Capella 4025 Assessment 2

Capella 4025 Assessment 2

Student Name

Capella University

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Applying an EBP Model

Chronic Obstructive Pulmonary Disease (COPD) remains a significant global health burden characterized by restricted airflow and progressive respiratory decline. According to the World Health Organization (WHO, 2024), COPD is a major contributor to mortality worldwide. This evidence-based practice (EBP) project emphasizes the role of nurses in providing personalized education to improve self-management among patients with COPD. The initiative is designed to reduce hospital readmissions caused by disease exacerbations by improving clinical decision-making and enhancing patient compliance. Through individualized education, nurses support the adoption of healthy behaviors, early symptom recognition, and proper inhaler usage. Moreover, consistent healthcare provider engagement fosters community awareness and mitigates readmissions by enhancing disease understanding.

Issue Associated with the Diagnosis

COPD is a leading cause of death globally, with approximately 3.6 million deaths reported in 2021, representing 5% of all global fatalities (WHO, 2024). Within the United States, the disease is ranked among the top ten causes of death, with around 16 million individuals formally diagnosed, though the actual number is likely higher due to underdiagnosis (CDC, 2024). Studies support nurse-led education as a key component in COPD care. ALHarbi et al. (2022) investigated the impact of a staff-directed education program among 60 patients with mild to moderate COPD. The findings revealed that participants in the intervention group experienced notable improvements in symptom monitoring, medication adherence, and lifestyle behaviors. Similarly, Zhang et al. (2023) evaluated a nurse-administered pulmonary rehabilitation program among 74 rural COPD patients. Over 13 weeks, the intervention group demonstrated significant gains in both the St. George’s Respiratory Questionnaire (SGRQ) scores and six-minute walk distance (6MWD), whereas the control group exhibited a decline. This approach, which included at-home education, guided exercises, and ongoing monitoring, effectively enhanced clinical outcomes and quality of life.

EBP Model and Its Steps

The Iowa Model of Evidence-Based Practice (EBP) provides a structured framework for clinical improvement, particularly in managing recurring COPD exacerbations (Dusin et al., 2023). The process initiates with the identification of a problem—in this case, the frequent flare-ups in COPD patients. Once established as a clinical priority, an interdisciplinary team is formed to explore viable interventions. This team critically appraises relevant research focused on nurse-led strategies. An intervention comprising educational sessions and home-based follow-ups is implemented, with outcomes measured by hospital readmission rates, medication adherence, and patient satisfaction. When proven effective, the protocol becomes part of routine care, with ongoing monitoring to ensure sustainable improvements. The model’s structured approach supports the integration of nurse-led education into standard COPD management, thereby driving continual quality improvement.

Following the assessment of clinical records and patient trends, it became evident that repeated hospitalizations were often linked to poor inhaler technique, limited health literacy, and ineffective self-care. A multidisciplinary team—including nurse practitioners, respiratory therapists, and educators—was assembled to identify EBP interventions targeting these gaps. The main objective was to enhance COPD care through structured, nurse-led education. Hu et al. (2022) demonstrated the efficacy of using the Knowledge, Attitude, and Practice (KAP) framework in improving nursing satisfaction, patient knowledge, compliance, and lung function among older adults. A pilot implementation of the intervention was launched, with outcome metrics such as hospitalizations and inhaler technique proficiency tracked over time. Based on positive clinical outcomes, the model was adopted into practice and supported by ongoing training and evaluation.

Application of the Model to Evidence Search

To assess the effectiveness of nurse-led interventions in minimizing COPD exacerbations, the Iowa Model was employed to guide evidence appraisal. This model promotes systematic decision-making and supports structured interventions that enhance symptom control and patient self-care. The identification of frequent flare-ups prompted a focused evidence search. Root causes included improper inhaler use, low health literacy, and inadequate follow-up. In response, a multidisciplinary team developed a PICOT question: In adults with severe COPD (P), how does a nurse-led education (I), compared to standard discharge education (C), influence hospital readmissions due to exacerbations (O) over 6 months (T)? (Howe, 2024). This question refined the literature search and aligned interventions with clinical needs.

Databases such as PubMed, CINAHL, and the Cochrane Library were used to gather evidence. Key search terms included “COPD,” “nurse-led interventions,” “patient education,” “inhaler training,” and “exacerbations.” The review yielded several high-quality, peer-reviewed studies supporting nursing interventions. A major challenge encountered during the search was ensuring the studies met strict quality criteria and were applicable to COPD patients with chronic symptoms. Despite these obstacles, the systematic approach ensured the identification of effective, evidence-based strategies for managing COPD through nursing education.

Credibility and Relevance of Resources

Three prominent studies were examined to validate the credibility and relevance of nurse-led interventions in COPD care. The study by ALHarbi et al. (2022) assessed a blended educational approach led by nurses and found significant improvements in self-management behaviors such as medication adherence and symptom tracking. Another study conducted by Rassouli et al. (2021) evaluated the impact of telehealth in COPD care, showing a 50% improvement in COPD assessment test (CAT) scores in the telehealth group versus standard care. This intervention also improved patient satisfaction and disease management, underscoring telehealth’s role in supporting remote COPD care. Finally, Wang et al. (2024) examined a sample of over 9000 COPD patients and found that nurse-led clinics were associated with a 16% decrease in mortality and reduced emergency visits. These results affirm the benefits of involving non-physician clinicians in patient education and monitoring. Each study was evaluated using the CRAAP test (Currency, Relevance, Authority, Accuracy, and Purpose), ensuring the inclusion of valid and up-to-date evidence applicable to nursing practice in COPD management.

Table: Summary of Key Studies Supporting Nurse-Led Interventions in COPD Care

Study	Intervention Type	Key Findings	Evaluation Tool
ALHarbi et al. (2022)	Blended Nurse-Led Education	Improved self-management scores and adherence in 60 patients with COPD	CRAAP
Rassouli et al. (2021)	Telehealth Support	50% increase in CAT scores; enhanced patient satisfaction; early diagnosis	CRAAP
Wang et al. (2024)	Nurse-Led COPD Clinics	16% lower mortality; 8% fewer emergency visits; improved clinical outcomes	CRAAP

Conclusion

Implementing the Iowa Model of EBP to guide nurse-led educational strategies for COPD patients underscores the critical value of structured, patient-centered care. The process ensures that clinical interventions are rooted in current research and tailored to individual patient needs. The model facilitates interdisciplinary collaboration, supports continuous outcome monitoring, and aligns with organizational care objectives. This EBP initiative illustrates how evidence-based strategies, when systematically applied, can significantly improve COPD management and enhance the overall quality of patient care.

References

ALHarbi, E. R., Wazqar, D. Y., & Sofar, S. M. (2022). A quasi-experimental study of the effect of a comprehensive blended health educational program on self-management practices among patients with chronic obstructive pulmonary disease. Heart & Lung, 56, 133–141. https://doi.org/10.1016/j.hrtlng.2022.07.005

CDC. (2024, June 12). COPD. Chronic Disease Indicators. https://www.cdc.gov/cdi/indicator-definitions/chronic-obstructive-pulmonary-disease.html

Dusin, J., Melanson, A., & Lawson, L. (2023). Evidence-based practice models and frameworks in the healthcare setting: A scoping review. British Medical Journal Open, 13(5). https://doi.org/10.1136/bmjopen-2022-071188

Capella 4025 Assessment 2

Howe, R. (2024). LibGuides: Respiratory Care: Evidence-Based Practice: PICO. Libguides.uthscsa.edu. https://libguides.uthscsa.edu/c.php?g=625986&p=4364976

Hu, W., Li, T., Cao, S., Gu, Y., & Chen, L. (2022). Influence of nurse-led health education on self-management ability, satisfaction, and compliance of elderly patients with chronic obstructive pulmonary disease based on knowledge, belief, and practice model. Computational and Mathematical Methods in Medicine, 2022(1), e1782955. https://doi.org/10.1155/2022/1782955

Rassouli, F., Germann, A., Baty, F., Kohler, M., Stolz, D., Thurnheer, R., Brack, T., Kähler, C., Widmer, S., Tschirren, U., Sievi, N. A., Tamm, M., & Brutsche, M. H. (2021). Telehealth mitigates COPD disease progression compared to standard of care: A randomized controlled crossover trial. Journal of Internal Medicine, 289(3), 404–410. https://doi.org/10.1111/joim.13230

Wang, K., Zhao, S., Yau, S. Z.-M., Wei, Y., Li, Y.-C., Orr, R. W.-C., Lam, I. H.-L., Wu, Y., Wong, E. L.-Y., Hung, C.-T., & Yeoh, E.-K. (2024). Outcomes and hospital service use among patients with COPD in a nurse- and allied health–led clinic. JAMA Health Forum, 5(7), e241575. https://doi.org/10.1001/jamahealthforum.2024.1575

WHO. (2024, November 6). Chronic Obstructive Pulmonary Disease (COPD). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(COPD)

Capella 4025 Assessment 2

Zhang, M., Mao, X., Li, F., & Xianyu. (2023). The effects of nurse‐led family pulmonary rehabilitation intervention on quality of life and exercise capacity in rural patients with COPD. Nursing Open, 10(8), 5606–5615. https://doi.org/10.1002/nop2.1804