessation, and medication adherence, in improving COPD management. These findings align closely with the case of Mr. James Carter in the Sentinel U simulation, as his symptoms mirror those seen in COPD patients, primarily due to a long history of smoking and poor treatment adherence. The study provides strong support for integrating structured interventions, such as pulmonary rehabilitation programs and smoking cessation efforts, into COPD care to enhance patient outcomes. Credibility & Usefulness The article was published in F1000Research, a peer-reviewed journal, ensuring credibility through an open-review process and expert validation. The authors have affiliations with reputable institutions specializing in pulmonary diseases, adding to the study’s reliability. Using a structured quantitative approach, the research applies validated questionnaires and statistical analysis, making its findings robust. Furthermore, referencing authoritative sources such as WHO and ATS strengthens the article’s trustworthiness. Although cross-sectional studies do not establish causation, this research offers valuable insights into COPD management. In particular, it provides guidance on effective interventions for Mr. Carter, such as pulmonary rehabilitation and smoking cessation programs, which could significantly improve his quality of life and disease management. NURS FPX 4025 Assessment 1 Article Link: https://doi.org/10.12688/f1000research.121783.1 References Assaf, E. A., Badarneh, A., Saifan, A., & Al-Yateem, N. (2022). Chronic obstructive pulmonary disease patients’ quality of life and its related factors: A cross-sectional study of the Jordanian population. F1000Research, 11, 581. https://doi.org/10.12688/f1000research.121783.1

NURS 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 Hello, Ms. Jackson. My name is __, and I will be performing a comprehensive head-to-toe assessment today to evaluate your overall health. This assessment will provide us with valuable insights into your current health status, allowing us to develop a personalized care plan. If you experience any discomfort during the assessment, please let me know so we can pause. Let’s begin. Comprehensive and Professional Assessment As I observe you, I take note of your posture, facial expressions, and overall level of alertness. You appear slightly tense, with visible signs of fatigue. Now, I will assess your mental status, which is a critical aspect of your health. Ms. Jackson, I will ask you a few questions to evaluate your orientation and cognitive function. Can you please tell me your full name? Do you know today’s date and where we are currently? Thank you. Moving forward, I will assess your emotional state. Have you noticed any recent changes in your mood, difficulty sleeping, or feelings of sadness or anxiety? Your willingness to share this information is greatly appreciated, as mental health is just as important as physical health. We will work together to develop a supportive care plan. Next, I will conduct a neurological assessment. I will shine a light into your eyes to observe your pupils’ reaction. Your pupils react equally to light, which is a good sign. Now, please follow my finger with your eyes without moving your head. Your eye movements are smooth. I will gently tap below your knee to test your reflexes, and the response is normal. Let’s assess your grip strength—please squeeze my fingers as hard as you can. The strength is equal on both sides. Finally, I will check your coordination. Can you touch your nose with your finger and then reach out to touch my hand? Cardiovascular, Respiratory, and Musculoskeletal Assessment Now, I will assess your cardiovascular health by listening to your heart sounds with my stethoscope. Please take a few deep breaths. Your heart sounds are clear, and your pulse is steady. Next, I will check your blood pressure; the reading is 145/90, which is slightly elevated. This may be influenced by factors such as stress or diet, and we can explore strategies to manage it. I will also assess your capillary refill by pressing on your fingertips, and your circulation appears normal. For the respiratory assessment, I will place my stethoscope on different areas of your chest and back to listen to your lungs. Please take a deep breath in and out. The lung sounds are normal, with no wheezing or crackling, which is a positive sign. Moving on, I will examine your abdomen by gently pressing on various areas. Please let me know if you experience any pain or discomfort. Your abdomen is soft, and there are no abnormal masses or tenderness. Your bowel sounds are normal. Next, I will evaluate your musculoskeletal and skin health. I will check your joint mobility by asking you to raise your arms and move them in a circular motion. That looks good. Now, let’s test your leg strength—please push against my hands with your feet. Your strength is equal on both sides. Your skin appears healthy, with no sores, rashes, or swelling. Additionally, I have checked your nails for any color changes or abnormalities, and everything appears normal. Discussion of Diagnosis and Findings Ms. Jackson, I have completed your head-to-toe assessment, and I would like to discuss my observations. Your symptoms of anxiety and depression appear to be contributing to your fatigue and may be affecting your focus, eating habits, and sleeping patterns. According to the Centers for Disease Control and Prevention (CDC, 2023), mental health conditions such as depression and anxiety can lead to poor sleep, restlessness, and frustration. Your vital signs show mild fluctuations, which may be linked to emotional distress. Additionally, I observed muscle tension, which is commonly associated with anxiety or chronic stress. You mentioned experiencing low moods, difficulty with motivation, and feeling overwhelmed, which align with symptoms of major depressive disorder (CDC, 2023). Furthermore, you expressed experiencing excessive worry and restlessness, which may indicate an anxiety component. It is important to recognize that mental health disorders such as depression and anxiety are medical conditions that can be managed effectively, just like hypertension or diabetes. These findings will help us create a treatment plan aimed at improving your overall well-being. Do you have any questions about my findings? It is essential that you feel comfortable and informed about the next steps. Table: Comprehensive Head-to-Toe Assessment Findings Assessment Category Findings Comments Mental Status Oriented to name, date, and location. No cognitive impairment noted; emotional health concerns identified (depression, anxiety). Neurological Pupillary response normal, smooth eye movements, normal reflexes, strong grip, good coordination. No abnormalities detected. Cardiovascular Blood pressure: 145/90 (slightly elevated), clear heart sounds, steady pulse. Stress may be contributing to the elevated blood pressure. Respiratory Lungs clear, normal breath sounds, no wheezing or crackles. Respiratory function appears normal. Abdomen Soft, non-tender, no unusual masses, normal bowel sounds. No abnormalities detected. Musculoskeletal & Skin Joint mobility normal, equal leg strength, skin clear with no rashes or swelling. No significant findings. Understanding of Pharmacological Needs Based on our assessment, Ms. Jackson, your symptoms are consistent with depression and anxiety. If medication is considered as part of your treatment plan, I want to ensure you understand your options. Selective serotonin reuptake inhibitors (SSRIs), such as sertraline and fluoxetine, are commonly prescribed for these conditions (Chu & Wadhwa, 2023). These medications help balance brain chemicals responsible for mood regulation. Another option is serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine, which are effective for both depression and anxiety. However, we must be mindful of your history of high blood pressure, as SNRIs can sometimes raise blood pressure (Calvi et al., 2021). These medications typically take several weeks to