Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in

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Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in
© 201 9. All Rights Reserved. Research Critiques and PICOT Question Guidelines – Final Draft Use this document to organize the content from your four studies into your final draft . Quantitative and Quantitative Studies Background 1. Summary of studies. Include problem, significance to nursing, purpose, objective , and research question. How do these two articles support the nurse practice issue you chose? 1. Discuss how these articles will be used to answer your PICOT question. 2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question. Method of Study: 1. State the methods of the articles you are comparing and describe how they are different. 2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method. Results of Study 1. Summarize the key findings of each of the studies into a comprehensive summary . 2. What are the implications of the four studies you chose in nursing practice? Et hical Considerations 1. Discuss two ethical consideration in conducting research. 2. Describe how the researchers in the four articles you choose took these ethical considerations into account while performing their research. Outcomes Comparison 1. What are the anticipated outcomes for your PICOT question ? 2. How do the outcomes of the four articles you chose compare to your anticipated outcomes?
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in
Two quantitative, peer-reviewed research articles that were identified in the Topic 1 assignment to complete Topic 1 assignment. You may need these articles to complete the assignment. Nursing practice problem will be Chronic obstructive pulmonary disease (COPD) in adults. PICOT Question: In adults who have been diagnosed with COPD exacerbations, does the use of pharmaceutical drugs such as antibiotics and bronchodilators improve the rate of recovery compared to the use of nutrition and oxygen therapy? Population (P): Adults > 18 years of age with COPD Intervention (I): Antibiotic Therapy and use of Bronchodilators Comparison (C): Use of nutrition and oxygen therapy Outcome (O): Quality of life (SGRQ), exacerbations (hospitalization rate and duration, and complications) Time (T): Short- to medium-term. Criteria Article 4 Article 6 APA-Formatted Article Citation with Permalink Hodson, M. (2016). Integrating nutrition into pathways for patients with COPD. British Journal of Community Nursing, 21(11), 548–552. https://doi-org.lopes.idm.oclc.org/10.12968/bjcn.2016.21.11.548 Permalink: https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=27809578&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1 Bades, A. (2014). Community management of chronic obstructive pulmonary disease (COPD). Journal of Community Nursing, 28(3), 51–56. Permalink: https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edo&AN=96548556&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1 How Does the Article Relate to the PICOT Question? The article discusses the use of nutrition to help in the improvement of patients that have COPD. It tries to explain how the use of nutrition can improve the health of a person with a COPD condition This article discusses the COPD condition. It discusses its risk factors and the various treatment methods that can be used in managing this condition. Quantitative, Qualitative (How do you know?) The article uses a quantitative research method. This is because the data that has been used in the article is obtained by analyzing old data. The article uses quantitative research. This is because they have analyzed old data from old, studied, and research articles. Purpose Statement Community nurses play a vital role in the ongoing care of patients living with COPD and are ideally placed to identify patients who are at risk of malnutrition and implement an appropriate nutritional care plan. This article aims to provide an overview of COPD to facilitate a general understanding of the disease, assist community nurses with early identification for prompt detection and highlight the pathways and management options available Research Question What are the causes of malnutrition? What are the consequences of malnutrition? What is the cost of malnutrition? How can malnutrition be managed? What are the symptoms of COPD? How can one make sure that COPD is identified earlier? Outcome The article found several causes of malnutrition, determined that the cost of malnutrition was high. The article identified several symptoms of COPD and was in which the disease could be identified earlier. Setting (Where did the study take place?) There was no physical settings, used data from different studies There was no physical settings, used data from different studies Sample No participants were used No participants were involved Method Quantitative research was used Quantitative research was used Key Findings of the Study Malnutrition is common to patients who have COPD It is caused by the effects of the disease, environmental, social, and psychological factors. COPD, if determined earlier, the disease’s risk factor can be avoided. If one is educated and offered guidance on nutrition and oral treatment, it can be managed easily. Recommendations of the Researcher COPD patients who have malnutrition should be referred to pulmonary rehabilitation Persons with malnutrition should stop smoking to improve their senses to make the food more pleasurable. People with this condition to be educated and given guidance on nutrition.
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in
1 Rough Draft Qualitative Research Critique and Ethical Considerations Name Institution name Course Name Professor Name Date Commented [A1]: Your title should detail your PICOT/subject of your paper 2 Rough Draft Qualitative Research Critique and Ethical Considerations Two qualitative research articles I chose from the week 1 assignment include Home oxygen therapy in patients with COP D (chronic obstructive pulmonary disease ): safety issues for nurse prescribers (Article 2) and the impact of community pharmacy -led medicines management support for people with COPD (Article 3) . The first research study explains why chain smokers are mostly affected by COPD than non -smokers. COPD is an inflammatory lung disease that is always characterized by airway obstr uction. COPD is a disease that damages the lungs over time, and it affects the way people breath e (López -Campos, Gallego & Hernández, 2019 ). The COPD condition is caused by long -term exposure to the irritants like cigarette smoke and other irritating gases that can damage the lu ngs. The PICOT question is on whether adults with COPD use pharmaceutical drugs like bronchodilators and antibiotics to boost their recovery rate compared to oxygen therapy and nutrition. People with chronic COPD are at the risk of developing other complications like heart problems, high blood pressure, lung cancer, and depression. This research study in article two aims to critically evaluate the issue that poses challenges to RNS (respiratory nurse specialist) , an independent prescriber. In article three, the purpose was to determine the effect of pharmaceutical medicine management support (in addition to the routine annual nurse -led reviews for long -term conditions) in patients with COPD in one community nursing team in Sheffield. Estimates are that America has at least 30 million people with COPD condition. This condition is always progressive but treatable. How Two Chosen Articles Support Nurse Practice Article two will be relevant in answering the PICOT qu estion because it discusses how oxygen therapy effectively prescribes it to patients with chronic obstructive pulmonary disease. Commented [A2]: Two authors should be format like this: ( López -Campos et al., 2019) Commented [A3]: Is this your background or introduction? You should always include an intro and you need to incl ude a level one heading for your background that details both articles and their relation to your PICOT Commented [A4]: Specify the article by the title or authours 3 Oxygen treatment helps raise the amount of oxygen flowing to the lungs and bloodstream of the patient with COPD. If the COPD is chronic, the blood oxygen level is very low. Therefore, getting additional oxygen helps extend the life span of those suffering from the disease because it makes them breathe better. Oxygen therapy is done by using oxygen -gas cylinders, oxyg en concentrato rs, or liquid -oxygen devices. The article states that oxygen systems are always portable, and there is no need to stay at home or get admitted to the hospital to use oxygen. Patients in this condition can still use oxygen while doing their daily tasks. It is advisable for people who use oxygen not to smoke . Oxygen should also not be used in open flames or around lit cigarettes. Without considering oxygen treatment carefully, there may be a danger of explosion or fire. After oxygen therapy, the treatm ent may improve the quality of life. It may help the COPD patient live longer since shortness of breath is reduced, and the patient regains energy (Rogliani et al., 2017) . Those who have rapid, severe, and sometimes high shortness of breath can get oxygen from the hospitals to make sure that they are under the doctor’s care. Article three relates to the research question by discussing the use of bronchodilators which are u sually administered using handheld inhalers. Bronchodilators are used for the treatment of COPD because they relieve bronchial obstruction, hyperinflation, airflow limitation and improves the ability of the lung to empty wastes and perfo rm well (George & B ender, 2019) . This article highlights the guidelines for using bronchodilators in the process of managing COPD. It is essential to treat COPD patients with good classes of bronchodilators that are friendly to the patien ts. Regular treatment of COPD with l ong -acting bronchodilators doesn’t reduce lung problems. This means that before the treatment of COPD patients with Bronchodilators is Commented [A5]: Which article? Use the title or the authors Commented [A6]: Expend why this is the case Commented [A7]: This does not need to be i talic ized 4 ascertained, these devices’ improvement is necessary. It is not clear if the difference in these devices has a clinical r ole in COPD treatment. The symptoms of COPD patien ts vary from time to time. During morning hours is when the symptoms are considered severe. According to this article’s hypothesis, fast -acting agents are effective on the morning symptoms of COPID than tho se w ith a slow onset of actions in providing relief after the morning dosing. A prompt symptom relief gives an assurance of the effectiveness and is the key factor behind patient compliance. The interventions of the two articles are similar to the PICOT question. The question is the use of oxygen therapy to increase the rate of re covery from COPD. Article two answers the first issue about oxygen therapy and factors that would lead a person to use oxygen at home or in the hospital. Article three provides a solution on the importance of bronchodilators in extending the life of a pati ent who suffers from COPD. The group of people used in both article’s study can be compared with the group selected for the PICOT question. Both studies were conducted on adults and can be used for an adult population aged greater than 18 years with COPD. Methods of Study Article two uses qualitative research method. They include already filled questionnaire that explains the risk of patients that use oxygen at home. Nurses have supplied this questionnaire, and it is essential in determining the best way to treat COPD. Article three uses observations a s the research method. The observation where pharmacy personnel was sent how inhalers were being used was recorded in the study. The use of Questionnaire is different from the observation method by the fact that a questionnaire provides the responses from patients while in observation the researcher needs to draw their own conclusions. The information obtained thru the questionaries was limited to pre -filled information on the questionnaire. Commented [A8]: Which article Commented [A9]: Where is the citation to support this content? Commented [A10]: Do not capitalize it 5 Additional information may be available which was not part o f the questionnaire. The observation could be limited to the observer’s knowledge and experience. The observation method is beneficial in knowing the effectiveness of home oxygen therapy. Questionnaire is important in collecting research data because the i nformation collected is more reliable and valid. Study Results and Implications in Nursing Practice In article two , the author’s findings were: the risks associated with oxygen use at home include; fire hazards that would cause skin burns and even deat h to the patients. This is because oxygen is not supposed to be used near the fire. After all, it could cause an explosion. The author’s findings in article three were that many patients lack knowledge on how to use inhalers. Patients with cognitive impairment have limited options to get a proper administration of medicine. The two studies are essential for those in nursing practice . Nurses can use the information provided to offer guidance and counseling to patients with COPD. They will explain to them the disadvantages of smoking while using oxygen. They will also advise them on installing fire safety equipment that wou ld reduce fire accidents. Nurses will be able to use other therapies when a patient has dementia, and it is difficult for them to use inhalers. Ethical Considerations While conducting the research study, it is vital to ensure that ethical considerations a re maintained. The researcher should maintain a high level of transparency and honesty while collecting data from different official websites (Arifin, 2018) . Respect and discipline is another ethical factor that should be considered while analyzing the data and presenting results. Respondents of research mostly react well when the researcher respects them and puts their ideas and values in consideration. Commented [A11]: Which article Commented [A12]: Where are the citations to support the results? You should include specific study results with proper citations. Commented [A13]: How so? Commented [A14]: Specify the specific ethica l considerations for each study 6 The authors of these two articles maintained a high degree of ethics. They used words of humility wh ile explaining how the use of oxygen therapy and bronchodilators would extend patients’ lives with COPD. They were not biased in providing useful information that would save lives when nurses use it appropriately. They were open to providing information ab out where they researched from. They did not reveal any confidential information from the two places where they sourced their research information. It is by ethics that the researchers were able to interact well with nurses and obtain relevant information for their research study. Conclusion COPD is an inflammatory lung disease characterized by airway obstruction at all times. The treatment can improve the quality of life after oxygen therapy. The morning symptoms of COPID are effective with rapid -acting agents. Risks associated with oxygen us age at home include fire risks that may cause patients skin burn and even die. Since shortness of breath is minimized and the patient regains energy, the medication will help the COPD patient live longer. A solution to the importance of bronchodilators in extending the life of a patient suffering from COPD was discussed in details in Article 3 . The information given can be used by nurses to provide advice and counseling to patients with COPD. While collecting data, researchers should uphold transparency and fairness. 7 References Arifin, S. R. M. (2018). Ethical considerations in qualitative study. International Journal of Care Scholars , 1(2), 30 -33. George, M. , & Bender, B. (2019). New insights to improve treatment adherence in asthma and COPD. Patient preference and adherence , 13, 1325. López -Campos, J. L., Gallego, E. Q., & Hernández, L. C. (2019). Status of and strategies for improving adherence to COPD tr eatment. International journal of chronic obstructive pulmonary disease , 14, 1503. Rogliani, P., Ora, J., Puxeddu, E., Matera, M. G., & Cazzola, M. (2017). Adherence to COPD treatment: myth and reality. Respiratory medicine , 129 , 117 -123. Commented [A15]: Remove this comma Commented [A16]: Journal titles are capitalized Commented [A17]: Correctly capitalize the journal titles
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in
1 RESEARCH CRITIQUE GUIDELINES Name Department of Nursing, University Course Name Professor Name Date Commented [A1]: Do not use all caps Commented [A2]: -Double space element of title page -Change your title to detail your PICOT/subject of your paper, also you only need two spaces in between the subject and other elements of the title page 2 RESEARCH CRITIQUE GUIDELINES Background Hodson, M. (2016 ) article attempts to study malnutrition among COPD affected patients on both the patient and the healthcare’s economy. Malnutrition is caused by the disease’s effects, psychological, social, and environmental factors. The patients suffering from COPD have many nut ritional problems, and they should regularly seek a nutritional assessment, early dietary intervention, and monitoring their quality of life and overall experience. The study’s problem is the causes of malnutrition among COPD patients and how it can be man aged. This article is significant to nursing since it enables patients to receive comprehensive and holistic care. The community nurses are trained to manage and identify patients at risk of malnutrition and meet their dietary needs. The research question was, “What are the consequences of malnutrition? What is the cost of malnutrition? How can malnutrition be managed?” The second article by Bades, A. (2014). COPD is an incurable progressive and debilitating disease; however, it can be managed after an e arly diagnosis. Due to the impact on the quality of life, people living with COPD often suffer depression which affects their quality of life. Education is essential for people with COPD to be responsible for their well -being and health. The research probl em how signs of COPD can be diagnosed earlier. The research objective is to obtain an overview, understand COPD and assist community nurses in detecting and understanding management options. The research question is, “What are the symptoms of COPD? How can one make sure that COPD is identified earlier?” Nurse Practice Supported by Chosen Articles Hodson, M. (2016) authored the first article answers the PICOT question by discussing nutritional help or assistance given to COPD patients by the community nurses. It illustrates how Commented [A3]: Do not use all caps Your intro should follow title and then your background Commented [A4]: Remove the authors initial from the text (onl y use the initial on your reference page) Commented [A5]: Remove the author first initial and the period after the parentheses 3 proper nutrition of patients is associated with the better COPD health c ondition of patients. The article discusses this by making the most out of food and drink; However, some patients are concerned with weight gain; they should understand how nutrition interventions are related to overcoming infections and performing one’s d aily activities . COPD patients may also use oral nutritional supplementation that provides energy, protein, minerals, and vitamins. In the second article by Bades, A. (2014), my PICOT question is answered where there are discussions of the risk factors and different treatment methods used in managing COPD. This article identifies the risk factors such as smoking, including passive smoking, having a family history with COPD, and occupational exposure to the disease such as dust, chemicals, and fumes. Add itionally, the article develops the treatment methods and early diagnosis of the condition to ease its effects, including; monitoring and assessing the disease, reducing the risk factors, and managing exacerbations. Method of Study This study (Hodson, M. (2016) used a descriptive analysis method to examine different variables. However, in the survey, secondary data sources were used when examining other variables; additionally, no samples were used. For example, it analyzed data from the BLF “British Lung foundations” where more than 1.2 million people in the United Kingdom were COPD. While according to NHS, in 2014, about 21% of COPD patients suffer from malnutrition. The main advantage of descriptive analysis is that there is a reliance on peer -reviewed articles; thus, the details used are more accurate and reliable. The downside is that due to fewer statistical tests of descriptive research, the results may be biase d. For the second article by Bades, A. (2014). Also employed descriptive analysis is used in summarizing data meaningfully to understand patterns that may arise from the data involved. Commented [A6]: Avoid first person Commented [A7]: Support this info with in -text citation Commented [A8]: Paragraphs should be at -least 4 sentences per APA recommendations 4 The article uses secondary research from NICE “national institute for health and care excellence” and BLF “British Lung Foundation.” Where about 900,000 people have been diagnosed with COPD, this method’s core advantage is the reliance on peer -reviewed articles; thus, the details used are more accurate and reliable. While t he disadva ntage is fewer statistical tests of descriptive research, the results may be biased. Results of Study The study’s findings by Hodson, M. (2016) indicated that malnutrition is common among COPD patients where nurses have an essential responsibi lity of managing nutrition among these patients. Guidelines have been developed to help community nurses identify crucial ways to address nutrition and advice patients about the appropriate diet to take. Nurses would be actively involved in screening COPD patients and give them proper care practices. This study is related to holistic care and evidence -based practice where nurses have to be involved in promoting their patient’s well -being. They should further ensure that patients receive the best nutritional care and develop feeding programs for them. In the second article by Bades, A. (2014). The summary that COPD is a debilitating and progressive incurable disease; although it can be managed through an early diagnosis, removing or identifying risk factors l ike; family history, smoking, occupation, etc., there should be patient sensitizations self -management plans among patients. This article is applying to my nursing practice, where we should be at the fore -front in assessing, educating, and informing COP D patients on how to manage their illnesses and live healthier lives. Through these practices, community nurses can gradually reduce COPD -related complications and deaths. Outcomes Comparison Commented [A9]: Where is citati on for this info. Commented [A10]: Avoid first person 5 My anticipated outcome for the PICOT question on Hodson, M. (2016) article was that appropriate feeding and nutrition programs for COPD patients would help them live better lives and alleviate the disease’s effects. From the article, we identify that nurses can be actively involved in developing feeding and nutriti on programs for patients, helping them avoid malnutrition and other related illnesses. Thus, the outcome of my question and for this article are equal since we can alleviate malnutrition among COPD patients through community nurse involvement. In the second article, Bades, A. (2014), by expected PICOT results were to identify and try solving COPD effects among the patients. This will involve early assessment for the disease since it is incurable. From the article, we determine that COPD’s treatm ent process is complex and requires nurses to identify and be involved in helping the patient alleviate the disease using self -assessment mechanisms. According to the article, COPD patients face physical, psychological, and social effects, which can be red uced if nurses are directly involved in caring for their patients. Thus, this article is also related to my PICOT by identifying and managing the COPD symptoms, thus reducing its complications and related deaths. Conclusion These articles aim to examine t he impact of malnutrition among COPD patients on both the patient and the healthcare system. The symptoms of the disease, as well as psychological, social, and environmental factors, all lead to malnutrition. COPD is a chronic, progressive, and debilitatin g condition that can be treated if diagnosed early. Nurses play a vital role in the control of nutrition. Patients with COPD have a better health status when they eat well. Some patients are worried about gaining weight; they should be mindful of how nutr ition interventions contribute to managing illnesses and carrying out everyday activities. Commented [A11]: Do not write in first person 6 References Bades, A. (2014). Community management of chronic obstructive pulmonary disease (COPD). Journal of Community Nursing, 28(3), 51 –56. https://lopes.idm. oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true &db=ccm&AN=107858651&site=eds – live&scope=site&custid=s8333196&groupid=main&profile=eds Hodson, M. (2016). Integrating nutrition into pathways for patients with COPD. British Journal of Community Nursing, 21(11), 548 –552. https://doi – org.lopes.idm.oclc.org/ 10.12968/bjcn.2016.21.11.548 Commented [A12]: Journal titles are italicized Commented [A13]: Journal articles are italiczed
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in
11 COPD research critique NAME: INSTITUTION COURSE NUMBER COURSE TITLE: INSTRUCTOR’S NAME: DUE DATE: COPD research critique COPD is the initial for “Chronic obstructive pulmonary disease,” which reduces the amount of air that flows into one’s lungs. The condition’s primary symptoms include; wheezing, difficulty breathing, coughing, and producing sputum or mucus. The common cause of the disease includes; prolonged exposure to particulate matter or irritating gases. The at-risk people include; those with lung cancer, heart disease, and smokers. Additionally, other conditions that may contribute to this disease include; bronchitis and emphysema. Zhao, Q et al. (2020). This research critique paper will be focusing on the research articles authored by Hodson 2016 and Badges 2014. The researchers aimed at addressing COPD conditions, their causes, and how to control them. This critique will comprehensively analyze these articles, the background to the study, support the nursing practice, study methods, results, and comparison of these results. The background The research by Hodson, (2016), begins by attempting to study issues of malnutrition and poor eating habits among COPD patients. Due to malnutrition, patients do not obtain the right care; additionally, the nurses should develop and implement food timetables for their patients. However, nutrition is not the only factor affecting COPD patients but also their environmental, psychological, and social behavior. Most COPD patients experience a nutrition problem; therefore, they should regally visit medical experts for assessments and checkups. Although this condition is incurable, it can be controlled when diagnosed earlier; therefore, improving the quality of care and well-being. Therefore the problem is how COPD patients’ needs can be addressed through early diagnosis and intervention mechanisms. In the nursing practice, this article is essential in fulfilling the need for holistic, comprehensive, and consistent care. The nurses and other healthcare officials should be educated about measures and processes they may use in diagnosing and controlling COPD through appropriate nutrition and dietary requirements. There were two research questions; “What are the consequences of malnutrition? What is the cost of malnutrition? How can malnutrition be managed?” According to the article by Bades, (2014), COPD is an incurable, deliberating, and progressive disease that can be easily managed when diagnosed at its early stages. However, due to misdiagnosis and impacts, most patients end up suffering emotionally, socially, and financially due to the illness, which reduces the quality of life. To improve one COPD patient’s health, it is essential to establish appropriate sensitization and educational mechanisms. The research question was “what are ways to diagnose COPD symptoms?” the research objective was understanding the role of community nurses in diagnosing and developing management options for COPD patients. The research question was, “What are the symptoms of COPD? How can one make sure that COPD is identified earlier?” The research supporting nursing practice The article by Hodson, (2016), will answer the PICOT question of how community nurses can be actively involved in actively assisting COPD patients in diagnoses and developing a nutrition strategy. Therefore, when COPD patients are appropriately fed, they are likely to achieve well-being and live better lives without suffering. Therefore nurses are involved in designing types of meals that patients will take. The problem is that most patients fear that they may become overweight or obese; however, it is the nurse’s duty to sensitize them on the potential disadvantages of not taking healthy meals. Additionally, nurses should be involved in selecting appropriate oral nutritional supplements that provide minerals, protein, vitamins, and energy to COPD patients. While the article by Bades, (2014), seeks to answer the PICOT question of how community nurses can be actively involved in the management and designing treatment methods for COPD patients, additionally, healthcare professionals should be involved in the identification of risk factors which includes smoking, a family history of COPD, passive smoking together with occupation or work-related exposure when working in factories one is exposed to fumes, dust, and chemicals. BBBBB develops methods to reduce one’s possibility of obtaining the infections by early diagnosing, monitoring patients, and eliminating risk factors (like work-related, active or passive smoking). The methods of study Hodson, (2016), applies descriptive analysis methods of study in examination and analyses of various variables throughout the research. Throughout the variable’s examination, Hudson uses secondary data sources. Furthermore, the research never used samples. The research applied data directly from the British Lung Foundation, where one million and two hundred thousand UK citizens were found to have COPD. The NHS further indicated that out of that population, about 21% were suffering from malnutrition. Nissen, F, (2018). The core advantage of descriptive analyses, as applied by Hudson, was that the source of data is always peer-reviewed. Therefore details are correct, accurate, and reliable. The negative side of descriptive analyses of the method involved a few statistical tests, so the results may be biased according to the point the research wants to reveal. Sultoni, S, et al, (2018), The second article by Bades, (2014), also used the descriptive analyses method; in summarizing and analyzing to show data patterns and results. The primary sources used were the British lung foundation and the national institute for healthcare excellence. Based on the research’s findings, approximately 900,000 UK citizens were dragonized with COPD. Nissen, F, (2018). According to Sultoni, S, et al, (2018), the pro of descriptive analyses as applied by Hudson were that the data source is always peer-reviewed. Therefore details are correct, accurate, and reliable. The negative side of descriptive analyses of the method involved a few statistical tests, so the results may be biased according to the point the research wants to reveal. The results of the study Hodson, (2016), established that malnutrition cases for COPD patients were rampant, and nurses have an essential role in ensuring that the nutrition is managed. The nurses should develop appropriate procedures and measures to be applied to food and water intake. Another result was nurses should be involved in advising educating the COPD patients on the importance of taking proper diets and answering their questions. Nurses should also be trained to diagnose and screen COPD patients within the disease’s early stages. The research is related to evidence-based and holistic care since it ensures patient’s well-being is promoted. The patients are entitled to receiving the best care since they trust and believe in the nurse’s intervention mechanisms. The article by Bades, (2014), informs the reader that COPD is a progressive and debilitating incurable disease which can be managed and controlled when dragonized in the early stages. The process of eliminating COPD includes; early diagnosis, identifying risk factors that patients are exposed to like active and passive smoking, family history of COPD infection, and occupational factors (example working in smoke, fumes, and dusty areas.) the research further established that community nurses should be involved in processes of sensitizing and developing self-management plans on-behalf of the patients. The article by BBBBB is related to the nursing practice where medical practitioners should be involved in assessing, informing, and educating COPD patients on ways to manage this condition and live healthier. When these practices are adequately applied, complications and deaths relating to COPD will reduce gradually. Ethical considerations According to Israel, et al, (2006), some ethical considerations when developing research include; ensuring there is informed consent where autonomy and rights of subjects have to be protected. It seeks to prevent integrity and protects patient’s liberty. For informed consent to be successful, subjects should be introduced to the study to describe what to expect. The second is not harming the subjects; the researcher should aim to learn about the subjects without making them suffer. The third is respecting confidentiality, where the response or analyses made throughout the research should not directly connect to any subject used throughout the research? The fourth ethical issue is the protection of vulnerable groups. Some vulnerable groups include; those with learning disabilities, the poor, dying, the mentally ill children, captive population (like students and prisoners), etc. Throughout the two research’s Bades, (2014), & Hodson, (2016), ethical guidelines have been followed in several ways; firstly is that the researchers did not publish private information of the subjects used. This promoted confidentiality and privacy. Secondly, the information published about COPD patients cannot be directly linked to any patients; therefore, the patient’s autonomy is protected. The third is that the vulnerable groups are protected throughout the researches since we do not get private information about children, the poor, the captive population, etc. The researcher should not link information provided to any member of these vulnerable groups. Outcomes comparison The anticipated outcomes for the PICOT question from Hodson, (2016), article was how proper feeding and nutrition programs could be used in developing better lives and reducing complications and deaths related to COPD. The article answers this question by analyzing how community nurses can be actively involved in making and implementing feeding programs for COPD patients. Additionally, nurses should be ready to educate their patients on avoiding the fear that they may become obese due to feeding. Nurses should act as caregivers and counselors since the condition is not easy when a patient is diagnosed with COPD. Therefore the expected outcome and the research’s outcome are equal for this research since they illustrate the nurses’ role in promoting holistic and comprehensive care. The article’s expected results by Bades, (2014), were the ways to identify and alleviate the effects of COPD condition. This process involved early diagnosis and intervention mechanisms. According to the article, COPD is an incurable disease that often leads to complications; however, its effects and symptoms can be gradually reduced when there is an early diagnosis. However, another issue is that COPD patients face; social, psychological, and physical issues. Therefore nurses ought to be directly involved in designing a plan of care for the patients. Therefore this article is related to the PICOT question of managing and identifying COPD to reduce its effects. References Bades, A. (2014). Community management of chronic obstructive pulmonary disease (COPD). Journal of Community Nursing, 28(3), 51–56. https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edo&AN=96548556&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1 Hodson, M. (2016). Integrating nutrition into pathways for patients with COPD. British Journal of Community Nursing, 21(11), 548–552. https://doi-org.lopes.idm.oclc.org/10.12968/bjcn.2016.21.11.548. https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=27809578&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1 Israel, M., & Hay, I. (2006). Research ethics for social scientists. Sage. https://books.google.co.ke/books?hl=en&lr=&id=4Qtuv0CBuKkC&oi=fnd&pg=PP2&dq=research+ethics&ots=U7DuSgvOw7&sig=TWoquz7XbG3pLuSumYoUZOS8ZWI&redir_esc=y#v=onepage&q=research%20ethics&f=false Nissen, F., Morales, D. R., Mullerova, H., Smeeth, L., Douglas, I. J., & Quint, J. K. (2018). Concomitant diagnosis of asthma and COPD: a quantitative study in UK primary care. British Journal of General Practice, 68(676), e775-e782. https://bjgp.org/content/68/676/e775.short Sultoni, S., Gunawan, I., & Ningsih, S. O. (2018, October). Descriptive Study of Efforts Integrates Character Values to Students. In 3rd International Conference on Educational Management and Administration (CoEMA 2018) (pp. 12-14). Atlantis Press. https://www.atlantis-press.com/proceedings/coema-18/25903246 Zhao, Q., Meng, M., Kumar, R., Wu, Y., Huang, J., Lian, N., … & Lin, S. (2020). The impact of COPD and smoking history on the severity of COVID‐19: A systemic review and meta‐analysis. Journal of medical virology, 92(10), 1915-1921. https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25889
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in
ORIGINAL ASSIGNMENT SUBMITTED Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question  Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor. – Isn’t we need to revise the following PICOT question? Original PICOT Question in topic 1 – In adults who have been diagnosed with COPD exacerbations, does the use of pharmaceutical drugs such as antibiotics and bronchodilators improve the rate of recovery compared to the use of nutrition and oxygen therapy? Population (P): Adults > 18 years of age with COPD Intervention (I): Antibiotic Therapy and use of Bronchodilators Comparison (C): Use of nutrition and oxygen therapy Outcome (O): Quality of life (SGRQ), exacerbations (hospitalization rate and duration, and complications) Time (T): Short- to medium-term. The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study). Research Critiques In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions. There are total four articles but we only talked about 2 [Hodson, M. (2016) and Bades, A. (2014)] in the paper? There is no mention of authors Moore, D. (2019) and Alton, S., & Farndon, L. (2018). The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question. Does the analysis from all four articles connect in the answer? Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper. Proposed Evidence-Based Practice Change Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes. General Requirements Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in
Two qualitative, peer-reviewed research articles that were identified in the Topic 1 assignment to complete Topic 1 assignment. Nursing practice problem will be Chronic obstructive pulmonary disease (COPD) in adults. Literature Evaluation Table Chronic obstructive pulmonary disease (COPD) can be identified as a very common disease in adults. The chain smokers are prone to this disease more than non-smokers. This disease can get worse as a person age. Although COPD has traditionally been considered a disease that affects men, in some countries, the prevalence and associated mortality rate are higher among women than among men. The COPD can be defined as a chronic inflammatory lung disease characterized by airway obstruction. This is a progressive disease that continues to damage the lungs over time, making the affected individual have difficulties breathing. This condition is caused by long-term exposure to irritants such as cigarette smoke and irritating gases that can damage a person’s lungs. This condition has several symptoms that are associated with it. These symptoms include difficulty breathing, coughing, wheezing, tightness in the chest, and excess sputum production. People suffering from this condition are at risk of developing different conditions such as lung cancer, high blood pressure, heart problems, and depression. Two clinical conditions are normally associated with a chronic obstructive disorder; these are emphysema and chronic bronchitis (Celli, 2019). Individuals who have been diagnosed with COPD have both conditions. Emphysema slowly destroys the wall sacs of the lungs and is one reason people with COPD experience breathing difficulties. Chronic bronchitis results in narrowing and inflammation of the bronchial tubes, resulting in mucus build up in the lungs. The risk factors for COPD are exposure to tobacco smoke, asthma, exposure to dust, fumes from burning fuel and chemicals, and genetics. It is estimated that in the United States, approximately 30 million people are suffering from this condition. Although this condition is progressive, it is treatable. PICOT Question: In adults who have been diagnosed with COPD exacerbations, does the use of pharmaceutical drugs such as antibiotics and bronchodilators improve the rate of recovery compared to the use of nutrition and oxygen therapy? Population (P): Adults > 18 years of age with COPD Intervention (I): Antibiotic Therapy and use of Bronchodilators Comparison (C): Use of nutrition and oxygen therapy Outcome (O): Quality of life (SGRQ), exacerbations (hospitalization rate and duration, and complications) Time (T): Short- to medium-term. Criteria Article 2 Article 3 APA-Formatted Article Citation with Permalink Moore, D. (2019). Home oxygen therapy in patients with COPD: safety issues for nurse prescribers. British Journal of Nursing (Mark Allen Publishing), 28(14), 912–917. https://doi-org.lopes.idm.oclc.org/10.12968/bjon.2019.28.14.912 Permalink: https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=31348713&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1 Alton, S., & Farndon, L. (2018). The impact of community pharmacy-led medicines management support for people with COPD. British Journal of Community Nursing, 23(6), 214–219. https://doi-org.lopes.idm.oclc.org/10.12968/bjcn.2018.23.6.214 Permalink: https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=129785121&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1 How Does the Article Relate to the PICOT Question? The article is relevant to the picot question since it discusses the effectiveness of oxygen therapy and the safety of prescribing it to patients who have the COPD condition It relates to the PICOT question since it discusses the proper use of bronchodilators that are best administered with the use of handheld inhalers Quantitative, Qualitative (How do you know?) It uses qualitative research. This is because the article there is a questionnaire that has to be filled by the attending nurse that assesses the risk of using patients using oxygen therapy at their homes. The qualitative research method was used in research. They handed out questionnaires and used observation where pharmacy personnel was sent to assess how they were using their inhalers. Purpose Statement The aim of this article is, therefore, to evaluate an issue critically that poses a challenge to the RNS as an independent prescriber. The aim was to assess the impact of pharmacy-led medicines management support (in addition to the routine annual nurse-led reviews for long-term conditions) in patients with COPD in one community nursing team in Sheffield. Research Question What are the issues that are the issues that affect home oxygen prescription? Are patients using inhalers correctly in the administration of bronchodilators? Outcome The author found doubts on the use of home oxygen therapy since the identified risks were so many. Most of the patients did not know how to use the inhalers correctly. Setting (Where did the study take place?) Personal residence for Mrs.Sue White COPD patients living around Sheffield Sample One participant Fifty-four patients were included in the study; however, nine were excluded from the study due to different reasons Method Questionnaire and observation Observation and use of questionnaires Key Findings of the Study Many risks are associated with the use of oxygen therapy at home. The risks include fire hazards that can either result in the death of the patient and skin burns Most patients don’t know how to use inhalers properly, and those who have dementia, also referred to as cognitive impairment, had limited options for the proper administration of the medicine Recommendations of the Researcher Giving medical guidance and counseling to COPD individuals to stop smoking. Installation of safety equipment such as fire breaks and flow stop devices to reduce fire incidents. The author’s recommendations were to use alternative therapies for patients with dementia as they did not use their inhalers properly.

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