Capella 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 widespread respiratory condition marked by persistent airway obstruction. According to the World Health Organization (WHO, 2024), COPD remains one of the leading causes of death globally. This evidence-based practice (EBP) initiative explores how nurse-led educational strategies can support patients in self-managing COPD. Emphasizing personalized instruction, the intervention aims to reduce hospital readmissions caused by exacerbations. Nurses provide critical guidance on lifestyle modifications, proper inhaler usage, early symptom recognition, and pulmonary rehabilitation. These interventions empower patients and increase healthcare professionals’ awareness, fostering improved clinical outcomes and reducing preventable readmissions.-

Issue Associated with the Diagnosis

COPD is a significant global health challenge, contributing to approximately 3.6 million deaths in 2021, accounting for around 5% of worldwide mortality (WHO, 2024). In the United States, COPD ranks among the top ten causes of death, with about 16 million Americans formally diagnosed and many more remaining unidentified (CDC, 2024). Evidence supports the effectiveness of nurse-led education in COPD management. ALHarbi et al. (2022) examined how a nurse-directed care model influenced self-management behaviors in 60 patients with mild-to-moderate COPD. After three months, participants exhibited notable improvements in medication adherence, symptom tracking, and lifestyle choices. Similarly, Zhang et al. (2023) studied 74 rural COPD patients and discovered that those receiving a nurse-led rehabilitation program experienced better health outcomes, as reflected in improved St. George’s Respiratory Questionnaire (SGRQ) scores and increased six-minute walk distances. These interventions included at-home education, exercise coaching, and structured follow-ups, illustrating how evidence-based nursing care improves health outcomes and supports safe, individualized treatment.

EBP Model and Its Steps

The Iowa Model of Evidence-Based Practice offers a systematic framework that is highly applicable to reducing the frequency of COPD exacerbations (Dusin et al., 2023). The process starts with identifying the clinical issue—in this case, repeated hospitalizations in COPD patients. Once the concern is prioritized, an interdisciplinary team is assembled to explore and evaluate possible solutions. The team reviews current literature emphasizing nurse-led strategies, ultimately implementing an educational intervention involving discharge instructions and follow-up care. Key outcomes such as exacerbation frequency, adherence to medications, and patient satisfaction are tracked to determine the intervention’s success. If results are favorable, the protocol is adopted into routine practice. This model ensures continuous improvement through outcome monitoring and fosters knowledge sharing. It provides a foundational structure for integrating nurse-led care to improve COPD management sustainably.

Implementation Using the Iowa Model

A thorough evaluation of clinical data revealed a connection between frequent exacerbations and poor disease self-management, including incorrect inhaler usage and limited health literacy. A team composed of respiratory therapists, nurse practitioners, and clinical educators identified nurse-led education as a viable intervention. Hu et al. (2022) implemented an educational strategy based on the Knowledge, Attitude, and Practice (KAP) model among elderly COPD patients. The results demonstrated improved nursing satisfaction, patient compliance, and pulmonary function. This intervention was first piloted and evaluated based on patient satisfaction, inhaler technique, and hospitalization rates. Positive outcomes led to its integration into standard care, with ongoing staff training and monitoring to ensure sustainability. The Iowa Model effectively guided this process, reinforcing the alignment of interventions with both clinical evidence and patient needs.

Application of the Model to Evidence Search

The Iowa Model was instrumental in evaluating staff-led interventions for COPD patients with poor symptom control and minimal self-management. By utilizing a structured, evidence-based approach, the model facilitated improved symptom recognition, treatment compliance, and engagement in care plans. The trigger for this initiative was derived from recurring hospitalizations linked to low health literacy and poor inhaler technique. These issues underscored the need for structured, nurse-driven education programs. A multidisciplinary team developed a targeted 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)? This format refined the clinical query, enabling precise literature searches and informed decision-making (Howe, 2024).

Searches were conducted in databases such as PubMed, CINAHL, and Cochrane Library, using terms like “COPD,” “nurse-led interventions,” and “inhaler training.” The systematic process yielded high-quality randomized controlled trials and peer-reviewed studies relevant to COPD education. However, challenges included maintaining stringent study selection criteria and ensuring the results were applicable to the broader population of adults with chronic symptoms.

Credibility and Relevance of Resources

Three principal sources affirm the value of nurse-led education in managing COPD. ALHarbi et al. (2022) conducted a quasi-experimental study that found significant improvements in self-care activities like symptom tracking and medication adherence after a blended education program. Rassouli et al. (2021) assessed telehealth’s impact and found it improved COPD Assessment Test (CAT) scores and patient satisfaction. Though more exacerbations were recorded in the telecare group, it likely reflected better monitoring. This study, published in a peer-reviewed, high-impact journal, enhances its credibility. Lastly, Wang et al. (2024) evaluated 9,048 COPD patients and revealed that those treated in nurse-led clinics had a 16% lower mortality rate and reduced emergency service usage. These resources were validated using the CRAAP framework (Currency, Relevance, Authority, Accuracy, Purpose), ensuring their applicability and quality in supporting evidence-based COPD education interventions.

Table: Summary of Key Evidence-Based Sources

Study	Sample & Method	Intervention	Outcomes
ALHarbi et al. (2022)	60 patients, quasi-experimental	Blended education program	Improved self-management, symptom monitoring, and lifestyle behaviors
Rassouli et al. (2021)	Randomized controlled crossover trial	Telehealth intervention	Higher CAT scores, improved satisfaction, better disease management
Wang et al. (2024)	9,048 COPD patients, observational study	Nurse-led clinic care	16% mortality reduction, fewer emergency and inpatient visits
Zhang et al. (2023)	74 rural patients, 13-week program	Home-based rehab + education	Better quality of life and exercise capacity
Hu et al. (2022)	Elderly patients, KAP-based education	Knowledge-Attitude-Practice (KAP) model	Enhanced self-care ability, compliance, and pulmonary function

Conclusion

The structured use of the Iowa Model of EBP to guide staff-led education strategies for COPD patients illustrates how personalized, evidence-based interventions can enhance patient outcomes. Grounded in current research and clinical collaboration, the approach aligns with individualized needs while promoting health literacy and disease self-management. This project serves as a testament to the power of applying clinical evidence through a structured model to drive quality improvements in chronic disease management.

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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

Capella 4025 Assessment 2

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)

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