Phillip March 14, 2024 No Comments

NURS FPX 9902 Assessment 2 Literature Search

NURS FPX 9902 Assessment 2 Literature Search Name Capella university NURS-FPX 9902 Nursing Doctoral Project 2 Prof. Name Date Literature Search Conducting an exhaustive literature search is imperative for the PICOT question, which centers on the influence of nutritional and telehealth interventions on lung functioning and readmission rates in COPD (Chronic Obstructive Pulmonary Disease) patients within a 2 to 3-month timeframe. A thorough literature review allows healthcare professionals and researchers to comprehend existing evidence, identifying knowledge gaps in this domain. By scrutinizing published studies, systematic reviews, and meta-analyses, one can evaluate the efficacy of nutritional and telehealth interventions, their potential advantages, and possible adverse effects. A comprehensive literature search aids in bridging the gap between research and practice, ensuring healthcare interventions are grounded in the best available evidence (Al-Moamary et al., 2021).   Literature Search Strategy A systematic approach was utilized to conduct an extensive literature search for the specified PICOT question. The search strategy incorporated relevant terms and Medical Subject Headings (MeSH) pertaining to COPD, nutritional interventions, telehealth interventions, lung functioning, and readmission. Databases such as PubMed, Embase, CINAHL, and the Cochrane Library were explored, and manual searches were conducted by reviewing reference lists of pertinent articles, systematic reviews, and meta-analyses. Following the initial search, 500 articles were retrieved. The inclusion of articles was determined by assessing the relevance of titles and abstracts to the PICOT question. This screening process narrowed down the included articles to 50, which underwent a full-text assessment for eligibility based on predetermined criteria (Ko et al., 2019). After the full-text assessment, a final selection of 20 articles was made based on their adherence to inclusion criteria. These chosen articles, including randomized controlled trials (RCTs), systematic reviews, and meta-analyses, contributed to a comprehensive analysis of available evidence. Employing this systematic literature search strategy ensured a rigorous approach to identifying relevant studies while minimizing bias. The final selection of 20 articles formed a robust evidence base to effectively address the PICOT question. The literature search strategy employed Boolean operators, combining terms such as “COPD AND nutritional interventions,” “COPD AND telehealth interventions,” “COPD AND lung functioning,” and “COPD AND readmission.” Using AND operators narrowed the search results, while OR operators broadened it. This systematic approach facilitated the retrieval of relevant articles, enabling a comprehensive analysis of the available evidence. This thorough literature review enhances understanding of the efficacy of nutritional and telehealth interventions in improving lung function and reducing readmission rates in COPD patients, guiding future clinical decisions and improving patient outcomes (Burton et al., 2022). Analysis of Evidence Critical appraisal was emphasized as a crucial step in evaluating the value of the 20 studies in clinical practice. Each study underwent meticulous examination to ascertain its evidence level, scrutinize the robustness of its methodology, and evaluate its potential applicability in real-world settings. By employing explicit and relevant criteria, the aim was to identify studies offering valuable insights with the potential to enhance patient outcomes. Subsequent stages of critical appraisal, namely evaluation and synthesis, delved into the collective findings of these studies, determining their overall impact on clinical practice. Through this comprehensive appraisal process, evidence that informed and enriched healthcare decision-making in COPD management was carefully selected and synthesized (Gaveikaite et al., 2019). The analysis of the selected 20 articles encompassed a comprehensive assessment of various aspects. Articles were classified based on their nature, such as peer-reviewed, clinical guidelines, or best practice guidelines, to ascertain the level of evidence they provided. Each article’s aim, hypothesis, or research question underwent meticulous scrutiny to understand the study’s primary focus clearly. The research variables and data analysis techniques employed were thoroughly assessed to evaluate the validity and reliability of the studies. Critical appraisal of the evidence was conducted using appropriate tools, including the Strength of Recommendation Taxonomy (SORT), to assess the quality and strength of the evidence. Notable quotes from the articles were also extracted to highlight key insights and perspectives, enriching the appraisal process (Gaveikaite et al., 2019). Organization of Literature According to the Main Themes The selection of five main themes—Telehealth and Telemedicine in COPD Management, Digital Tools and COPD Management, COPD Self-Management and Rehabilitation, Personalized Medicine and COPD, and Readmission Rates and Healthcare Disparities in COPD—provides a structured approach to organizing the evidence and literature from the 20 selected articles. Categorizing articles into these themes facilitates the identification of commonalities and differences in research questions, methodologies, and findings across studies. Analyzing the evidence based on these themes aids in identifying trends, emerging interventions, and potential areas for future research in COPD management (Janjua et al., 2021). Conclusion Conducting a comprehensive literature search using a well-defined strategy is vital for addressing the PICOT format question focused on the impact of nutritional and telehealth interventions on lung functioning and readmission rates in COPD patients within 2 to 3 months. By employing the suggested search terms, utilizing relevant databases, and conducting hand searches, researchers can ensure a thorough exploration of the available evidence. A comprehensive literature search enables evidence-based decision-making and improves COPD management and patient outcomes. References Al-Moamary, M. S., Köktūrk, N., Idrees, M. M., Şen, E., Juvelekian, G., Saleh, W. A., Zoumot, Z., Behbehani, N., Hatem, A., Masoud, H. H., Snouber, A., & van Zyl-Smit, R. N. (2021). Unmet need in the management of chronic obstructive pulmonary disease in the Middle East and Africa region: An expert panel consensus. Respiratory Medicine, 189. https://doi.org/10.1016/j.rmed.2021.106641 Burton, M., Valet, M., Caty, G., Aboubakar, F., & Reychler, G. (2022). Telerehabilitation physical exercise for patients with lung cancer through the course of their disease: A systematic review. Journal of Telemedicine and Telecare. https://doi.org/10.1177/1357633×221094200 Gaveikaite, V., Grundstrom, C., Winter, S., Chouvarda, I., Maglaveras, N., & Priori, R. (2019). A systematic map and in-depth review of European telehealth interventions efficacy for chronic obstructive pulmonary disease. Respiratory Medicine, 158, 78–88. https://doi.org/10.1016/j.rmed.2019.09.005 Janjua, S., Carter, D., Threapleton, C., Prigmore, S., & Disler, R. (2021). Telehealth interventions: Remote monitoring and consultations for people with chronic obstructive pulmonary disease (COPD). Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd013196.pub2 Ko, F. W. S., Chan, K. P., & Hui, D. S.

Phillip January 29, 2024 No Comments

NURS FPX 9902 Assessment 5 Reflection

NURS FPX 9902 Assessment 5 Reflection Name Capella university NURS-FPX 9902 Nursing Doctoral Project 2 Prof. Name Date Reflection Hello, I am… As I approach the culmination of this course, I take a moment to ponder the advancements in my doctoral project and the experiences garnered throughout the duration. Reflection serves as a potent instrument, enabling the assessment of achievements, confrontations with challenges, and identification of areas for enhancement. It fosters the refinement of critical thinking and problem-solving skills, offering profound insights into the trajectory of the project and personal growth as a researcher. This virtual check-in provides an opportunity to delve into these reflections, facilitating discussions on my progress, gaining clarity on the work, and devising strategies for sustained development. Improvement Opportunities Related to Literature Synthesis Contemplating the construction of a literature synthesis for the PICOT question concentrated on interventions for COPD, I acknowledge the significance of a meticulous and systematic literature search strategy. Executing an exhaustive search using pertinent keywords and MeSH terms enabled the retrieval of diverse sources, encompassing published research, systematic reviews, and official publications. By supplementing this with manual searches of reference lists, the assurance was made that no pertinent studies were overlooked (Golder et al., 2019). The screening process, grounded in predefined inclusion and exclusion criteria, honed the initial pool of articles, culminating in a final selection of 33 articles meeting the eligibility requirements. These articles, spanning various study designs, contribute to a robust and representative body of evidence, effectively addressing the research question (Costal et al., 2021). NURS FPX 9902 Assessment 5 Reflection In the course of the literature synthesis, successes and challenges were encountered. Successful aspects involved identifying key themes and trends within selected articles, recognizing knowledge gaps, and pinpointing potential areas for future research. Detailed analysis of each piece of evidence provided an understanding of the positive outcomes of telehealth interventions on the health of COPD patients. However, challenges surfaced as well. Some studies exhibited limited sample sizes or methodological limitations, demanding careful consideration during the analysis and interpretation of evidence. Additionally, the copious amount of gathered information necessitated meticulous organization and synthesis to ensure a coherent and comprehensive review (Riccio et al., 2020). Moving forward, there are opportunities for improvement in the literature synthesis, including the enhancement of critical appraisal skills for assessing evidence quality and strength, conducting a thorough evaluation of evidence quality to identify biases and limitations, incorporating additional sources such as gray literature and non-English publications for a more comprehensive understanding, and ensuring careful organization and synthesis of gathered information to maintain coherence and comprehensiveness in the review. Augmenting critical appraisal skills will enable a more comprehensive assessment of evidence quality, and including additional sources could provide a broader perspective on the topic (Messerschmidt et al., 2022). Support of Project and Practice Decisions The review of literature plays a pivotal role in supporting project and practice decisions. Researchers and healthcare professionals gain access to a plethora of existing knowledge and evidence through a comprehensive literature review. This facilitates an understanding of the current state of research, identification of knowledge gaps, and building upon the existing evidence base (Li et al., 2019). Insights derived from the literature review inform project decisions, such as selecting appropriate interventions or designing research studies, ensuring alignment with the best available evidence. Additionally, the literature review offers valuable guidance for clinical practice decisions, elucidating effective interventions, potential adverse effects, and areas necessitating further investigation. It empowers healthcare professionals to make informed decisions, enhance patient outcomes, and bridge the gap between research and practice (Brice & Almond, 2020). In my project on literature search and synthesis, the literature review played a critical role in guiding and shaping the entire process. A comprehensive literature review granted access to a wealth of existing knowledge and evidence related to interventions for COPD. The review facilitated an understanding of the current research state, identification of knowledge gaps, and recognition of potential areas for future research. Insights gained from the literature review not only informed the selection of relevant articles but also aided in developing inclusion and exclusion criteria for the screening process. Furthermore, the review provided a deeper understanding of key themes, trends, and the impact of nutritional and telehealth interventions on lung functioning and readmission rates within a specific timeframe. It also assisted in recognizing potential limitations and methodological considerations within the studies, enabling critical analysis and interpretation of the evidence. Improvement Opportunities Related to Collaboration Reflecting on collaboration and other relevant work at the project site, I have experienced a dynamic and engaging environment that significantly contributed to the progress of my doctoral project. Collaborating with fellow researchers, healthcare professionals, and stakeholders has proven beneficial in expanding perspectives and refining ideas. Through regular meetings, discussions, and feedback sessions, valuable insights were gained, including effective search strategies, manual searches of reference lists, and awareness of potential challenges posed by limited sample sizes and methodological limitations. These insights enhanced critical appraisal skills and shaped my approach to the literature search and synthesis process. Furthermore, constructive criticism received and the collective expertise of the team fostered creativity, innovation, and a shared sense of purpose, ultimately enhancing the quality of my project. The outcomes of collaboration at the project site have been substantial and tangible. Working alongside experienced professionals in the field provided access to knowledge, resources, and practical expertise, enriching my understanding of the subject matter and enabling the application of theoretical concepts to real-world situations. Collaborators’ input and contributions have played a pivotal role in shaping my project’s direction, refining research questions, and identifying potential implications for practice. Through their support and guidance, challenges were navigated, obstacles overcome, and meaningful progress achieved in my doctoral journey (van Leeuwen & Janssen, 2019). As with any collaborative endeavor, there are always opportunities for improvement. Fostering even stronger interdisciplinary collaboration is an area that could benefit from further attention. Actively seeking input from professionals in different fields and engaging in cross-disciplinary discussions can provide a broader perspective and incorporate diverse

Phillip January 27, 2024 No Comments

NURS FPX 9902 Assessment 3 Literature Synthesis

NURS FPX 9902 Assessment 3 Literature Synthesis Name Capella university NURS-FPX 9902 Nursing Doctoral Project 2 Prof. Name Date Literature Synthesis This assessment provides detailed insights into the doctoral student’s search strategy and methods employed to locate literature for synthesis. Its primary goal is to facilitate the synthesis of literature discovered during the research process. The doctoral learner will comprehensively outline the process used to identify literature sources, elucidate the interrelations among these sources, and discern commonalities and differences in research questions, methodologies, and findings. Search Strategy The development of a literature search strategy is crucial for the success of a doctoral project. The references obtained offer evidence-based support to define patient problems and suggest improvements in quality. The literature search commenced after identifying a patient-related problem at the project site and formulating a PICOT question for caregivers of chronic obstructive pulmonary disorder (COPD) patients. The project site and Capella Institutional Review Board (IRB) approved this PICOT and quality improvement project. Four databases, including Cumulative Index of Nursing and Allied Health (CINAHL), Nursing and Allied Health, PubMed, and the Capella Library, were utilized for evidence gathering. The search initially focused on “COPD readmission,” narrowing down results to peer-reviewed articles within the last five years. Fifteen articles meeting the search criteria were selected, printed, and assessed according to the hierarchy of evidence. Subsequently, each database was individually utilized for literature searches, such as “COPD Readmissions” and the “teach-back method.” Articles meeting criteria were retained and used in the project and synthesis. The overall literature search process involved careful consideration of relevance, publication date, and hierarchy of evidence. A total of 1,500 articles were assessed, resulting in 15 retained for the project, supporting the PICOT question and intervention. Synthesis of the Literature COPD Readmissions COPD is a chronic inflammatory lung disease with a global impact on mortality. Initiatives like the Learn More Breath Better campaign by the National Heart, Lung, and Blood Institute (NHLBI) aim to reduce hospitalizations. The Hospital Readmission Reduction Program (HRRP) by the Centers for Medicare & Medicaid Services (CMS) addresses financial implications. Studies, including randomized control trials, cohort studies, and systematic reviews, explore strategies such as personalized action plans, telephonic consultations, and predictive modeling to decrease COPD readmissions. Self-Care Risk factors, including smoking and environmental influences, contribute to COPD. Screening for socioeconomic issues is crucial, aligning with guidelines for controlled COPD and acute exacerbations. Education focusing on smoking cessation, symptom management, and proper inhaler use is essential. Systematic reviews and randomized control trials emphasize tailoring education strategies to individual needs, including multiple evidence-based approaches. Teach-Back Method The teach-back method emerges as a pivotal tool for educating COPD patients, promoting self-management skills, and reducing readmissions. Studies advocate for training healthcare professionals as educators, emphasizing the importance of assessing patient readiness to learn. Electronic learning, national action plans, and healthcare provider training contribute to a comprehensive approach to education delivery. The teach-back method proves effective in enhancing patient knowledge and decreasing hospitalizations. Conclusion The literature synthesis uniformly supports the efficacy of the teach-back method in improving COPD patient outcomes. Quality improvement projects incorporating this method show positive results in patient knowledge, self-management, health literacy, and overall well-being, thereby contributing to the reduction of COPD readmissions. The multifaceted approach to education, including various learning styles and delivery methods, ensures a comprehensive and effective strategy for enhancing patient care. References Aida, A., Svensson, T., Svensson, A., Chung, U.-I., & Yamauchi, T. (2020). Ehealth delivery of educational content using selected visual methods to improve health literacy on lifestyle-related diseases: Literature review. JMIR mHealth and uHealth, 8(12), e18316. https://doi.org/10.2196/18316 Allegrante, J. P., Wells, M. T., & Peterson, J. C. (2019). Interventions to support behavioral self-management of chronic diseases. Annual Review of Public Health, 40(1), 127–146. https://doi.org/10.1146/annurev-publhealth-040218-044008 Buhr, R. G., Jackson, N. J., Kominski, G. F., Dubinett, S. M., Mangione, C. M., & Ong, M. K. (2020). Readmission rates for chronic obstructive pulmonary disease under the hospital readmissions reduction program: An interrupted time series analysis. Journal of General Internal Medicine, 35(12), 3581–3590. https://doi.org/10.1007/s11606-020-05958-0 Centers for Medicare and Medicaid Services. (n.d.). Hospital readmissions reduction program (HRRP). cms.gov. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program Gagné, M., Lauzier, S., Babineau-Therrien, J., Hamel, C., Penney, S.-E., Bourbeau, J., Moisan, J., & Boulet, L.-P. (2019). COPD-specific self-management support provided by trained educators in everyday practice is associated with improved quality of life, health-directed behaviors, and skill and technique acquisition: A convergent embedded mixed-methods study. The Patient – Patient-Centered Outcomes Research, 13(1), 103–119. https://doi.org/10.1007/s40271-019-00386-7 Hawthorne, G., Richardson, M., Greening, N. J., Esliger, D., Briggs-Price, S., Chaplin, E. J., Clinch, L., Steiner, M. C., Singh, S. J., & Orme, M. W. (2022). A proof of concept for continuous, non-invasive, free-living vital signs monitoring to predict readmission following an acute exacerbation of COPD: A prospective cohort study. Respiratory Research, 23(1). https://doi.org/10.1186/s12931-022-02018-5 NURS FPX 9902 Assessment 3 Literature Synthesis Hegelund, A., Andersen, I., Andersen, M. N., & Bodtger, U. (2019). The impact of a personalised action plan delivered at discharge to patients with COPD on readmissions: A pilot study. Scandinavian Journal of Caring Sciences, 34(4), 909–918. https://doi.org/10.1111/scs.12798 Hosseinzadeh, H., & Shnaigat, M. (2019). Effectiveness of chronic obstructive pulmonary disease self-management interventions in primary care settings: A systematic review. Australian Journal of Primary Health, 25(3), 195. https://doi.org/10.1071/py18181 Hu, Y., Lan, Y., Ran, Q., Gan, Q., & Huang, W. (2022). Analysis of the Clinical Efficacy and Molecular Mechanism of Xuefu Zhuyu Decoction in the Treatment of COPD Based on Meta-Analysis and Network Pharmacology. Computational and mathematical methods in medicine, 2022, 2615580. https://doi.org/10.1155/2022/2615580 Jolly, K., Majothi, S., Sitch, A., Heneghan, N., Moore, D., Riley, R., Bates, E., Turner, A., Bayliss, S., Price, M., Singh, S., Adab, P., Fitzmaurice, D., & Jordan, R. (2016). Self-management of health care behaviors for COPD: A systematic review and meta-analysis. International Journal of Chronic Obstructive Pulmonary Disease, 305. https://doi.org/10.2147/copd.s90812 National Heart, Lung, and Blood Institute. (n.d.-a). Learn more breathe better. Retrieved from https://www.nhlbi.nih.gov/BreatheBetter National Heart, Lung, and Blood Institute. (n.d.-b). COPD videos. Retrieved from https://www.nhlbi.nih.gov/health-topics/education-and-awareness/copd-learn-morebreathe-better/copd-videos National Heart, Lung, and Blood Institute. (n.d.-c). COPD national action plan. Retrieved from https://www.nhlbi.nih.gov/resources/copd-national-action-plan Oh, E., Lee, H., Yang, Y., Lee, S., & Kim,

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