NURS FPX4030 Capella University Evidence Based Practice Paper Discussion

Sources of Evidence

A search strategy was employed to address the PICOT question using databases such as CINAHL, PubMed, and Cochrane Library. The search was limited to the years 2019 to 2023, aiming to retrieve reliable and evidence-based literature on telehealth implementation. The terms “stroke,” “cerebrovascular accident,” “adult patients,” “post-stroke,” “readmission,” “nursing,” and “telemedicine” were among those used in the medical and keyword searches. In feasibility or controlled trials, stroke survivors who received telerehabilitation as an intervention group were compared to a control group that received standard care. Most keywords and articles from the United States in 2019-2023 were included. The exclusion criteria encompassed the absence of telehealth utilization, non-inclusion of individuals with stroke, lack of relevance to home health or case management, and no mention of admission. Out of the 27 articles examined, only 18 citations met the eligibility criteria, which included factors such as being in the English language and reviewing the title and abstract to ensure there were no duplicates. CINAHL yielded nine pertinent articles, PubMed yielded three pertinent articles, and Cochrane Library yielded two pertinent articles. Only five articles were selected for full-text review to address the PICOT question.

Findings

            The five studies used to address the PICOT question yielded the following findings. According to the findings of the research conducted by Xu et al. in 2022, patients who were given either telehealth or in-person follow-up after two weeks of their discharge had a considerably lower incidence of readmission within thirty days than those who were not given either kind of follow-up. The implications of these findings are significant for integrating telemedicine into standard medical practice, aiming to enhance outcomes in patients with heart failure. According to a study conducted by Sobhani et al. (2021), telestroke-based longitudinal stroke care has the potential to be economically feasible by reducing the length of hospital stays. Dawson et al. (2021) discovered that implementing a 30-day post-discharge telemonitoring program can potentially decrease readmissions among high-risk stroke patients. In contrast, a study by Wong et al. (2023) examined the implementation of telecare appointments in a nurse-led post-acute stroke clinic. The findings suggested that this approach could protect against the risk of infectious disease transmission to stroke survivors who are unable to access conventional healthcare services due to limited mobility. Sharrief et al. (2023) examine strategies for overcoming barriers to telehealth utilization in stroke patients and populations with unfavorable social determinants of health.

NURS FPX4030 Capella University Evidence Based Practice Paper Discussion

NURS FPX4030 Capella University Evidence Based Practice Paper Discussion

Question Description

I need help finishing this paper. I need to explain the importance of incorporating credible evidence into an evidence-based practice model used to address a quality or safety issue, or a chosen diagnosis.

Develop a 2-4-page scholarly paper in which you describe a quality or safety issue, or a chosen diagnosis, and then identify and analyze credible evidence that could be used as the basis for applying EBP to the issue.

The goal of using evidence-based research findings is to enhance safety and quality of patient care and ensure optimal outcomes are achieved.

It is not uncommon to hear a nurse say, “why change it as we’ve always done it this way.” However, this is no longer acceptable in today’s practice environment.

The profession of nursing has evolved, and the expectation is that the professional nurse has a scientific foundation to support the care that is provided.

As the profession of nursing continues to evolve and engage in health care transformation, baccalaureate-prepared nurses are expanding taking on leadership roles that include incorporating EBPs. To be able to do this, the nurse needs to understand the criteria and makes a resource credible, as this is crucial when deciding if the research is valid and reliable for implementation into health care settings.

It would be an excellent choice to complete the Vila Health Determining the Credibility of Evidence activity prior to developing the report.

The activity is a media simulation that offers an opportunity to review a scenario and work on determining the credibility of presented evidence. These skills will be necessary to complete Assessment 2

successfully. This media simulation is one potential source of context on which to base your assessment submission. This will take just a few minutes of your time and is not graded.

DEMONSTRATION OF PROFICIENCY

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 2

• Analyze the relevance and potential effectiveness of evidence when making a decision.
• Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.
• Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis.

Competency 3

• Apply an evidence-based practice model to address a practice issue.
• Explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis.

Competency 4

• Plan care based on the best available evidence.
• Describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.

Competency 5

• Apply professional, scholarly communication strategies to lead practice changes based on evidence.
• Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

PROFESSIONAL CONTEXT

As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.

SCENARIO

For this assessment, you may choose from the following options as the context for the quality or safety issue or chosen diagnosis for researching and completing this assessment:

• The specific diagnosis you identified in your previous assessment.
• The simulation Vila Health: Determining the Credibility of Evidence.
• A personal practice experience in which a sentinel event occurred.

INSTRUCTIONS

The purpose of this analysis is to better understand what constitutes credibility of journal articles as well as websites. The role of the baccalaureate-prepared nurse in incorporating evidence-based research continues to growth in clinical practice.

As quality improvement (QI) measures to reduce safety risks continue to be emphasized, the need for evidence-based models and evidence-based templates is growing.

This type of systematic approach to incorporating evidence-based findings allows nurses to make clinical and operational decisions based upon the best available evidence. When the most up-to-date evidence-based findings are utilized, patient-centered care improves outcomes and enhances the patient experience.

For this assessment:

• Explain the criteria that should be used when determining the credibility of journal articles as well as websites.
• Support your explanations with references to the literature or research articles that describe criteria that should be used to determine credibility.
• Your identification and determination of credibility should be done within the context of your chosen scenario for this assessment. For example, if you choose to use the provided Vila Health scenario, your initial identification of resources should be of resources that will best help address the presented issue.
• However, if you are locating resources to help provide evidence-based care for the diagnosis you identified in the first assessment, you may want to begin your literature and evidence search from the databases that identified. Any of the three scenario options are acceptable. So, pick the one that most interests you.
• Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.Describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.
• Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.
• Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis.
• This is where you are selecting the specific resources to help address the issue in your chosen scenario.
• Explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis.
• Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

SUBMISSION REQUIREMENTS

Your assessment should meet the following requirements:

• Length of submission: 2–4-page scholarly paper, this does not include the APA-formatted title page and reference list.
• Number of references: Cite 3–5 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than five years old.
• APA formatting: References and citations are formatted according to current APA style.
• Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.

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NURS FPX4030 Capella University Evidence Based Practice Paper Discussion attachment_1

NURS FPX4030 Capella University Evidence Based Practice Paper Discussion

Evidence-Based Practice
Canes Lebrun Jr
NURS-FPX4030
Capella University
7/3/2020

Description of a quality or safety issue

Evidence-Based Practice (EBP) in nursing is one of the vital principles of modern-day medicine. EBP involves the collection, processing, and implementing problem-solving research to improve clinical practice while focusing on the patient’s needs.

The focus on the quality or safety issue relates to oxygen use in patients with Chronic Obstructive Pulmonary Disease (COPD).

To uphold the safety and health of a patient, nurses must adhere to EBP in nursing when giving CORP patients oxygen (McDonald, 2015).

Some arguments indicate that providing such patients with oxygen risks the development of serious problems such as acidosis, hypercarbia, and even death. However, the EBP protocol facilitates the provision of oxygen to COPD patients.

Criteria considered when determining credible resources such as journal articles and websites.
In conducting appropriate research, it is recommended to use credible sources of information. The criteria for selecting reliable sources would consider several factors.

Firstly, the authority and creditability of the resources. Under the considerations, the features would include the author, whether being a person or an organization.

The author’s qualification in a certain subject matter is also an important aspect, as well as the publisher. Secondly, observing the accuracy and reliability of the resource. The factors in evaluating are whether the resource has citations or footnotes to affirm its claim.

The sources could also include facts or statistical data and whether another source can verify such information.

Thirdly, it is important to consider currency and timeliness. The requirements encompassed the period when the document was published and whether the data is verifiable. Besides the publication date, it is vital to check whether it provides current information required, thus necessitating the usage of recent sources.

Lastly, the focus on objectivity or biasness as means of evaluating sources. The consideration entails assessing whether the source represents facts or opinions, thus making judgments on subjectivity or objectivity of the resources.

Credibility and relevance of evidence and resources

In 1971, two studies were conducted in the U.S and U.K to establish whether treating hypoxemia in COPD could play a part in improving the rate of mortality. The two studies followed the standard procedure of medical experiments. As a result, there were several discoveries that could be applicable to nurses.

Firstly, in the ambulatory oxygen, some factors could be useful in taking care of a COPD patient. Ambulatory oxygen therapy can be applied as a component of the continuous process of offering oxygen supply to patients before being taken to a healthcare facility.

In every case, the use of oxygen is aimed at maximizing the hours per day a patient with COPD can utilize their oxygen (McDonald, 2015). The experiment would also be essential in the maintenance of sufficient physical activity, such as engagement in pulmonary rehabilitation.

Secondly, the aspect of oxygen in moderate hypoxemia. The results of the experiment in the study showed that mortality benefits were emanating from therapy offered to patients having severe hypoxemia and COPD having undergone long-term therapy.

However, there is no considerable benefit for constant supplementation of oxygen in patients with less severe degrees of hypoxemia. Thirdly, the risks associated with the application of oxygen in acute exacerbations of COPD.

Historically, patients with acute exacerbations of COPD could get complications associated with hypercapnia when subjected to supplementary oxygen of high concentration levels (Hatipoğlu & Stroller, 2018). The rationale behind the phenomenon relates to combinations of hypoventilation.

These Haldane effects entail displacement of Carbon monoxide held by hemoglobin in high levels of oxygen and complicating ventilation-perfusion mismatch. The evidence provides information supporting the assertions.

The other issue related to the safety of patients entails the application of titrated oxygen therapy in COPD patients. Evidence indicates that acute exacerbations of COPD should be offered with titrated oxygen therapy to attain an oxygen saturation goal of about 88-92%.

Consequently, the movement could be vital in preventing the risks of both hypoxemia and hypoxemia. In the scenario of acute exacerbations, there exists a 2.4 fold rise in the danger of causing death compared to a patient issued with titrated oxygen. (Pilcher et al. 2015) The increase in the mortality rates is due to a rise in carbon dioxide partial pressure.

There are other conditions such as hypoxemia results in decreased myocardial reperfusion injury or coronary blood flow and rebound hypoxia in case oxygen supply stops unexpectedly. Other means of reducing high oxygen concentration could be avoided by offering bronchodilators by metered-dose or an air-driven nebulizer with a spacer instead of a nebulizer driven with oxygen.

Importance of incorporating credible evidence into EBP

Patient safety is crucial in increasing the survival rate for patients in need of oxygen. The nurses are involved in administering oxygen to the patients needing. However, COPD patients need the right concentration of oxygen that would not risk their lives. The evidence aims to explore studies and experiment with reliable facts to use in the EBP nursing practice.

The integration of EBP nursing practice would be crucial in preventing organ failure or hypoxia during the process of supplementing patients with oxygen. It is important to consider the condition of the patient and apply the most effective available oxygen concentration. Supplementing oxygen is an appropriate treatment based on the evidence, thus enhancing the quality of life for COPD patients and enable them to live longer.

References

• Hatipoğlu, U., & Stroller, J. (2018). Supplemental oxygen in patients with stable chronic obstructive pulmonary disease: evidence from Nocturnal Oxygen Treatment Trial to Long-term Oxygen Treatment Trial. 24(2), 179-186. doi:10.1097/MCP.0000000000000461
• McDonald, C. F. (2015). Oxygen therapy for COPD. Journal of Thoracic Disease, 11(6), 1632–1639. doi:10.3978/j.issn.2072-1439.2014.10.23
• Pilcher, J., Weatherall, M., & Beasley, R. (2015). Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. Expert Review of Respiratory Medicine, 9(3), 287-293. doi:10.1586/17476348.2015.1016503