Capella FPX 4025 Assessment 4

Name

Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Presenting Your PICO(T) Process Findings to Your Professional Peers

Hello, everyone. The name ____ introduces me as I present a research-supported design to enhance treatment results for COPD patients who face protection from both exacerbations and hospital admissions. This presentation is derived from my findings produced during Assessment 3, where I examined a PICO(T) inquiry about structured pulmonary rehabilitation treatment to reduce COPD-related hospitalizations relative to traditional care for six months.

Diagnosis: Associated Outcomes, Potential Risks, and Common Complications

COPD stands as a long-term lung condition that causes continual airway blockage from harmful substances, including smoking tobacco products and occupational exposures. The disease contains two main conditions: chronic bronchitis and emphysema, which decrease lung function while increasing breathlessness, and both reduce exercise ability and produce frequent acute attacks. Hospitals become necessary for these patients whose disease condition worsens because it creates higher hospitalization risks and reduces their overall well-being, leading to poorer health outcomes among individuals with moderate to severe COPD stages. Poor COPD management, together with delayed treatment of exacerbations, triggers various severe consequences that cannot be reversed.

The multiple occurrences of exacerbations in COPD patients lead to decreased lung functioning while causing permanent respiratory failure and growing risks of pulmonary hypertension alongside cardiac complications. Hospital visits because of COPD lead to higher healthcare expenses, while patients stay in hospital treatment longer and face greater chances of needing rehospitalization (Navarro et al., 2023). Provisional groups, including senior citizens, poor residents, and individuals from particular racial backgrounds, experience increased vulnerability because of their restricted healthcare opportunities. Initiating pulmonary rehabilitation at suitable times remains essential because it decreases COPD exacerbations, delivers better patient results, and minimizes lasting complications (Echávez et al., 2023).

Developing the Evidence-Based Research Question

The PICO(T) framework was applied to develop a focused research question addressing the management of COPD and its frequent exacerbations. The components are as follows:

P (Population): Adults diagnosed with moderate to severe COPD.

I (Intervention): Participation in a structured Pulmonary Rehabilitation (PR) program.

C (Comparison): Standard care without pulmonary rehabilitation.

O (Outcome): Reduction in the frequency of acute exacerbations and hospitalizations.

T (Time): Over a six-month period.

Research Question: In adults with COPD, does participation in a structured pulmonary rehabilitation program, compared to standard care without rehabilitation, reduce the frequency of acute exacerbations and hospitalizations over six months?

Overview of Supporting Evidence

The project analyzed COPD outcomes affected by PR through multiple peer-reviewed research. According to Navarro et al. (2023) study, Patients in a PR program experienced 39.8% fewer hospital admissions, 42.4% shorter stays, and 41% fewer emergency department visits, confirming PR’s clinical effectiveness and economic value. Scientific reviews performed by Echávez et al. (2023) state that 18 RCTs showed that PR enhances cardiovascular performance and decreases hospital admissions after COPD acute episodes. Feld (2024) found that PR initiation within three weeks after hospital discharge correlated to lower rates of readmission by half, along with decreased need for nursing home placements, even though PR is utilized infrequently in actual practice settings.

The research conducted by Sami et al. (2021) validated these findings about PR. However, it recognized implementation challenges due to access barriers and inadequate usage rates. The evaluation of every article employed the CRAAP methodology to establish its timely information and relevant scientific backing. Studies show that Pneumococcal conjugate vaccination should be considered a dependable treatment method for COPD, provided its administration is shortly after a patient experiences an acute exacerbation (Venkitakrishnan et al., 2025).

Response to the PICO(T) Inquiry

Structured PR programs aim to assess their effectiveness for aged adults aged 65 and older in lowering COPD exacerbations and hospital admissions compared to routine treatment, while extending across twelve weeks. Research based on peer-reviewed studies confirmed the positive effects of PR. People who took part in PR programs showed improved health results, together with decreased healthcare service usage. Remedial PR programs showed patients reduced their hospital stay time by 42.4% according to Navarro et al. (2023) while also resulting in 41% fewer emergency department trips and 39.8% fewer hospital admissions compared to standard-care recipients. The research conducted by Echávez et al. (2023) based on 18 randomized controlled trials proves that PR improves cardiovascular functions while decreasing hospital admissions during acute exacerbations.

Hospital patients who received pulmonary rehabilitation treatment between day 14 and day 21 following discharge experienced half the readmission rate and reduced the need for long-term care placement based on Feld’s (2024) findings, although practitioners currently employ PR insufficiently. Sami et al. (2021) supported the healthcare benefits of PR yet confirmed that implementation barriers stem from limited access and disregard for its use. The CRAAP test verifies that each study meets standards for validity to support the obtained results. The collected evidence demonstrates how PR stands as a valid intervention that enhances COPD results alongside protection against complications for elderly patients.

Essential Components of the Care Plan

The reduction of COPD exacerbations, together with hospitalizations, requires an evidence-based structured plan that delivers patient-centered care. The initial step requires admission of qualified seniors into PR programs after hospital release, when enrollment ideally occurs during the first three weeks to take advantage of their maximum motivation and clinical requirements (Feld, 2024). The rehabilitation sessions for elderly patients should include breathing exercises together with supervised aerobic training and strength exercises, as well as respiratory muscle training, because of their limited physical abilities. Telehealth connected with community-based physical rehabilitation services helps patients overcome typical barriers to PR delivery.

Patients with restricted mobility and transportation problems can take part in full PR programs through home-based or mobile delivery services. Community partnerships, together with mobile units, create opportunities for direct service delivery in underserved locations, creating better access to care for all patients (Sami et al., 2021). All medical organizations need interdisciplinary care coordination for effective treatment delivery. Physical rehabilitation in PR must be combined with smoking cessation counseling, together with dietary guidance to manage medications and offer psychosocial assistance. Patient outcomes assessment through regular checks and progress monitoring allows healthcare providers to change treatment approaches while increasing patient participation rates.

The implementation of patient-reported logs, together with follow-up calls and shared decision-making tools, helps enhance both patient motivation and self-efficacy. Healthcare teams should work to achieve broader PR implementation by establishing policy recommendations and conducting staff training programs, as well as awareness campaigns. Healthcare institutions need to establish support systems that overcome existing barriers so PR becomes an ongoing element of COPD care management. Multi-component care strategies, which include rapid PR intervention alongside available distribution networks and complete supportive methodologies, improve COPD maintenance duration and lower healthcare expenditure for elderly patients.

Conclusion

Standard COPD care should adopt structured PR programs that benefit elderly adult patients. Through its implementation, PR demonstrates both clinical benefits, which decrease hospital admissions and ED visits, lower length of stay, and enhance patient outcomes. Healthcare providers should execute patient-based approaches involving prompt post-discharge enrollment alongside interdisciplinary teamwork, telehealth, and community service expansion to reduce barriers to PR use. Through policies leading to educational outreach and systemwide modifications, healthcare providers can expand PR accessibility, which will provide COPD patients with both equal services and enduring advantages.

References

Echávez, M., Guapo, N. C., Betancur, A. F. L., Machado, A., & Bidonde, J. (2023). Pulmonary rehabilitation for acute exacerbations of COPD: A systematic review. Respiratory Medicine, 219, 107425. https://doi.org/10.1016/j.rmed.2023.107425

Feld, J. J. (2024, March). Pulmonary rehabilitation after COPD hospitalization nearly halves readmissions. Pulmonology Advisor. https://www.pulmonologyadvisor.com/news/copd-pulmonary-rehabilitation-nearly-halves-readmissions/

Navarro, M. E. T., Sampedro, F. G., Dobaño, J. M. Á., Santías, F. R., Rábade, C., García, C. R., Baleato, Ó. L., Fidalgo, R. L., Martínez, N. S., Gabaldón, J. R., Mouriño, A. C., París, R. A., Blanco, V. R., Sanz, C. Z., Núñez, N. R., López, A. L., Ferreiro, L., & Cuadrado, L. V. (2023). A pulmonary rehabilitation program reduces hospitalizations in chronic obstructive pulmonary disease patients: A cost-effectiveness study. Annals of Thoracic Medicine, 18(4), 190–198. https://doi.org/10.4103/atm.atm_70_23