Capella FPX 4025 Assessment 2

Name

Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Applying an EBP Model

Chronic Obstructive Pulmonary Disease (COPD) is a chronic respiratory condition characterized by airflow limitation. According to the World Health Organization (WHO, 2024), COPD continues to rank among the foremost causes of global mortality. This evidence-based practice (EBP) initiative centers on the clinical application of nurse-led education strategies aimed at enhancing self-management skills among individuals with COPD. These tailored interventions are intended to minimize hospital readmissions caused by disease exacerbations. By educating patients on proper inhaler usage, early symptom recognition, and pulmonary rehabilitation practices, nurses play a key role in promoting healthier lifestyles and supporting long-term disease control. Collaborative healthcare support further enhances patient understanding and improves clinical outcomes.

Issue Associated with the Diagnosis

COPD remains a significant contributor to global mortality, accounting for an estimated 3.6 million deaths in 2021, representing about 5% of all worldwide deaths (WHO, 2024). In the United States, COPD is among the top ten causes of death, with over 16 million confirmed diagnoses and potentially more undetected cases (CDC, 2024). Numerous studies advocate for the integration of nurse-led education into COPD care protocols. For instance, AlHarbi et al. (2022) explored a nurse-guided intervention for 60 patients with mild-to-moderate COPD, revealing marked improvement in symptom tracking, medication compliance, and lifestyle adjustments after a three-month period. Similarly, Zhang et al. (2023) assessed a home-based pulmonary rehabilitation program implemented by nurses for 74 rural COPD patients. The intervention group demonstrated significant progress in both the St. George’s Respiratory Questionnaire (SGRQ) scores and six-minute walk distance compared to the control group. These findings support the effectiveness of nurse-led strategies in enhancing COPD self-management and clinical stability.

EBP Model and Its Steps

The Iowa Model of Evidence-Based Practice offers a systematic framework for improving healthcare outcomes and is well-suited for managing frequent COPD exacerbations (Dusin et al., 2023). The model initiates with identifying a clinical issue—frequent COPD flare-ups—recognized as a priority for intervention. A multidisciplinary team, including nurses, respiratory therapists, and educators, is then assembled to assess relevant evidence. Interventions are proposed, such as nurse-led patient education sessions and structured home follow-ups. These are tested for effectiveness using metrics like readmission rates, adherence to treatment, and patient satisfaction. Upon successful outcomes, the intervention becomes part of the standard care protocol, with continuous evaluation ensuring ongoing quality improvement. The model not only enables tailored care but also fosters team collaboration and alignment with clinical goals.

A key discovery involved associating repeated COPD exacerbations with inadequate disease management, poor inhaler use, and limited health literacy. Hu et al. (2022) implemented the Knowledge, Attitude, and Practice (KAP) model in their nurse-led teaching program for elderly COPD patients. The program enhanced patient knowledge, satisfaction, and compliance, while improving pulmonary function, thus demonstrating the benefit of structured education. Pilot implementations measured improvements in hospital admissions and inhaler proficiency. The Iowa Model effectively structured this implementation process, enabling targeted intervention, teamwork, and measurable outcomes.

Application of the Model to Evidence Search

The Iowa Model was utilized to evaluate the efficacy of staff-directed interventions in reducing exacerbations among COPD patients with poor disease control. The issue-triggered approach identified root causes such as improper inhaler use and inadequate follow-up. These observations formed the basis for developing a structured nurse-led education plan. A clear PICOT question was developed to guide the evidence search: In adults with severe COPD (P), how does nurse-led education (I), compared to standard discharge education (C), influence hospital readmission rates due to exacerbations (O) over a six-month period (T)? (Howe, 2024).

A comprehensive literature search was conducted using databases like PubMed, CINAHL, and the Cochrane Library. Search terms included “COPD,” “nurse-led interventions,” “inhaler technique,” and “patient education.” The rigorous search yielded peer-reviewed articles and clinical trials that informed the intervention design. Challenges during this process included setting quality appraisal standards and ensuring applicability to a diverse COPD population.

Credibility and Relevance of Resources

The following table summarizes three peer-reviewed studies that underscore the value of nurse-led interventions in COPD management:

Study	Findings	Credibility Assessment
AlHarbi et al. (2022)	Demonstrated improved self-management behaviors in patients receiving a comprehensive educational intervention over 3 months.	Peer-reviewed journal (Heart & Lung); passed CRAAP criteria.
Rassouli et al. (2021)	Found that telecare interventions improved COPD Assessment Test scores and satisfaction, albeit with increased detection of moderate exacerbations.	Published in Journal of Internal Medicine; peer-reviewed with statistically significant results.
Wang et al. (2024)	Showed a 16% reduction in mortality and reduced emergency care utilization among patients managed in nurse-led clinics.	Published in JAMA Health Forum; demonstrated clear clinical benefits using a large sample size.

These studies reinforce the impact of non-physician-led care in enhancing patient adherence, self-care, and satisfaction. All resources were carefully selected using the CRAAP test to ensure relevance, timeliness, and reliability for clinical practice application.

Conclusion

Utilizing the Iowa Model of EBP in developing nurse-led COPD education strategies demonstrates the effectiveness of structured care in improving patient outcomes. Through integrating current clinical evidence with collaborative care approaches, this EBP initiative enhances symptom control, reduces hospital readmissions, and supports sustained patient engagement. The model’s structured approach ensures that care interventions are not only evidence-based but also tailored to meet individual patient needs, setting a strong foundation for continued improvements in COPD management.

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

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

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

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

Capella FPX 4025 Assessment 2

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

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

Capella FPX 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