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, 107, 103-111.

Stevermer, J. J., Boker, J., & Zink, T. (2021). Managing chronic obstructive pulmonary disease in primary care: Clinical guidelines and patient education. American Family Physician, 103(4), 245-254.

Sutton, L., & Phelps, C. (2021). Telephonic consultations and COPD readmission rates: A quality improvement initiative. Nursing Practice, 54(7), 45-50.

World Health Organization. (2019). Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Retrieved from WHO website.

Zafar, A. (2019). Financial burden of chronic diseases on healthcare systems. Health Affairs, 38(2), 285-293.

NURS FPX 9902 Assessment 3 Literature Synthesis

Zhong, Y., Li, T., & Chen, M. (2019). Predictive modeling for readmissions in COPD patients: An innovative approach. BMC Pulmonary Medicine, 19(1), 54.