Category: NURS-FPX9902

NURS FPX 9902 Assessment 5 Reflection Name Capella university NURS-FPX 9902 Nursing Doctoral Project 2 Prof. Name Date Reflecting on Doctoral Progress: Enhancing Literature Synthesis and Collaboration in COPD Research Reflection is an integral aspect of academic growth, especially in the context of a doctoral project. As I approach the final stages of my program, it is crucial to evaluate both my research progress and the lessons learned along the way. This reflective process not only allows me to assess my achievements but also helps me identify areas for further development, ensuring continuous improvement in my research project and my personal growth as a scholar. The Importance of Reflection in Research Reflection is vital for assessing progress and addressing challenges in research. By regularly reviewing accomplishments, researchers can recognize successes, tackle challenges, and plan for the next steps in a project. Virtual check-ins, in particular, foster deep engagement with the work, enhancing critical thinking and aiding in making informed decisions regarding the direction of the research. Enhancing Literature Synthesis in COPD Research A primary focus of my doctoral research is the literature synthesis related to interventions for Chronic Obstructive Pulmonary Disease (COPD). Crafting a comprehensive literature review is essential to guide the project. A detailed search strategy, using relevant keywords and MeSH terms, was employed to ensure the inclusion of a wide range of scholarly sources. Combining manual and database searches allowed me to gather research studies, systematic reviews, and clinical reports for a comprehensive collection of evidence. The inclusion and exclusion criteria were instrumental in refining the article selection process, with the final selection of 33 articles reflecting diverse study designs and meeting eligibility standards (Costa et al., 2021). This process highlighted the importance of thoroughness in literature synthesis, which strengthened the quality of evidence for my research question. Overcoming Challenges in Literature Review Despite the successes in the literature synthesis process, challenges emerged, particularly regarding small sample sizes and methodological concerns in some studies. These challenges, however, provided opportunities to enhance my critical appraisal skills. By identifying the limitations in the evidence, I was able to refine my approach to data analysis and interpretation, ensuring a more nuanced understanding of the findings. Synthesizing a large volume of information required careful organization to maintain clarity in the review. Moving forward, I plan to further develop my skills in evaluating the quality and strength of evidence, expanding the scope to include gray literature and non-English sources for a broader perspective (Messerschmidt et al., 2022). The Role of Literature Review in Practice Decisions The literature review not only supports the research project but also informs clinical practice decisions. A thorough review of existing evidence provides healthcare professionals with the necessary knowledge to make informed decisions about interventions. Studies on COPD, for example, emphasize the effectiveness of telehealth and nutritional interventions in improving lung function and reducing readmissions (Jiang et al., 2023). These insights are critical for guiding clinical decisions, ensuring that patient care aligns with the latest evidence. By synthesizing findings from the literature, I have been able to make informed decisions for my project, selecting appropriate interventions and identifying key themes within the research. This ensures the project remains relevant and provides insight into the potential impact of interventions on patient outcomes. The Value of Collaboration in Research Collaboration has been an essential element of my doctoral journey. Working closely with fellow researchers, healthcare professionals, and other stakeholders has enriched my understanding of the research topic. Regular discussions and feedback have allowed me to refine my research question, improve literature search strategies, and address potential methodological concerns. Diverse perspectives have sparked creativity, significantly enhancing the quality of the project. Collaboration has also provided opportunities for professional growth, allowing me to gain practical insights from experienced professionals to navigate challenges and refine my approach. The supportive environment at my project site has played a crucial role in advancing the project and addressing key research questions. Improving Collaborative Practices for Greater Impact Despite the successes, there is always room for improvement in collaboration. One area to focus on is interdisciplinary collaboration, which can offer broader perspectives, especially in projects that span multiple areas of expertise. Additionally, improving communication within the team could streamline information sharing and coordination, leading to increased productivity (Gallagher & Savage, 2020). Addressing Preconceptions and Biases in Research As researchers, we must be aware of our preconceptions, biases, and assumptions, as they can significantly influence the research process. Personal experiences, cultural influences, and societal norms can affect how data is interpreted and how research questions are approached. While these factors may offer valuable starting points, they can also limit the scope of inquiry. By challenging these biases and actively seeking diverse viewpoints, I can ensure that my research remains objective and inclusive. This practice fosters a more comprehensive and balanced approach to data analysis and decision-making (Hernández-Sellés et al., 2019). Leveraging Scholarly and Authoritative Sources for Credibility Using scholarly and authoritative sources is crucial for ensuring the credibility of research findings. In COPD management, studies on telehealth and nutritional interventions have shown significant improvements in patient outcomes. For instance, a systematic review by Fan and Zhao (2021) demonstrated the positive effects of telehealth in COPD management, while research by Niranjan et al. (2022) highlighted the benefits of nutritional interventions in improving lung function. Clinical guidelines, such as those from the Global Initiative for Chronic Obstructive Lung Disease (GOLD), also support the integration of these interventions into comprehensive COPD care (Vila et al., 2023). Citing reputable sources strengthens the validity of the research and ensures that findings are grounded in the most reliable and current evidence. Evaluating Source Relevance for Informed Decision-Making To ensure the relevance and quality of sources, it is essential to evaluate their credibility through tools like the CRAAP and RADAR tests. These tests assess the currency, relevance, authority, accuracy, and purpose of a source, ensuring that only the most reliable information is included in the literature review (Sye & Thompson, 2023). Applying these tools guarantees

NURS FPX 9902 Assessment 4 Name Capella university NURS-FPX 9902 Nursing Doctoral Project 2 Prof. Name Date

NURS FPX 9902 Assessment 3 Literature Synthesis Name Capella university NURS-FPX 9902 Nursing Doctoral Project 2 Prof. Name Date Comprehensive Literature Synthesis: Strategies and Insights This literature synthesis outlines the doctoral student’s approach to searching and analyzing relevant sources, focusing on their connection to a defined research question. It compares and contrasts different research methodologies and their findings, presenting a clear and structured overview of the literature review process. Search Strategy A well-developed literature search strategy is vital for supporting improvements in patient care, particularly in the context of a doctoral project. The search process began with the identification of a patient-related issue, followed by the formulation of a PICOT question and obtaining approvals from both the project site and Capella’s Institutional Review Board (IRB). The research question posed was: For caregivers of patients with chronic obstructive pulmonary disease (COPD), how does the implementation of COPD disease education using the teach-back method, compared to current practices, affect 30-day medication adherence and hospital readmission over 10 weeks? Databases and Search Terms The search involved four databases accessible through Capella’s library: the Cumulative Index of Nursing and Allied Health (CINAHL), Nursing and Allied Health, PubMed, and Capella Library. The search terms included keywords such as “COPD readmission” and “teach-back method.” Peer-reviewed articles published in the last five years were prioritized. After filtering and cross-referencing, 15 articles were selected based on the inclusion criteria. Table 1: Literature Search Strategy Overview Database Search Term Initial Results Filtered Results Selected Articles CINAHL COPD readmission 355 64 5 Nursing and Allied Health COPD readmission 1,228 1,194 3 PubMed Teach-back method 58,327 8 8 Capella Library General search 4,128 1,298 5 Key highlights of the search process: CINAHL: The initial search returned 355 articles, which were filtered down to 64, with 5 being directly relevant to COPD readmission strategies. Nursing and Allied Health: Over 1,200 articles were found, and 3 articles were selected to support evidence-based quality improvement. PubMed: Focusing on the teach-back method, 8 articles were identified to support patient education and discharge strategies. Capella Library: The search provided 5 articles reinforcing the PICOT question. Manual reference searches and guideline explorations also contributed additional high-quality resources. Evidence and Study Types Each article was reviewed and classified according to the CASP guidelines, ensuring high-quality evidence. The included studies covered a wide range of research methodologies, summarized in the following table. Table 2: Types of Studies Included Study Type Count Randomized Control Trials 3 Systematic Reviews 6 Retrospective Studies 3 Meta-Analyses 2 Quality Improvement Projects 2 Mixed-Method Studies 1 Qualitative Descriptive Studies 1 Cross-Sectional Studies 1 Logistic Regression Models 1 Cohort Studies 1 Synthesis of Literature Reducing Readmissions COPD is a progressive disease that requires focused interventions to reduce exacerbations and hospital readmissions, which impose a significant burden on both patients and healthcare systems. The Centers for Medicare and Medicaid Services (CMS) introduced the Hospital Readmission Reduction Program (HRRP), which incentivizes hospitals to reduce readmission rates (CMS, n.d.). Key findings related to readmission reduction include: Educational Initiatives: Programs like the NHLBI’s Learn More Breathe Better provide healthcare providers with tools for patient education at discharge (NHLBI, n.d.). Action Plans: Randomized trials have shown that discharge plans, coupled with home health support, can reduce readmissions, though limitations in sample size exist (Hegelund et al., 2019). Economic Impact: Chronic diseases, including COPD, contribute to 41% of healthcare spending, prompting hospitals to adopt cost-effective strategies (Zafar, 2019). Innovative Approaches: Structured telephonic consultations and predictive modeling have shown promise in reducing COPD readmissions (Sutton & Phelps, 2021; Zhong et al., 2019). The combination of continuous monitoring and self-care education holds potential to improve patient outcomes. Self-Care and Patient Education Effective patient education is essential in COPD management, particularly in overcoming socioeconomic and health literacy barriers. Smoking cessation and preventive measures are central to managing COPD (Hu et al., 2022). Clinical guidelines emphasize personalized care plans to reduce the risk of exacerbations (Stevermer et al., 2021). Notable recommendations for enhancing COPD care include: Risk Factor Screening: Identifying factors such as comorbidities and smoking status is crucial (Pahus et al., 2019). Teach-Back Method: This method ensures that patients understand their care plans, leading to improved adherence and health literacy (Allegrante et al., 2019). Teach-Back Method Implementation The teach-back method encourages patients to repeat their understanding of medical information, thereby improving communication and engagement. A systematic review demonstrated that this approach is effective in reducing readmissions and enhancing medication adherence (Hegelund et al., 2019). Benefits of implementing the teach-back method include: Enhanced Communication: Patients feel more empowered to manage their disease effectively (Santos et al., 2020). Quality Improvement: Integrating the teach-back method into chronic disease care leads to measurable improvements in patient outcomes. Conclusion This comprehensive synthesis underscores the importance of adopting evidence-based strategies in chronic disease management. Prioritizing patient education, self-care, and the teach-back method can significantly enhance COPD management, reduce readmissions, and improve overall patient outcomes. As healthcare continues to evolve, patient-centered approaches remain essential. References Allegrante, J. P., Barlow, J., & Kaplan, G. (2019). Patient activation and adherence in chronic disease management: A systematic review. Patient Education and Counseling, 102(8), 1384-1390. Buhr, G. T., Bartholomew, A. A., & Jacobs, J. (2020). Impact of the Hospital Readmission Reduction Program on COPD readmission rates. Journal of Healthcare Management, 65(5), 325-332. CMS. (n.d.). Hospital Readmission Reduction Program. Retrieved from CMS website. Hegelund, A., Damsgaard, M. T., & Moller, D. (2019). Patient activation and adherence in chronic disease management: A systematic review. BMC Health Services Research, 19(1), 400. Hu, D., Liu, X., & Qian, J. (2022). Environmental and socioeconomic factors influencing the risk of COPD in patients. International Journal of Chronic Obstructive Pulmonary Disease, 17, 1225-1234. NURS FPX 9902 Assessment 3 Literature Synthesis NHLBI. (n.d.-a). Learn More Breathe Better campaign. Retrieved from NHLBI website. Pahus, D., Tjalma, R., & Pedersen, S. H. (2019). Screening for risk factors in COPD patients: A cross-sectional study. Respiratory Medicine, 153, 1-8. Santos, R., Tomaz, L., & Souza, E. (2020). Impact of the teach-back method on medication adherence in patients with chronic diseases. International Journal of Nursing Studies,

NURS FPX 9902 Assessment 2 Literature Search Name Capella university NURS-FPX 9902 Nursing Doctoral Project 2 Prof. Name Date Literature Search The literature search for this project aimed to assess the effectiveness of individualized cognitive behavioral therapy (CBT) and motivational interviewing for patients with opioid addiction. A systematic and strategic approach was adopted, utilizing several scholarly databases, including PubMed, CINAHL, PsycINFO, and the Cochrane Library. These databases were selected for their reliability in offering high-quality research in the healthcare and psychology domains. The search was guided by keywords and phrases relevant to the PICOT question, such as opioid addiction, cognitive behavioral therapy, motivational interviewing, client-centered treatment, and readmission rates. Boolean operators such as “AND” and “OR” were employed to combine search terms, while filters for peer-reviewed articles and recent publications were used to refine results (Hah et al., 2020). This strategy aimed to locate the most pertinent studies that assess the impact of these interventions on reducing readmission rates in patients with opioid addiction. Literature Search Strategy To identify relevant studies, a combination of strategies was employed. Key terms, including Medical Subject Headings (MeSH), such as Opioid-Related Disorders, Cognitive Behavioral Therapy, and Motivational Interviewing, were used to enhance search specificity. Additionally, reviewing reference lists of identified studies helped uncover supplementary resources. This comprehensive approach ensured that studies published in the last five years were included. Inclusion criteria focused on research involving adult patients with substance use disorders who received individualized CBT and motivational interviewing, with readmission rates as an outcome. Studies not in English, those involving children, and research with insufficient methodological rigor were excluded. Furthermore, gray literature, including government reports and dissertations, was considered when peer-reviewed sources were scarce (DeBar et al., 2021). Ultimately, 20 to 30 high-quality sources were selected for in-depth analysis to maintain a robust and up-to-date evidence base. Analysis of Evidence An analysis of the 20 selected peer-reviewed articles provided valuable insights into the effectiveness of CBT and motivational interviewing in treating opioid addiction. The studies employed various methodologies, including randomized controlled trials and systematic reviews, to evaluate outcomes such as reduced readmission rates and improved mental health. Key findings revealed that both CBT and motivational interviewing were effective in managing opioid addiction and co-occurring psychiatric conditions such as anxiety and depression (Buckner et al., 2023; McHugh et al., 2024). Despite these promising outcomes, gaps remained in understanding the long-term effects of these interventions, as well as their effectiveness across diverse demographic groups. Furthermore, research emphasized the need to consider cost-effectiveness and the delivery modality of these therapies in different healthcare settings (MacLean et al., 2024; Olmstead et al., 2020). Literature Search and Analysis Table Section Details Literature Search Databases: PubMed, CINAHL, PsycINFO, Cochrane Library. Search terms: Opioid addiction, CBT, motivational interviewing, readmission rates. Boolean operators (AND/OR) and filters for publication date and peer-reviewed articles. Inclusion Criteria Studies on adult patients with substance use disorders, focusing on CBT and motivational interviewing interventions. Outcomes: Reduced readmission rates. Exclusion Criteria Non-English studies, research on children, and articles with poor methodological quality. Sources and Analysis Peer-reviewed studies, systematic reviews, gray literature (government reports, dissertations). 20 peer-reviewed articles analyzed for relevance and methodological rigor. Identified gaps in long-term treatment outcomes and demographic-specific findings. References Amin, M., Reza Davasaz Irani, F., Fattahi, P., & Pakseresht, S. (2023). Effects of brief cognitive behavioral therapy on mental health in substance-related disorder: A randomized controlled trial. BMC Psychiatry, 23(1). https://doi.org/10.1186/s12888-023-05413-4 Bertholet, N., Meli, S., Palfai, T. P., Cheng, D. M., Alford, D. P., Bernstein, J., Samet, J. H., Lloyd-Travaglini, C., & Saitz, R. (2020). Screening and brief intervention for lower-risk drug use in primary care: A pilot randomized trial. Drug and Alcohol Dependence, 213, 108001. https://doi.org/10.1016/j.drugalcdep.2020.108001 NURS FPX 9902 Assessment 2 Literature Search Borsari, B., Li, Y., Tighe, J., Manuel, J. K., Gökbayrak, N. S., Delucchi, K., Morasco, B. J., Abadjian, L., Cohen, B. E., Baxley, C., & Seal, K. H. (2021). A pilot trial of collaborative care with motivational interviewing to reduce opioid risk and improve chronic pain management. Addiction, 116(9). https://doi.org/10.1111/add.15401 Buckner, J. D., Scherzer, C. R., Crapanzano, K. A., & Morris, P. E. (2023). Group cognitive behavioral therapy for substance use disorders among psychiatric inpatients in a medically underserved area: An intervention for opioid misuse. Public Health Reports, 138(1_suppl), 90S–95S. https://doi.org/10.1177/00333549231170219 Buckner, J. D., Walukevich-Dienst, K., Crapanzano, K. A., Tucker, R. P., & Tynes, L. L. (2021). Brief motivational interviewing–based interventions for opioid misuse in hospital settings. Translational Issues in Psychological Science, 7(2), 114–129. https://doi.org/10.1037/tps0000280 DeBar, L., Mayhew, M., Benes, L., Bonifay, A., Deyo, R. A., Elder, C. R., Keefe, F. J., Leo, M. C., McMullen, C., Owen-Smith, A., Smith, D. H., Trinacty, C. M., & Vollmer, W. M. (2021). A primary care–based cognitive behavioral therapy intervention for long-term opioid users with chronic pain. Annals of Internal Medicine, 175(1). https://doi.org/10.7326/m21-1436 NURS FPX 9902 Assessment 2 Literature Search Hah, J. M., Trafton, J. A., Narasimhan, B., Krishnamurthy, P., Hilmoe, H., Sharifzadeh, Y., Huddleston, J. I., Amanatullah, D., Maloney, W. J., Goodman, S., Carroll, I., & Mackey, S. C. (2020). Efficacy of motivational-interviewing and guided opioid tapering support for patients undergoing orthopedic surgery (MI-Opioid Taper): A prospective, assessor-blind, randomized controlled pilot trial. EClinicalMedicine, 28. https://doi.org/10.1016/j.eclinm.2020.100596

NURS FPX 9902 Assessment 1 Name Capella university NURS-FPX 9902 Nursing Doctoral Project 2 Prof. Name Date