Capella 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

Remote Collaboration and Evidence-Based Care

Greetings. My name is _______, and today’s presentation focuses on interdisciplinary collaboration and its application in remote care teams. While exploring a case scenario from Vila Health, we will develop an evidence-based care plan for the patient that can be implemented in remote settings. Moreover, we will discuss how interprofessional collaboration benefits remote teams and how it can be leveraged in future care situations. Let us begin our presentation by discussing the background of the Vila Health scenario. 

Scenario and Proposed Evidence-Based Care Plan

Our patient is a 25-year-old transgender male who is diagnosed with gender dysphoria based on his behavioral health assessment. He lives in an underserved area with minimal access to healthcare facilities. The interdisciplinary healthcare team for this patient includes a physician, a nurse, a mental health expert, and an endocrinologist. After consulting with the physician, our patient has expressed his interest in receiving hormonal and surgical interventions for his health condition. In a virtual meeting, all interprofessional team members have decided to conduct an in-depth evaluation of the patient’s conditions to segregate gender dysphoria from other health conditions that may look alike before initiating hormonal or surgical treatment. 

Evidence-based Care Plan

The evidence-based care plan to improve patient safety and health outcomes in remote care settings includes comprehensive assessment, tele-education and counseling, hormonal therapy, and surgical intervention. 

• The plan begins with a thorough initial assessment conducted remotely, utilizing validated screening tools to evaluate the severity of gender dysphoria. These tools include the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (Brecht et al., 2024). Moreover, we will evaluate the patient’s mental health status using the standardized Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) scale (Hajek et al., 2023). These comprehensive assessments will also help in excluding health conditions that may mimic gender dysphoria for the confirmation of diagnosis. 
• Secondly, the plan leverages telehealth technology to offer tele-education and counseling sessions for our patients. Telehealth has emerged as a valuable tool for transgender populations to facilitate health education (Radix et al., 2022). Through virtual platforms, our interdisciplinary team will provide education on transgender healthcare, including the effects and risks of hormonal therapy and surgical interventions. Additionally, the team will offer psychological support and counseling to help the patient navigate their gender identity journey. Through telehealth, we aim to empower our patients, improve health care, and enhance healthcare accessibility for patients (Radix et al., 2022). 

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• Another evidence-based practice includes collaboration with an endocrinologist to initiate hormonal therapy. Following the established guidelines, the team will prescribe hormone replacement medications tailored to the patient’s needs and preferences. Hormone replacement therapy (HRT) can alleviate gender dysphoria by aligning secondary sex characteristics with gender identity, improving mental well-being and quality of life (Meyer et al., 2020). 
• Lastly, they will facilitate a surgical intervention under the guidance of a qualified surgeon. Anderson et al. (2022) elaborate on the benefits of surgical intervention by aligning physical attributes with gender identity, enhancing body satisfaction, and improving overall psychological functioning and social integration.

Further information related to the patient’s support system and potential barriers to healthcare access will help address specific patient needs. Moreover, data on the patient’s past experiences with healthcare providers and treatments for gender dysphoria could inform the approach to care and potential treatment preferences. Thus, this information aids in evidence-based decision-making. 

Evidence-Based Practice Model

We developed this evidence-based care plan using the Knowledge-to-Action (KTA) model. According to the ten Ham-Baloyi (2022), this model helps healthcare professionals to transfer evidence-based knowledge into practice. This leads to effective patient care. In developing the evidence-based care plan, firstly, the problem of gender dysphoria was identified by recognizing the need to address the issue in a transgender male patient. Then, credible and relevant evidence from literature studies was synthesized to determine the best practices for gender dysphoric patients.

These included comprehensive assessment, tele-education, and hormonal and surgical interventions. The third step consists of the collaboration of interdisciplinary teams to plan remote care for the patient. The next step includes assessing barriers to implementation and addressing them through virtual care delivery. Furthermore, the team will implement the care plan through virtual consultations, education sessions, and treatment initiation, coordinating with area-specific support groups and healthcare resources. Lastly, we will evaluate the outcomes of the interventions and adjust the plan as needed based on the patient’s response and feedback. Through this iterative process, the interprofessional team aims to ensure the delivery of evidence-based care, aligning with best practices and patient interests. 

A multifaceted approach is essential to evaluate the benefits of interventions to patient outcomes. Using Patient-Reported Outcomes Measures (PROMs), the team can assess subjective experiences. This method includes questions about the patients experiencing the interventions and their outcomes (Churruca et al., 2021). In our case, we will evaluate the improvements in gender dysphoria symptoms, mental health status, and quality of life. Additionally, we will measure objective metrics such as physical health indicators (e.g., hormone levels, vital signs), adherence to treatment regimens, and functional outcomes (e.g., ability to engage in daily activities and work productivity), providing valuable insights into the effectiveness of an evidence-based care plan. 

Evaluation of Evidence for Making Care Plan

Although every source of information used to make an evidence-based care plan is credible and valuable, the most useful and relevant source of evidence is Radix et al. (2022). While comprehensive assessments hormonal, and surgical interventions are essential and best practices for gender dysphoria patients, tele-education plays a crucial role in remote care settings to sustain the efforts of improving patient outcomes and quality of life. The authors of this literature study emphasize the importance of digital health and technologies in overcoming barriers of geographical distance and healthcare accessibility, primarily found in our patients’ care. Thus, the study demonstrates its relevance to our case study. Moreover, Radix et al. (2022) mention that tele-education allows for disseminating evidence-based information and resources, empowering patients to make informed decisions about their care.

Furthermore, virtual counseling sessions provide a safe and supportive environment for patients to explore their gender identity, address emotional concerns related to gender dysphoria, and develop coping strategies with the guidance of trained professionals. Therefore, this resource is precious for healthcare professionals to plan remote-based collaborative care for transgender patients in delivering comprehensive healthcare services, improving access, and enhancing patient outcomes. The CRAAP test is used to determine the value and relevance of this resource. According to this tool, resources that are currently published, have relevance to the topic/subject of the study, are authorized by field-specific experts and reputable journals, support their claim with accurate resources, and the purpose is aligned with the objective of the researchers, are credible, relevant, and valuable (Esparrago-Kalidas, 2021). The article by Radix et al. (2022) fulfills all these criteria, representing it as a trustworthy resource. 

Interdisciplinary Collaboration

Interdisciplinary remote collaboration offers several benefits, including enhanced patient care outcomes, comprehensive care planning, and holistic support. With the diverse expertise of these professionals, such as physicians, nurses, mental health experts, and endocrinologists, the teams can deliver comprehensive care to address the complex needs of patients. In telehealthcare services, this collaboration fosters shared clinical decision-making and promotes continuity of care, ensuring patients’ safety and improved outcomes (Tan et al., 2023). However, several communication and collaboration challenges may emerge during remote care coordination, including communication barriers and lack of accessibility and knowledge regarding technological use. 

To mitigate these challenges, the teams must establish clear communication protocols and utilize effective communication tools to bridge gaps in communication styles and accommodate different time zones. Additionally, providing training and technical support to team members on telehealth platforms can improve proficiency and confidence in using remote collaboration tools. Regular team meetings with defined agendas and designated time slots for discussion can foster open communication and ensure alignment on goals and objectives despite geographical distances. Interdisciplinary training programs are one of the ways interprofessional collaboration can be better leveraged to manage future care situations effectively. These cross-disciplinary educational programs will foster a culture of coordination and mutual respect within the teams (Zechariah et al., 2019), resulting in successful care planning and implementation. 

 Conclusion

I want to conclude my presentation by stating that remote collaboration is an essential component of healthcare that emerged after the pandemic. In our patient’s case, limited healthcare access and geographical limitations have diminished health outcomes. Thus, an evidence-based care plan that includes comprehensive assessment, tele-education and counseling, and hormonal and surgical interventions is designed using credible and relevant sources of evidence. To effectively implement this care plan, interprofessional collaboration is imperative. Thus, it is necessary to take the required measures to mitigate the challenges of care teams and improve coordination, ultimately enhancing patient outcomes and quality of life. 

 References

Anderson, D., Wijetunge, H., Moore, P., Provenzano, D., Li, N., Hasoon, J., Viswanath, O., Kaye, A. D., & Urits, I. (2022). Gender dysphoria and its non-surgical and surgical treatments. Health Psychology Research, 10(3), 38358. https://doi.org/10.52965/001c.38358 

Brecht, A., Bos, S., Ries, L., Hübner, K., Widenka, P.-M., Winter, S. M., & Calvano, C. (2024). Analyzing body dissatisfaction and gender dysphoria in the context of minority stress among transgender adolescents. Child and Adolescent Psychiatry and Mental Health, 18(1), 30. https://doi.org/10.1186/s13034-024-00718-y 

Churruca, K., Pomare, C., Ellis, L. A., Long, J. C., Henderson, S. B., Murphy, L. E. D., Leahy, C. J., & Braithwaite, J. (2021). Patient‐reported outcome measures (PROMS): A review of generic and condition‐specific measures and a discussion of trends and issues. Health Expectations : An International Journal of Public Participation in Health Care and Health Policy, 24(4), 1015–1024. https://doi.org/10.1111/hex.13254 

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Esparrago-Kalidas, A. J. (2021). The effectiveness of CRAAP test in evaluating credibility of sources. International Journal of TESOL & Education, 1(2), 1–14. https://i-jte.org/index.php/journal/article/view/25 

Hajek, A., König, H.-H., Buczak-Stec, E., Blessmann, M., & Grupp, K. (2023). Prevalence and determinants of depressive and anxiety symptoms among transgender people: Results of a survey. Healthcare, 11(5). https://doi.org/10.3390/healthcare11050705

Meyer, G., Boczek, U., & Bojunga, J. (2020). Hormonal gender reassignment treatment for gender dysphoria. Deutsches Ärzteblatt International, 117(43), 725–732. https://doi.org/10.3238/arztebl.2020.0725

Radix, A. E., Bond, K., Carneiro, P. B., & Restar, A. (2022). Transgender individuals and digital health. Current HIV/AIDS Reports, 19(6), 592–599. https://doi.org/10.1007/s11904-022-00629-7

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Tan, A. J. Q., Chua, W. L., McKenna, L., Tan, L. L. C., Lim, Y. J., & Liaw, S. Y. (2023). Interprofessional collaboration in telemedicine for long‐term care: An exploratory qualitative study. Journal of Nursing Scholarship, 55(6), 1227–1237. https://doi.org/10.1111/jnu.12925 

ten Ham-Baloyi, W. (2022). Assisting nurses with evidence-based practice: A case for the Knowledge-to-Action Framework. Health SA Gesondheid, 27, 2118. https://doi.org/10.4102/hsag.v27i0.2118

Zechariah, S., Ansa, B. E., Johnson, S. W., Gates, A. M., & Leo, G. D. (2019). Interprofessional education and collaboration in healthcare: An exploratory study of the perspectives of medical students in the United States. Healthcare, 7(4), 117. https://doi.org/10.3390/healthcare7040117 

Capella 4030 Assessment 3 Picot Questions and An Evidence Based Approach

Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

PICO (T) Questions and an Evidence-Based Approach

Chronic Obstructive Pulmonary Disease (COPD) is a progressive and complex health condition requiring a multifaceted approach to care. This approach results in effective COPD management and positive patient outcomes if integrated with credible evidence. While exploring further, this assessment focuses on a PICO(T) question related to the disease and credible and relevant evidence that helps answer the inquiry. Lastly, based on these evidence-based findings, we conclude a decision for our PICO(T) question elaborated in this paper. 

Practice Issue to be Explored and PICO(T) Question

COPD is a chronic inflammatory lung disease characterized by persistent airway restriction. Two conditions typically emerge due to constant airflow limitations: chronic bronchitis and emphysema. Several factors contribute to the development of the diseases, including smoking, environmental exposure to pollutants (such as secondhand smoke, occupational dust, and chemicals), genetic predisposition, and respiratory infections (Yan et al., 2020). Among these, smoking is the primary and substantial risk factor, accounting for 15.2% of cases in individuals who are currently smoking and 7.6% in past smokers. Prolonged exposure to cigarette smoke damages the respiratory pathways, leading to inflammation, narrowing of the airways, and destruction of lung tissue (Wheaton et al., 2019). Smoking cessation is the most effective intervention to prevent COPD and its complications. Through a PICO(T) approach, we aim to explore the effectiveness of smoking cessation among smoking individuals diagnosed with COPD. 

PICO(T) Inquiry

Among smokers with early-stage COPD (P), does combined smoking cessation interventions (behavioral and pharmacological options) (I) compared to standard care (C) reduce the risk of disease progression and exacerbations (O)? 

Benefit of PICO(T) Approach

A PICO(T) approach offers a structured framework for formulating focused research questions and guiding evidence-based inquiry (Hosseini et al., 2024). Exploring the effectiveness of smoking cessation as compared to medication management in COPD patients through the PICO(T) approach will enable healthcare professionals to conduct a systematic review of the existing evidence, identify the gaps in knowledge, and evaluate the evidence to make informed decisions (Hosseini et al., 2024). Additionally, the approach will facilitate the application of credible findings to clinical practice, informing individualized treatment strategies and public health interventions aimed at reducing the COPD burden associated with smoking. Moreover, employing a PICO(T) approach enhances the applicability of research on COPD and smoking, ultimately improving patient outcomes and advancing healthcare practice. 

Identification of Sources of Evidence

Based on the eligibility criteria, several resources are identified that can potentially answer the PICO(T) question. The requirements include relevance, currency, scope and coverage, methodological rigor, and applicability. 

• Relevance: The resources should contain relevant information to the PICO(T) question (Dagne & Beshah, 2021). In this case, the sources of information focus on best practices and interventions related to COPD. 
• Currency: The resources should provide up-to-date evidence, including recent research studies, systematic reviews, and guidelines, to ensure the information is current and applicable to contemporary healthcare practice (Tawfik et al., 2019). 
• Scope and Coverage: The resources should cover a broad range of relevant topics related to the topic (Hosseini et al., 2024), such as COPD management, smoking cessation interventions, pharmacotherapy options, and long-term outcomes, ensuring comprehensive coverage of the research question.
• Methodological Rigor: Research studies and systematic reviews should demonstrate the rigorous methodology, including appropriate study designs, sample sizes, statistical analysis, and risk of bias assessment, to ensure the reliability and validity of the findings (Tawfik et al., 2019). 
• Applicability: The resources should provide information that applies to clinical practice, guiding healthcare providers in making evidence-based decisions (Dagne & Beshah, 2021), for example, regarding smoking cessation interventions and COPD management strategies for patients with early-stage COPD.

Capella 4030 Assessment 3

To effectively answer the PICO(T) question regarding smoking cessation intervention as compared to pharmacotherapy in COPD patients, several sources of evidence can be utilized. These include databases like PubMed and Cochrane Library. PubMed is a comprehensive database containing many peer-reviewed articles and systematic reviews relevant to COPD management and smoking cessation interventions (Ossom Williamson & Minter, 2019). Similarly, the Cochrane Library specializes in systematic reviews and evidence synthesis, providing high-quality, up-to-date reviews on the effectiveness of various diseases and their interventions, including smoking cessation strategies and their impact on COPD outcomes.

Moreover, a peer-reviewed journal, the American Journal of Respiratory and Critical Care Medicine (AJRCCM) can be utilized to identify research articles and reviews on respiratory diseases, including COPD and smoking cessation interventions. Lastly, the American Thoracic Society (ATS) Website offers guidelines, position statements, and resources related to respiratory diseases and smoking cessation, representing a reputable source of evidence-based information and its relevance to our PICO(T) inquiry (American Thoracic Society, n.d.). These sources effectively answer the PICO(T) question based on the criteria presented earlier. 

Findings from the Relevant Sources of Evidence

Several findings are relevant to the PICO question about smoking cessation in comparison with standard care. 

• A research article presented in the PubMed database by Andreas et al. (2023) mentions the importance of smoking abstinence to improve outcomes for COPD patients. The article emphasizes the effectiveness of smoking cessation therapy, including a combination of behavioral and pharmacological interventions (treating withdrawal symptoms), to alleviate the risk of COPD progression and reduce healthcare costs. 
• Galiatsatos et al. (2021) present a clinical guideline by ATS, highlighting the efficacy of integrated smoking cessation and medication management for tobacco-dependent individuals, including COPD patients who are currently habitual of smoking. This practice guideline focuses on the effectiveness of pharmacologic treatment as part of comprehensive smoking cessation interventions, including the use of medications such as nicotine replacement therapy (NRT), bupropion, and varenicline. The findings of this resource are that these interventions reduced the decline in lung function and alleviated the risk of exacerbations and disease progression, making them the most credible for PICO(T) inquiry. 

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• Another article by Tsikrika et al. (2023) underscores the efficacy of combination smoking cessation therapy. The findings from this study are that quitting smoking can improve COPD conditions, reduce the risk of mortality, and improve lung function. However, it is only possible if behavioral and pharmacotherapy interventions are employed together. This article also highlights that some authors still focus on the effectiveness of standard care, such as pulmonary rehab and bronchodilators. Yet, advances in research focus on smoking cessation through combined efforts as they have promising outcomes for elevating smoking abstinence. This resource is highly credible as it provides relevant and up-to-date information. Moreover, it fulfills the criteria of credibility and relevance, as mentioned earlier. 

Decision-Making on PICO Question Using the Findings

Based on the findings from the literature, it is evident that combined smoking cessation interventions, encompassing both behavioral and pharmacological options, offer significant benefits in reducing the risk of disease progression and exacerbations among smokers with early-stage COPD. The most relevant findings are from the studies by Galiatsatos et al. (2021) and Tsikrika et al. (2023). These articles specifically guide healthcare professionals about the pharmacotherapy options that can improve patient health, reduce the risk of disease progression, decrease healthcare costs, and improve lung function.

Behavioral interventions, such as counseling and support programs, combined with pharmacological options like nicotine replacement therapy and medications such as varenicline, have been shown to promote smoking cessation and improve COPD outcomes effectively. Thus, the decision on our PICO(T) inquiry is to use combined smoking cessation to improve patient health, reduce the risk of disease progression, decrease healthcare costs, and improve lung function. While some studies still focus on standard care interventions such as pulmonary rehabilitation and bronchodilators, recent advances and evidence-based practices underscore the critical importance of smoking cessation in COPD management. Therefore, smoking cessation interventions should be prioritized in the management of smokers with early-stage COPD to reduce disease progression and exacerbations.  

References

American Thoracic Society. (n.d.). Ats website. https://www.thoracic.org/about/governance/ats-website/index.php

Andreas, S., Kotz, D., Batra, A., Hellmann, A., Mühlig, S., Nowak, D., Schultz, K., Worth, H., & Schüler, S. (2023). Smoking cessation in patients with COPD. Pneumologie (Stuttgart, Germany), 77(4), 206–219. https://doi.org/10.1055/a-2020-4284 

Dagne, A. H., & Beshah, M. H. (2021). Implementation of evidence-based practice: The experience of nurses and midwives. PLoS ONE, 16(8), e0256600. https://doi.org/10.1371/journal.pone.0256600

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Galiatsatos, P., Garfield, J., Melzer, A. C., Leone, F. T., Farber, H. J., Ruminjo, J. K., & Thomson, C. C. (2021). Summary for clinicians: An ATS clinical practice guideline for initiating pharmacologic treatment in tobacco-dependent adults. Annals of the American Thoracic Society, 18(2), 187–190. https://doi.org/10.1513/AnnalsATS.202008-971CME 

Hosseini, M.-S., Jahanshahlou, F., Akbarzadeh, M. A., Zarei, M., & Vaez-Gharamaleki, Y. (2024). Formulating research questions for evidence-based studies. Journal of Medicine, Surgery, and Public Health, 2, 100046. https://doi.org/10.1016/j.glmedi.2023.100046

Ossom Williamson, P., & Minter, C. I. J. (2019). Exploring PubMed as a reliable resource for scholarly communications services. Journal of the Medical Library Association : JMLA, 107(1), 16–29. https://doi.org/10.5195/jmla.2019.433 

Tawfik, G. M., Dila, K. A. S., Mohamed, M. Y. F., Tam, D. N. H., Kien, N. D., Ahmed, A. M., & Huy, N. T. (2019). A step by step guide for conducting a systematic review and meta-analysis with simulation data. Tropical Medicine and Health, 47(1), 46. https://doi.org/10.1186/s41182-019-0165-6

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Tsikrika, S., Dai, S., Dilektasli, A., Katsaounou, P., & Dagli, E. (2023). Challenges and perspectives of tobacco cessation in special groups of patients and populations. Breathe, 19(2), 220224. https://doi.org/10.1183/20734735.0224-2022 

Wheaton, A. G., Liu, Y., Croft, J. B., VanFrank, B., Croxton, T. L., Punturieri, A., Postow, L., & Greenlund, K. J. (2019). Chronic obstructive pulmonary disease and smoking status—United States, 2017. Morbidity and Mortality Weekly Report, 68(24), 533–538. https://doi.org/10.15585/mmwr.mm6824a1 

Yan, X., Xu, L., Shi, B., Wang, H., Xu, X., & Xu, G. (2020). Epidemiology and risk factors of chronic obstructive pulmonary disease in Suzhou: A population-based cross-sectional study. Journal of Thoracic Disease, 12(10), 5347–5356. https://doi.org/10.21037/jtd-20-1616 

Capella 4030 Assessment 2 Determining the Credibility of Evidence and Resources

Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

Determining the Credibility of Evidence and Resources

This paper explores Chronic Obstructive Pulmonary Disease (COPD) further and identifies credible and relevant sources of information related to the disease. Additionally, we explore the evidence-based approach and its benefits for COPD management. Finally, this analysis elaborates on an Evidence-Based Practice (EBP) model, integrating credible evidence to improve the quality of healthcare delivery and COPD care in healthcare facilities. 

COPD and Evidence-based Approach

COPD is a respiratory illness resulting from constricting airways due to constant exposure to lung irritants. This health condition is declared the sixth leading cause of mortality in the United States, with a prevalence of 6.5%, i.e., 14.2 million individuals, in 2021 (Liu et al., 2023). COPD commonly manifests as chronic cough, shortness of breath, wheezing, and chest tightness. The disease has a multifactorial etiology involving genetic predisposition and environmental exposures like smoking. Moreover, it is a progressive disease, resulting in variable symptoms and exacerbations (Safiri et al., 2022). Due to the complex nature of the health condition, a comprehensive and multidisciplinary approach to care is necessary. Thus, an evidence-based approach is crucial in managing COPD. 

The EBP approach integrates the best evidence from research studies, clinical guidelines, and expert consensus. Moreover, it includes patient-centered care, emphasizing patients’ needs and preferences (Li et al., 2019). This approach assists healthcare professionals in optimizing patient outcomes and ensuring the delivery of high-quality care. In the context of COPD, healthcare providers can make informed decisions about COPD management strategies, choosing the best practices and proven methods for enhancing patient outcomes. Furthermore, this approach promotes continuous learning and professional development among healthcare professionals, fostering a culture of critical thinking, inquiry, and innovation in COPD care. 

Criteria to Determine the Credibility of Online Resources

The widely used criteria in healthcare research for determining the credibility and relevance of journal articles and websites are CRAAP. 

CRAAP Criteria

The CRAAP test is an evaluation tool used for academic and research articles. It is a mnemonic for Currency, Relevance, Authority, Accuracy, and Purpose. One of the example articles by Khan et al. (2023) fulfills the CRAAP criteria as follows: 

1. Currency: The article was published in 2023, making the information up-to-date. 
2. Relevance: It provides reliable insights into COPD management among hospitalized patients, demonstrating relevance to the chosen diagnosis. 
3. Authority: Published in a reputable journal (Cureus) by field-specific and expert authors. 
4. Accuracy: The information is supported by credible evidence, enhancing its accuracy and precision. 
5. Purpose: The review aims to provide readers with evidence-based information on COPD management, enhance knowledge, and improve clinical practices. 

Credible and Relevant Sources of Information

In the pool of online information, several sources of information are available that fulfill the criteria of credibility and relevance. Some of the sources related to COPD care and management are elaborated below: 

• The article by Liu et al. (2023) is a credible report on the prevalence of COPD, highlighting the importance of early interventions and adequate management of the disease to reduce the incidence rate and poor consequences. Thus making it highly relevant and purposeful for healthcare professionals and public health experts to improve COPD outcomes. It is a 2023 publication, indicating recentness and providing up-to-date information on COPD prevalence trends. The authors are affiliated with reputable organizations, and the article was reported by the Centers for Disease Control and Prevention (CDC), lending credibility to the study. It is supported by various relevant and recent studies, indicating its accuracy and validity. 

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• Another research article in the PubMed database by Wodwaski and Webber (2023) is highly credible. This is the most useful resource as it directly addresses the evaluation and management of COPD patients, providing guidelines for healthcare providers to care for them and reduce the risk of readmissions and complications. This resource fulfills the CRAAP criteria as it is a recent publication highly relevant for healthcare professionals. It is an authorized publication in a professional and modern journal, focusing on the needs of hospice and home care nurses. Credible references accurately support the article and have a clear purpose of guiding healthcare practices related to COPD management. 
• Nici et al. (2020) have written official practice guidelines from the American Thoracic Society (ATS), published in its official publication, the American Journal of Respiratory and Critical Care Medicine. It is one of the most useful resources as it guides healthcare practices according to the standardized guidelines developed by reputation organizations, experting in thoracic medicine. It is a CRAAP-based resource, published recently, highly relevant for healthcare professionals and researchers in pulmonary medicine. Moreover, it is accurate and has no biases, with a clear purpose of guiding healthcare practices related to the pharmacological management of COPD. 

Integrating Credible Evidence into an EBP Model

Integrating credible and relevant information into an EBP model is crucial for addressing COPD effectively. Credible evidence from research articles, practice guidelines, and reputable organizations helps healthcare professionals make effective decisions about disease management (Li et al., 2019). Through an evidence-based practice model, the researchers can utilize a systematic approach of inquiry and clinical decision-making to optimize patient outcomes, minimize risks, and enhance the efficiency of healthcare delivery. One example of an EBP model is the Knowledge to Action (KTA) model. It is an organized framework for translating evidence into practice. The KTA model permits healthcare systems to bridge the gap between knowledge and action, leading to more effective, efficient, and patient-centered care (ten Ham-Baloyi, 2022). It is a seven-step model, beginning with identifying the issue/knowledge gap, such as COPD care and management.

Then, the credible and best research evidence is synthesized and distilled on COPD treatments and interventions. This step helps healthcare professionals to gain a comprehensive understanding of effective strategies. In the next step, the researchers adapt the synthesized knowledge and tools to fit the local context and meet the specific needs of patients with COPD, considering patient preferences, resource availability, and organizational culture. Additionally, implementation strategies, such as education, training, and quality improvement initiatives, facilitate healthcare providers’ uptake of evidence-based practices. Lastly, continuous monitoring, evaluation, and feedback mechanisms are established to enable iterative refinement of evidence-based practices based on patient outcomes and healthcare experiences (ten Ham-Baloyi, 2022).

References

Khan, K. S., Jawaid, S., Memon, U. A., Perera, T., Khan, U., Farwa, U. E., Jindal, U., Afzal, M. S., Razzaq, W., Abdin, Z. U., & Khawaja, U. A. (2023). Management of chronic obstructive pulmonary disease (COPD) exacerbations in hospitalized patients from admission to discharge: A comprehensive review of therapeutic interventions. Cureus, 15(8), e43694. https://doi.org/10.7759/cureus.43694 

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses—systematic review. Medicine, 98(39), e17209. https://doi.org/10.1097/MD.0000000000017209 

Liu, Y., Carlson, S. A., Watson, K. B., Xu, F., & Greenlund, K. J. (2023). Trends in the prevalence of chronic obstructive pulmonary disease among adults aged ≥18 years—United States, 2011–2021. MMWR. Morbidity and Mortality Weekly Report, 72. https://doi.org/10.15585/mmwr.mm7246a1

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Nici, L., Mammen, M. J., Charbek, E., Alexander, P. E., Au, D. H., Boyd, C. M., Criner, G. J., Donaldson, G. C., Dreher, M., Fan, V. S., Gershon, A. S., Han, M. K., Krishnan, J. A., Martinez, F. J., Meek, P. M., Morgan, M., Polkey, M. I., Puhan, M. A., Sadatsafavi, M., … Wedzicha, J. A. (2020). Pharmacologic management of chronic obstructive pulmonary disease. An official American Thoracic Society clinical practice guideline. American Journal of Respiratory and Critical Care Medicine, 201(9), e56–e69. https://doi.org/10.1164/rccm.202003-0625ST 

Safiri, S., Carson-Chahhoud, K., Noori, M., Nejadghaderi, S. A., Sullman, M. J. M., Ahmadian Heris, J., Ansarin, K., Mansournia, M. A., Collins, G. S., Kolahi, A.-A., & Kaufman, J. S. (2022). Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: Results from the Global Burden of Disease Study 2019. BMJ, e069679. https://doi.org/10.1136/bmj-2021-069679

ten Ham-Baloyi, W. (2022). Assisting nurses with evidence-based practice: A case for the Knowledge-to-Action Framework. Health SA Gesondheid, 27, 2118. https://doi.org/10.4102/hsag.v27i0.2118 

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Wodwaski, N., & Webber, E. (2023). Assessment and management of COPD. Home Healthcare Now, 41(1), 6–13. https://doi.org/10.1097/NHH.0000000000001126 

Capella 4030 Assessment 1 Locating Credible Databases and Research

Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

Locating Credible Databases and Research – Introduction 

Chronic Obstructive Pulmonary Disease (COPD) is a respiratory health problem characterized by obstructed airways, resulting in difficulty breathing. The main contributing factor of this disease is the long-term exposure to respiratory irritants, such as smoke. This paper delves into locating credible and relevant evidence on COPD, assisting novice nurses in researching the diagnosis and adequately managing such patients in clinical settings. Furthermore, in the paper, the reader will learn about the collaboration and communication strategies that can be employed between senior and junior nurses. Moreover, the paper discusses the best places within the healthcare environment for research and identifies five credible online sources for COPD research. Lastly, it elaborates on the criteria that can be used to evaluate the credibility and relevance of these resources. 

Communication and Collaboration Strategies

Senior nurses within clinical settings are responsible for assisting newly trained nurses in understanding and researching credible evidence related to unfamiliar diagnoses. For such purposes, they must employ several communication and collaboration strategies to develop their professional competence and establish good professional relationships. 

Education Programs

Research education programs where nurses are trained in conducting literature reviews, accessing relevant databases, and searching and appraising relevant literature have improved knowledge and confidence, clinical practices, and patient outcomes (King et al., 2022). These training programs augment their professional competence by fostering a culture of continuous learning and empowering novice nurses with evidence-based practice. Moreover, these programs led by senior nurses can promote collaboration and build professional relationships within the team. 

Journal Clubs 

Another strategy is to establish COPD-focused journal clubs. These clubs benefit participants by allowing them to gather regularly for critical appraisal and discussions on recent research articles on healthcare issues/diseases. These clubs promote understanding of healthcare topics and evidence-based practices among nurses (Hassan et al., 2023). Through journal clubs, novice nurses learn to evaluate the quality and relevance of research literature, enhancing their professional competence to conduct evidence-based practice. Additionally, senior nurses can participate as facilitators, strengthening professional relationships within the nursing team. 

Mentoring 

Pairing novice nurses with experienced mentors with expertise in COPD care and research is another collaboration strategy. This structured support system provides novice nurses personalized guidance and experiences from senior nurses related to patient care to accelerate their learning curve, research productivity, and professional competence. Moreover, this mentoring system cultivates a sense of fellowship and mutual respect between senior and junior nurses, laying the foundation for long-lasting professional relationships (Gularte-Rinaldo et al., 2023). 

The Best Places to Access Resources within the Workplace

The best places within our hospital to locate credible and relevant evidence related to COPD include computer labs, nursing workstation computers, the nursing education department, and interdisciplinary team meetings. Senior nurses will guide the novice nurse to the computer lab for the hospital’s online library. They may access various medical research databases pertinent to COPD, such as CINAHL, PubMed, Medline, and the Cochrane Library. These databases provide access to many scholarly articles, systematic reviews, and clinical trials, enabling the nurse to gather evidence-based information (Oermann et al., 2021). Next, experienced nurses would encourage juniors to use computers at the nursing station to search for hospital policies, procedures, and guidelines for COPD management.

Accessing these resources directly at the workstation ensures convenience and efficiency, allowing nurses to seamlessly integrate evidence into their clinical practice. The hospital policies and procedures are good resources as they include best practices endorsed by the institution, ensuring consistency of care within the hospital (Foley, 2020). The nursing education department may have physical resources, such as textbooks and journals on COPD management. Moreover, they offer training workshops on evidence-based practices to help novice nurses explore and deepen their understanding of diseases (King et al., 2022). Lastly, novice nurses can be encouraged and taken to interdisciplinary team meetings to access expertise and knowledge from various healthcare professionals involved in COPD management. 

The Five Credible Sources and their Justification

The five credible sources of information related to COPD are listed according to the ranking related to their usefulness for nurses. 

• PubMed is the most helpful source for nurses to find evidence on COPD as it extensively covers medical research, providing credible, authoritative, and peer-reviewed information (Ossom Williamson & Minter, 2019). 
• Second on the list is the American Thoracic Society (ATS) website. This website offers guidelines, position statements, and resources for respiratory diseases, including COPD. As a reputable professional organization in the field of pulmonary medicine, the ATS website’s information is evidence-based and trustworthy, making it a valuable source for nurses (American Thoracic Society, n.d.). 

Capella 4030 Assessment 1

• Third is the Agency for Healthcare Research and Quality (AHRQ), which produces evidence-based reports, guidelines, and tools to improve healthcare quality and safety in the United States. AHRQ’s focus on synthesizing and disseminating high-quality evidence makes it a beneficial source for US-based nurses to implement evidence-based practices (AHRQ, n.d.). 
• Another valuable database is the Cochrane Library. It specializes in systematic reviews and evidence synthesis, providing high-quality, up-to-date reviews of interventions for various health conditions, including COPD. It is an excellent source of evidence on the effectiveness of different treatment options and interventions in COPD management.
• Lastly, the National Heart, Lung, and Blood Institute (NHLBI) website offers evidence-based information on COPD, including diagnosis, management, and research updates. The resources on this website help researchers and healthcare professionals design care plans and decision-making related to COPD management (NHLBI, NIH, 2023). 

Criteria to Determine Credibility of Resources

Two tools can be employed to assess resource credibility: the CRAAP test and the DISCERN tool. According to Esparrago-Kalidas (2021), the CRAAP test is a tool used to evaluate the credibility and quality of information sources, such as academic and research articles. It assesses sources based on Currency, Relevance, Authority, Accuracy, and Purpose. Currency examines the timeliness of the information, while relevance assesses its relation to the topic. Additionally, authority evaluates the credibility of the author and publishing journal, and accuracy examines the reliability of the information. Finally, purpose assesses the intentions behind the authors’ work. 

On the other hand, the DISCERN tool is a systematic method of evaluating the quality of online health information, such as patient education materials on various websites. It consists of 16 questions designed to assess multiple aspects of the resource, including reliability, relevance, and bias. DISCERN examines factors such as the scope and aims of the resource, the credibility of the sources cited, the balance of information presented, and the evidence supporting the claims made. By applying the DISCERN tool, individuals can make informed judgments about the credibility and usefulness of health information resources, ensuring they access accurate and reliable information to inform their healthcare decisions (Daraz & Bouseh, 2021).

References

AHRQ. (n.d.). Agency For Healthcare Research and Quality: A profile. https://www.ahrq.gov/cpi/about/profile/index.html 

American Thoracic Society. (n.d.). Ats website. https://www.thoracic.org/about/governance/ats-website/index.php

Daraz, L., & Bouseh, S. (2021). Developing a quality benchmark for determining the credibility of web health information- a protocol of a gold standard approach. Frontiers in Digital Health, 3, 801204. https://doi.org/10.3389/fdgth.2021.801204

Esparrago-Kalidas, A. J. (2021). The effectiveness of CRAAP test in evaluating credibility of sources. International Journal of TESOL & Education, 1(2), 1–14. https://i-jte.org/index.php/journal/article/view/25

Capella 4030 Assessment 1

Foley, C. M. (2020). A study of the relationship between hospital policy and nursing practice Thesis, University of Tasmania. https://doi.org/10.25959/100.00035866 

Hassan, N., Singh, K., Kunjavara, J., Mannethodi, K., Alomari, A. M. A., Joy, G. V., Singh, R., & Al Lenjawi, B. (2023). Development and validation of the Nursing Journal Club Perception Scale (NJCPS). Journal of Education and Health Promotion, 12, 213. https://doi.org/10.4103/jehp.jehp_1043_22 

Gularte-Rinaldo, J., Baumgardner, R., Tilton, T., & Brailoff, V. (2023). Mentorship respect study: A nurse mentorship program’s impact on transition to practice and decision to remain in nursing for newly graduated nurses. Nurse Leader, 21(2), 262–267. https://doi.org/10.1016/j.mnl.2022.07.003 

King, O., West, E., Lee, S., Glenister, K., Quilliam, C., Wong Shee, A., & Beks, H. (2022). Research education and training for nurses and allied health professionals: A systematic scoping review. BMC Medical Education, 22, 385. https://doi.org/10.1186/s12909-022-03406-7 

NHLBI, NIH. (2023, October 25). Copd research. https://www.nhlbi.nih.gov/research/copd 

Capella 4030 Assessment 1

Oermann, M. H., Wrigley, J., Nicoll, L. H., Ledbetter, L. S., Carter-Templeton, H., & Edie, A. H. (2021). Integrity of databases for literature searches in nursing. Ans. Advances in Nursing Science, 44(2), 102–110. https://doi.org/10.1097/ANS.0000000000000349

Ossom Williamson, P., & Minter, C. I. J. (2019). Exploring PubMed as a reliable resource for scholarly communications services. Journal of the Medical Library Association : JMLA, 107(1), 16–29. https://doi.org/10.5195/jmla.2019.433 

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

Remote Collaboration and Evidence-Based Care

Hello, everyone. My name is Raven; today I’ll be talking about how evidence-based treatment and remote cooperation can work together to handle a patient’s case in a rural area successfully. The patient, a man with chronic obstructive pulmonary disease (COPD) who is 70 years old, faces limited access to specialized pulmonary care due to geographical constraints. I’ll explain how remote collaboration can effectively manage his COPD, utilize an evidence-based practice model to tailor his care plan and identify the most relevant evidence for developing this plan. Additionally, I will address strategies to overcome obstacles and challenges in interdisciplinary collaboration.

Evidence-Based Care Plan

To enhance the safety and results for the Vila Health patient, a remote team of healthcare experts has to collaborate to develop an evidence-based care plan. An interdisciplinary team of healthcare providers is included in the plan since the patient presents with symptoms such as a chronic cough, shortness of breath, and recurring respiratory infections. The pulmonologist advises starting bronchodilator therapy, which includes inhaled corticosteroids and long-acting beta-agonists. Clinical guidelines from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) approve this combination therapy. It improves lung function and reduces symptoms in COPD patients (Suissa, 2023). The pharmacist will ensure the patient understands the proper use of inhalers, review potential drug interactions, and educate the patient on the importance of medication adherence to prevent exacerbations and hospitalizations.

The respiratory therapist will continue conducting remote pulmonary rehabilitation sessions, including breathing techniques, advice on physical activity, and knowledge of worsening exacerbations. Studies have demonstrated that remote pulmonary rehabilitation can significantly enhance exercise tolerance, reduce breathlessness, and enhance COPD patients’ quality of life (Wedzicha et al., 2024). The therapist will track the patient’s progress and modify the exercises as necessary.The primary care nurse, Sarah, will schedule regular virtual follow-up visits to monitor the patient’s progress, assess symptoms, and make necessary adjustments to the treatment plan. These follow-ups will help detect issues early, allowing prompt intervention and continuous support (Cristina Rezende1 et al., 2023).

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Education is crucial for managing COPD effectively. The pharmacist and respiratory therapist will provide comprehensive education to the patient and his family about COPD, proper inhaler technique, lifestyle modifications, and recognizing early signs of exacerbations. This education will empower the patient to manage his condition more effectively and reduce the risk of complications (Yıldırım & Kaşıkçı, 2023). Given the patient’s rural location, telehealth technology will be leveraged to facilitate ongoing care. This includes video consultations, remote monitoring devices to track vital signs and lung function, and digital tools for symptom tracking (Cristina Rezende1 et al., 2023). Training the patient and his family on these technologies will ensure effective communication and monitoring.

Additional information and data that could have been useful include detailed medical history and previous treatments for COPD to understand what has or has not worked in the past. Moreover, a comprehensive assessment of the patient’s home environment must identify potential hazards or barriers to effective self-management. Furthermore, information on the patient’s access to technology and internet connectivity is crucial for implementing remote care solutions. Lastly, the data on the patient’s nutritional status and any other comorbid conditions that could impact his COPD management should be considered, along with insights into the patient’s support system, including family or community resources, to ensure he has adequate assistance at home.

Ways to Use and Apply Evidence-Based Practice Model

The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model was crucial in developing our care plan for the Vila Health patient with COPD. We followed the steps outlined in the JHNEBP Model: Posing a clinical inquiry, gathering data, analyzing and interpreting that data, fusing that data with patient preferences and clinical knowledge, and assessing the results (Hu & Whitney, 2023). Firstly, we formulated a clinical question based on the patient’s needs and symptoms, such as “What interventions are most effective in managing COPD symptoms in rural patients?” This helped guide our search for relevant evidence. Next, we conducted a thorough literature review to collect evidence from peer-reviewed journals, clinical guidelines, and research studies using different databases, including Google Scholar, PubMed, Cochrane Library, and CINAHL. We focused on finding evidence supporting interventions such as bronchodilator therapy, pulmonary rehabilitation, and patient education in managing COPD effectively.

We critically appraised the gathered evidence to assess its validity, reliability, and relevance to our patient’s case. This step ensured that we only incorporated high-quality evidence into our care plan. Integrating clinical knowledge with the evidence involved synthesizing the research findings with the knowledge and experience of our multidisciplinary team, including the pulmonologist, respiratory therapist, pharmacist, and primary care nurse. Together, we determined the most appropriate interventions tailored to the patient’s needs and preferences. Finally, we will evaluate the outcomes of our care plan by monitoring the patient’s progress through regular follow-up visits and assessing changes in symptoms, lung function, quality of life, and treatment adherence. Additionally, we will gather feedback from the patient and his family to determine their satisfaction with the care provided (Hu & Whitney, 2023).

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Ideas for evaluating the positive benefits to patient outcomes include using standardized measures measuring the quality of life and symptom intensity, such as the Modified Medical Research Council (mMRC) Dyspnea Scale and the COPD Assessment Test (CAT). A CAT questionnaire evaluates how a patient’s health is affected by (COPD). It assesses symptoms such as coughing up phlegm, dyspnea, chest tightness, and decreased activity. A straightforward grading system called the Modified Medical Research Council (mMRC) Dyspnea Scale measures how dyspneic COPD patients feel throughout different activities.

There are five grades, ranging from 0 (no dyspnea unless during vigorous exercise) to 4 (difficulty breathing to leave the house or during clothing or undressing) (Pisi et al., 2021).  We can also track objective measures such as spirometry results to assess improvements in lung function. Patient-reported outcomes, such as decreased frequency of exacerbations or improved ability to perform daily activities, will provide valuable insights into the effectiveness of our care plan (O’Donohoe et al., 2023). Regular communication and collaboration among the healthcare team will facilitate ongoing evaluation and adjustment of the care plan to optimize patient outcomes.

The Most Useful and Relevant Evidence in Making Care Plan

Reflecting on the evidence collected, the study by Cristina Rezende et al. (2023) was particularly relevant and useful for making decisions regarding the care plan. This resource provided comprehensive insights into how telehealth and telemedicine can effectively manage COPD patients, especially those in remote or underserved areas. The study highlighted several key points that directly informed our care plan. Firstly, it demonstrated the efficacy of telehealth interventions in improving patient outcomes post-hospitalization for COPD exacerbations. This reinforced our decision to leverage telehealth for continuous monitoring and follow-up visits. Additionally, the review emphasized the importance of patient education through telemedicine, aligning with our plan to provide thorough education on inhaler use, lifestyle modifications, and recognizing signs of exacerbations. The evidence supported the use of telehealth for ongoing symptom management, which is critical for our patients who experience chronic cough and shortness of breath. Moreover, the study underscored the value of telemedicine in increasing accessibility to specialized care for patients in rural areas, a significant factor for our patients with limited access to pulmonary care.

Applying the CRAAP criteria—Currency, Relevance, Authority, Accuracy, and Purpose—the study was highly current (2023), directly relevant to our patient’s telehealth needs for COPD management, authored by credible experts, and published in a peer-reviewed journal ensuring accuracy. The purpose was clear and unbiased, aiming to explore effective telehealth interventions. Utilizing this study strengthened our evidence-based care plan, providing a comprehensive and practical approach to remotely managing the patient’s COPD.

Benefits and Strategies to Mitigate Challenges of Interdisciplinary Collaboration

There are many advantages to interdisciplinary cooperation in a remote environment, including pooling diverse expertise, enhancing patient care, and improving outcomes through comprehensive care plans. For the COPD patient, this collaboration allowed the primary care nurse, pulmonologist, respiratory therapist, and pharmacist to integrate their specialized knowledge, leading to a tailored and effective treatment strategy. However, challenges such as communication barriers and coordination difficulties can arise. To mitigate these, one strategy is establishing regular, structured virtual meetings with clear agendas and defined roles for each team member, ensuring all voices are heard and all aspects of patient care are covered (Rubinger et al., 2020).

Another strategy is to utilize shared digital platforms for real-time updates and documentation, facilitating seamless information exchange and continuity of care (Watson & Wilkinson, 2022). Leveraging these strategies, interdisciplinary collaboration can be more effective and significantly enhance patient outcomes. For future care situations, better leveraging this collaboration could involve training all team members in telehealth technologies and communication best practices, ensuring a smoother, more efficient remote working environment (Jonasdottir et al., 2022).

Conclusion

In conclusion, remote collaboration and evidence-based care significantly improve the management of COPD in patients with limited access to specialized care, as demonstrated in our 70-year-old patient’s case. By leveraging the expertise of an interdisciplinary team and utilizing telehealth technologies, we developed a comprehensive care plan that includes bronchodilator therapy, remote pulmonary rehabilitation, and patient education. Applying the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model ensured a systematic approach to integrating high-quality evidence into our plan. We optimized patient outcomes by addressing challenges through structured virtual meetings, sharing digital platforms, and focusing on continuous evaluation using tools like the COPD Assessment Test (CAT) and the mMRC Dyspnea Scale. Future improvements in interdisciplinary collaboration can be achieved by enhancing team training in telehealth technologies and communication best practices, ensuring efficient and practical remote care delivery.

References

Cristina Rezende1, L., Geraldo Ribeiro1, E., Carvalho Parreiras1, L., Assunção Guimarães1, R., Maciel dos Reis1, G., Fernandes Carajá1, A., Batista Franco2, T., Patrícia de Souza Mendes1, L., Maria Augusto1, V., & Lara Silva1, K. (2023). Telehealth and telemedicine in the management of adult patients after hospitalization for COPD exacerbation: A scoping review. Jornal Brasileiro de Pneumologia, 49(3), e20220067. https://doi.org/10.36416/1806-3756/e20220067 

Hu, A., & Whitney, R. L. (2023). Evaluating the impact of an evidence-based practice education program in a nurse residency program on evidence-based practice beliefs, implementation, and competency. Journal for Nurses in Professional Development. https://doi.org/10.1097/nnd.0000000000000968 

Jonasdottir, K., Thordardottir, I., & Jonsdottir, T. (2022). Health professionals’ perspective towards challenges and opportunities of telehealth service provision: A scoping review. International Journal of Medical Informatics, 167, 104862. https://doi.org/10.1016/j.ijmedinf.2022.104862 

O’Donohoe, P., Reasner, D. S., Kovacs, S. M., Byrom, B., Eremenco, S., Barsdorf, A. I., Arnera, V., & Coons, S. J. (2023). Updated recommendations on evidence needed to support measurement comparability among modes of data collection for patient-reported outcome measures: A good practices report of an ISPOR task force. Value in Health, 26(5), 623–633. https://doi.org/10.1016/j.jval.2023.01.001 

Pisi, R., Aiello, M., Calzetta, L., Frizzelli, A., Tzani, P., Bertorelli, G., & Chetta, A. (2021). The COPD assessment test and the modified medical research council scale are not equivalent when related to the maximal exercise capacity in COPD patients. Pulmonology. https://doi.org/10.1016/j.pulmoe.2021.06.001 

Rubinger, L., Gazendam, A., Ekhtiari, S., Nucci, N., Payne, A., Johal, H., Khanduja, V., & Bhandari, M. (2020). Maximizing virtual meetings and conferences: a review of best practices. International Orthopaedics, 44(8), 1461–1466. https://doi.org/10.1007/s00264-020-04615-9 

NURS FPX 4030 Assessment 4 Remote Collaboration and Evidence Based Care

Suissa, S. (2023). Single-inhaler triple versus dual bronchodilator therapy for GOLD group E and other exacerbating patients with COPD: Real-world comparative effectiveness and safety. The European Respiratory Journal, 62(3), 2300883–2300883. https://doi.org/10.1183/13993003.00883-2023 

Watson, A., & Wilkinson, T. M. A. (2022). Digital healthcare in COPD management: A narrative review on the advantages, pitfalls, and need for further research. Therapeutic Advances in Respiratory Disease, 16(1), 175346662210754. https://doi.org/10.1177/17534666221075493 

Wedzicha, J. A., Allinson, J. P., & Calverley, P. M. A. (2024). COPD in the 21st Century. In Google Books. European Respiratory Society. https://books.google.com/books?hl=en&lr=&id=XPz5EAAAQBAJ&oi=fnd&pg=PA255&dq=remote+pulmonary+rehabilitation+in+copd&ots=tMOrVjqAgt&sig=n8Xzx_RYN09B6kz-R92AVTlf1L0 

Yıldırım, Z., & Kaşıkçı, M. (2023). The effect of education on self-care agency and rational drug use of patients with COPD. Patient Education and Counseling, 114, 107804. https://doi.org/10.1016/j.pec.2023.107804 

NURS FPX 4030 Assessment 3 Picot Questions and an Evidence Based Approach

Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

PICO(T) Questions and an Evidence-Based Approach

Healthcare issues can be more effectively examined and addressed using the PICOT question strategy, which stands for Population, Intervention, Comparison of Strategies, Outcomes, and Time frame. This method allows nurses to compare different approaches and perform comprehensive research to identify the most useful and practical evidence for resolving healthcare issues for a particular patient or population (McClinton, 2022). This assessment will utilize the PICOT question approach to investigate a specific healthcare issue and evaluate evidence-based care practices that are best suited to address the problem.

Exploring the Healthcare Issue with the PICOT Approach

Urinary Tract Infections (UTIs) are a common and significant healthcare issue that can lead to severe complications if not effectively managed. Exploring UTIs using the PICOT approach allows for a structured and comprehensive analysis to identify the most effective interventions for prevention and treatment. The societal costs associated with UTIs, including healthcare expenses, are estimated to be around US$3.5 billion annually in the United States. This highlights the urgency of addressing UTIs efficiently (Pinto et al., 2021).

A specific PICOT-formatted research question for this issue is: 

In adult patients prone to recurrent urinary tract infections (Population), does the use of cranberry supplements (Intervention) compared to antibiotics (Comparison) reduce the recurrence rate of UTIs (Outcome) over 6 months (Time-Frame)? 

 Using the PICOT approach benefits the exploration of UTIs in several ways. It ensures that the research is focused and specific, helping to identify relevant studies and data that directly address the issue of UTI recurrence. By clearly defining the intervention and comparison, the approach allows for a direct comparison of the effectiveness of different treatment strategies. The emphasis on measurable outcomes, in this case, the recurrence rate of UTIs, facilitates an evidence-based assessment of the intervention’s success. Specifying a 6-month time frame provides a precise period for evaluating the effectiveness of the interventions, ensuring the results are timely and relevant. Focusing on adult patients prone to recurrent UTIs helps tailor the interventions to the needs of this specific group, potentially improving patient care and outcomes. By exploring UTIs through the PICOT approach, healthcare providers can systematically review and implement the most effective evidence-based practices, ultimately enhancing patient care and reducing the burden of UTIs (Cai, 2021).

Sources of Evidence to Answer PICO(T) Question

One can explore various evidence-based resources using different databases, journals, and websites. To gather substantial evidence on urinary tract infections (UTIs) and their treatment, valuable databases include Google Scholar, PubMed, ProQuest, Cochrane Library, CINAHL, MEDLINE, and the Capella University Library. Specific journals for UTI research include the “International Journal of Urological Nursing,” “American Urological Association (AUA),” “American Journal of Kidney Diseases,” and “Clinical Kidney Journal.” These journals feature evidence-based studies on UTIs and related topics. Useful websites for answering the PICOT question on UTIs include those of the American Urological Association (AUA), the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO).

The CRAAP criteria, which stand for Currency, Relevance, Authority, Accuracy, and Purpose, are used to assess the potential of these sources to answer the PICOT question. These criteria help nurses evaluate the relevance and reliability of a resource for their research (Muis et al., 2022). Applying these criteria to the PICOT question ensures that the selected resources provide current, pertinent, and accurate information from credible and intentional publications, effectively supporting evidence-based practice in managing UTIs.

 Findings from Articles or Evidence-Based Sources

Research on cranberry supplementation for prevention of urinary tract infection (UTI) reveals promising results. A prospective study observed a significant decrease in UTI frequency among women taking cranberry supplements over six months and a notable reduction in antibiotic use. Over six months, participants reported a significant decrease in UTIs from 2.2 to 0.5 on average and a 68% reduction in antibiotic use (Jeitler et al., 2022).  This study’s controlled design and significant findings highlight cranberry’s potential efficacy in UTI prevention. Additionally, patient surveys indicate widespread use of cranberry supplements for RUTI prevention, particularly among younger age groups (de Llano et al., 2020). Another meta-analysis focused on outcome-specific measures and found promising results. It revealed that cranberry extract significantly reduced the risk of recurrent UTIs by 30%, specifically for culture-confirmed UTIs.

These findings corroborate previous research indicating cranberry’s potential effectiveness in UTI prevention (Havranova et al., 2020). A review article discussed various non-antimicrobial and non-pharmacologic strategies for preventing recurrent UTIs, including cranberry products, D-mannose, probiotics, and behavioural modifications. The review highlighted the limited evidence from observational studies and small randomized trials, raising concerns about product purity and potential interactions of over-the-counter nutraceuticals (Finney et al., 2022). All of these evidence-based resources are deemed credible as they satisfy the CRAAP criteria and offer relevant information about urinary tract infections (UTIs) and the PICOT question.

Relevance of Findings and Decision-Making

The findings from the chosen sources of evidence provide valuable insights into making decisions related to a PICOT(T) question concerning urinary tract infections (UTIs) and their prevention. The prospective study by Jeitler et al. (2022) highlights the significant decrease in UTI frequency among women taking cranberry supplements over six months and a notable reduction in antibiotic use. This controlled study design and its significant findings underscore cranberry’s potential efficacy in UTI prevention, making it a highly relevant and likely contributor to positive outcomes. Similarly, patient surveys conducted by de Llano et al. (2020) indicate widespread use of cranberry supplements for recurrent UTI prevention, particularly among younger age groups.

This real-world evidence supports the practical utility and acceptance of cranberry supplementation as a preventive measure against UTIs, adding to its relevance and potential for positive outcomes. Furthermore, the meta-analysis by Havranova et al. (2020) emphasizes the effectiveness of cranberry extract in reducing the risk of recurrent UTIs by 30%, particularly for culture-confirmed UTIs. These findings corroborate previous research, strengthening the case for cranberry supplementation as an effective strategy for UTI prevention. 

However, it’s essential to consider the review article by Finney et al. (2022), which highlights the limited evidence from observational studies and small randomized trials on non-antimicrobial and non-pharmacologic strategies for preventing recurrent UTIs. This cautious perspective reminds us to evaluate the available evidence and potential limitations when deciding on UTI prevention strategies. Overall, the findings from these sources collectively underscore the relevance and possible positive outcomes associated with cranberry supplementation as a preventive measure against recurrent UTIs. The prospective study, patient surveys, and meta-analysis findings provide robust evidence supporting the efficacy of cranberry supplementation.

Conclusion

In conclusion, the PICOT framework, combined with evidence-based research, offers crucial insights into addressing healthcare challenges like UTIs. The evidence presented, including studies and surveys, underscores the potential of cranberry supplementation in reducing UTI recurrence rates. While promising, it’s essential to acknowledge research limitations. By synthesizing diverse evidence, healthcare providers can make informed decisions to improve patient care and mitigate the UTI burden effectively.

References

Cai, T. (2021). Recurrent uncomplicated urinary tract infections: Definitions and risk factors. GMS Infectious Diseases, 9(3). https://doi.org/10.3205/id000072 

de Llano, D. G., Moreno-Arribas, M. V., & Bartolomé, B. (2020). Cranberry polyphenols and prevention against urinary tract infections: Relevant considerations. Molecules, 25(15), 3523. https://doi.org/10.3390/molecules25153523 

Finney, E. L., Pagura, E. J., & MacLachlan, L. S. (2022). Efficacy and safety of alternative treatments for the prevention of recurrent urinary tract infections. Current Bladder Dysfunction Reports, 18(1), 42–50. https://doi.org/10.1007/s11884-022-00678-z 

Havranova, J., Cardio, S., Krinock, M., Widawski, M., Sluder, R., Kumar, A., Hippen, J., & Goel, H. (2020). Cranberry extract for preventing recurrent urinary tract infections: An outcome-specific meta-analysis of prospective trials. Journal of Womens Health and Development, 3(3), 222–242. https://www.fortuneonline.org/articles/cranberry-extract-for-preventing-recurrent-urinary-tract-infections-an-outcomespecific-metaanalysis-of-prospective-trials.html?url=cranberry-extract-for-preventing-recurrent-urinary-tract-infections-an-outcomespecific-metaanalysis-of-prospective-trials 

NURS FPX 4030 Assessment 3 Picot Questions and an Evidence Based Approach

Jeitler, M., Michalsen, A., Schwiertz, A., Kessler, C. S., Koppold-Liebscher, D., Grasme, J., Kandil, F. I., & Steckhan, N. (2022). Effects of a supplement containing a cranberry extract on recurrent urinary tract infections and intestinal microbiota: A prospective, uncontrolled exploratory study. Journal of Integrative and Complementary Medicine, 28(5), 399–406. https://doi.org/10.1089/jicm.2021.0300

Muis, K. R., Denton, C., & Dubé, A. (2022). Identifying CRAAP on the internet: A source evaluation intervention. Advances in Social Sciences Research Journal, 9(7), 239–265. https://doi.org/10.14738/assrj.97.12670

Pinto, H., Simões, M., & Borges, A. (2021). Prevalence and impact of biofilms on bloodstream and urinary tract infections: A systematic review and meta-analysis. Antibiotics, 10(7), 825. https://doi.org/10.3390/antibiotics10070825 

NURS FPX 4030 Assessment 2 Determining the Credibility of Evidence and Resources

Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

Determining the Credibility of Evidence and Resources

Healthcare treatments and procedures significantly influence patients’ quality of life and safety. Every healthcare professional is critically responsible for assessing the credibility and authenticity of evidence-based practices in their clinical work. This analysis focuses on the issue of Urinary Tract Infections (UTIs), highlighting the importance of nurses seeking credible evidence for clinical application. Through in-depth analysis, substantial evidence of effective nursing practices for UTIs can lead to better patient health outcomes and an enhanced quality of life.

The Quality and Safety Issue Benefiting from an Evidence-Based Approach

Urinary Tract Infections (UTIs) are among humans’ most prevalent bacterial infections, signifying a serious problem for public health. These infections significantly impact healthcare systems and patients’ quality of life. The societal costs, including healthcare expenses, are estimated to be around US$3.5 billion annually in the United States (Pinto et al., 2021). UTIs are prevalent in both hospital and community settings, often leading to complications such as kidney infections and sepsis, particularly among Populations at risk, including the elderly, expectant mothers, and people with compromised immune systems. This calls for a pressing need to address UTIs in a timely manner using authentic treatments and guidelines supported by evidence.

Applying an evidence-based approach to managing and treating UTIs is crucial for several reasons. Firstly, evidence-based guidelines help reduce antibiotic resistance by ensuring the appropriate use of antibiotics, which is vital in preserving their efficacy (Stracy et al., 2022). Secondly, utilizing current and effective treatments based on evidence improves patient outcomes, leading to faster recoveries, fewer complications, and a lower recurrence rate of infections, thereby directly enhancing patients’ quality of life (Wagenlehner et al., 2020). Additionally, evidence-based practices contribute to cost-effectiveness in healthcare by reducing unnecessary diagnostic tests and treatments, leading to better resource allocation (Navarro et al., 2020). Moreover, these practices enhance patient safety by minimizing the risk of adverse effects and healthcare-associated infections.

Criteria to Determine Credibility of Resources

Research identifies several criteria for evaluating the credibility of resources, one of which is the CRAAP criteria: Currency, Relevance, Authority, Accuracy, and Purpose (Muis et al., 2022). This set of criteria assesses the timeliness of the article by considering its publication date and examines the relevance of the resource’s content to the issue being studied. It also evaluates the authors’ expertise and connection to the pertinent fields of study. Finally, it verifies the accuracy of the information and ensures that the resource’s purpose aligns with the goals of the ongoing research (Muis et al., 2022).

Applying the CRAAP Criteria

These criteria are applied in the following bibliography:

Navarro, D. F., Sullivan, F., Lorenzo, A. A., & Santiago, V. H. (2020). Point-of-care tests for urinary tract infections: Protocol for a systematic review and meta-analysis of diagnostic test accuracy. BMJ Open, 10(6), e033424. https://doi.org/10.1136/bmjopen-2019-033424

This resource was published in the year 2020, indicating its currency. Regarding the relevance criterion, the article addresses the topic of urinary tract infections, which is the focus of this assessment. The article specifically examines the accuracy of point-of-care tests for diagnosing UTIs, making it highly pertinent to the issue at hand. The authors are experts in their respective fields and have substantial backgrounds in medicine and research. The study’s findings are accurate and are derived from a systematic review and meta-analysis, ensuring robust statistical analysis. Lastly, this resource aims to enhance diagnostic accuracy for UTIs, which aligns with improving patient outcomes through better diagnosis and treatment protocols.

Analysis of Credibility and Relevance of Resources and Evidence

The evidence-based resources cited in this paper can be analyzed to ensure their credibility and relevance. All these resources fit the CRAAP criteria. The article by Pinto et al. (2021) fulfills the CRAAP criteria as it was published within the last three years, indicating its currency. This resource is relevant to urinary tract infections (UTIs) as it discusses the prevalence and impact of biofilms on the bloodstream and UTIs. The authors are experts in their fields, and the results are based on a systematic review and meta-analysis, ensuring accuracy. Lastly, the article aims to provide insights into the impact of biofilms on infections, which is crucial for understanding and managing UTIs. Similarly, the resource by Stracy et al. (2022) is up-to-date, meeting the currency criterion.

The article is relevant to UTIs as it addresses minimizing the emergence of antibiotic resistance in bacterial infections, a significant concern in UTI treatment. The authors are from relevant fields, including medicine and microbiology, and the results are accurate and derived from thorough research. This article emphasizes strategies to reduce antibiotic resistance, vital for effective UTI management. The resource by Wagenlehner et al. (2020) also fulfills the CRAAP criteria and has been published within the last few years. It is relevant as it discusses complicated UTIs’ epidemiology, definition, and treatment.

The authors are experts in urology, and the findings are accurate, based on extensive research. The article aims to provide comprehensive information on managing complicated UTIs, highlighting the importance of appropriate treatment protocols. Among these, the most useful resource is by Stracy et al. (2022), as it addresses the critical issue of antibiotic resistance, which is a significant challenge in treating bacterial UTIs. This resource provides valuable strategies for minimizing resistance and ensuring the effectiveness of antibiotic treatments in managing UTIs.

Significance of Integrating Research Data into Evidence-Based Models

To enhance patient outcomes, the Johns Hopkins Evidence-Based Practice (EBP) paradigm offers a structured technique for fusing patient choices, clinical expertise, and the best accessible data. This model can significantly enhance the management and treatment of Urinary Tract Infections (UTIs), a common and impactful healthcare issue. By incorporating the latest evidence, healthcare professionals can optimize UTI management, improve patient outcomes, enhance safety, and resource optimization. The model involves formulating precise clinical questions, gathering and evaluating evidence, and translating findings into practice.

For instance, healthcare professionals can pose questions such as identifying the most effective antibiotic regimen for reducing UTI recurrence rates in specific patient populations. Subsequently, high-quality evidence can be identified and analyzed through comprehensive literature reviews and adherence to evaluation criteria like the CRAAP criteria. This evidence can then inform the development or updating of clinical guidelines, training protocols for healthcare staff, and monitoring mechanisms to assess the impact of implemented changes on patient outcomes.

Conclusion

In conclusion, integrating evidence-based practices into UTI management is crucial for improving patient outcomes and healthcare quality. By rigorously assessing the credibility and relevance of research using criteria like the CRAAP criteria, healthcare professionals ensure the use of high-quality information. The structured approach of the Johns Hopkins Evidence-Based Practice model facilitates the translation of evidence into clinical decisions, leading to better treatment protocols and resource utilization. Overall, evidence-based approaches play a pivotal role in enhancing patient care and safety in managing UTIs.

References

Navarro, D. F., Sullivan, F., Lorenzo, A. A., & Santiago, V. H. (2020). Point-of-care tests for urinary tract infections: Protocol for a systematic review and meta-analysis of diagnostic test accuracy. BMJ Open, 10(6), e033424. https://doi.org/10.1136/bmjopen-2019-033424 

Pinto, H., Simões, M., & Borges, A. (2021). Prevalence and impact of biofilms on bloodstream and urinary tract infections: A systematic review and meta-analysis. Antibiotics, 10(7), 825. https://doi.org/10.3390/antibiotics10070825 

NURS FPX 4030 Assessment 2 Determining the Credibility of Evidence and Resources

Stracy, M., Snitser, O., Yelin, I., Amer, Y., Parizade, M., Katz, R., Rimler, G., Wolf, T., Herzel, E., Koren, G., Kuint, J., Foxman, B., Chodick, G., Shalev, V., & Kishony, R. (2022). Minimizing treatment-induced emergence of antibiotic resistance in bacterial infections. Science, 375(6583), 889–894. https://doi.org/10.1126/science.abg9868 

Wagenlehner, F. M. E., Bjerklund Johansen, T. E., Cai, T., Koves, B., Kranz, J., Pilatz, A., & Tandogdu, Z. (2020). Epidemiology, definition and treatment of complicated urinary tract infections. Nature Reviews Urology, 17(10). https://doi.org/10.1038/s41585-020-0362-4 

NURS FPX 4030 Assessment 1 Locating Credible Databases and Research

Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

Locating Credible Databases and Research

Healthcare systems aim to relieve patient suffering and enhance health outcomes. This can be accomplished when healthcare professionals deliver accurate and effective treatments. In this case, a novice nurse at a local teaching hospital has been assigned a urinary tract infection (UTI) patient. Given her limited knowledge and experience, she has sought assistance. As a baccalaureate-prepared nurse, I will guide her in finding credible and evidence-based practices for treating patients with urinary tract infections.

Communication Strategies to Motivate Nurses to Research Urinary Tract Infections

Creating an open and supportive environment is essential for fostering a culture of continuous learning among nurses. Regular check-ins and team meetings where nurses can discuss their experiences and challenges, such as managing urinary tract infections (UTIs), encourage open dialogue. UTIs, commonly caused by bacteria such as Escherichia coli, require accurate diagnosis and effective treatment, typically involving antibiotics. Senior nurses and supervisors should actively listen and respond empathetically, reassuring novice nurses that seeking information and asking questions is a strength.

This approach reduces anxiety, builds confidence, and promotes self-directed research into evidence-based practices for UTI treatment, such as the appropriate use of antibiotics and patient education on preventive measures. Open communication enhances professional competence and strengthens team cohesion, improving collaboration and patient outcomes. Research by Bergstedt and Wei (2020) indicates that open communication significantly enhances job satisfaction and professional growth.

Implementing a structured mentorship program pairs experienced nurses with novice nurses for guidance and support. Regular mentorship meetings allow mentors to share knowledge and research strategies, helping novices access and interpret evidence-based resources on UTI management, such as current guidelines for antibiotic therapy and the importance of fluid intake and hygiene. This one-on-one interaction fosters a supportive relationship where novice nurses can discuss their uncertainties and receive tailored advice. Mentorship programs enhance clinical skills, build strong professional relationships, and ensure novice nurses feel valued and supported. According to Mijares and Radovich (2020), structured mentorship significantly contributes to the professional development of novice nurses, enhancing their clinical competence and job satisfaction.

The Best Places to Complete Research Within Workplace

Nurses need to research urinary tract infections (UTIs) in healthcare settings where they have access to reliable evidence for diagnosis. The ideal places for such research in hospitals include resource centers or libraries with medical textbooks, journals, and reference materials, offering extensive literature relevant to medical conditions (Scott, 2021). These environments provide a conducive and focused setting for nurses and other healthcare professionals to conduct thorough research. Additionally, computer labs in hospital research departments offer a peaceful space for online research using medical databases, enabling nurses to access up-to-date, evidence-based information on UTIs through scholarly articles and systematic reviews (Davies et al., 2020).

Nurses should utilize essential resources like medical databases and clinical practice guidelines provided by medical and healthcare associations, which offer guidance on UTI treatment options and monitoring protocols. By using these resources, new nurses can expand their knowledge of various diseases, including UTI management, leading to evidence-based care delivery (Doyle et al., 2020).

The Five Credible Sources for Urinary Tract Infection

Obtaining evidence-based information on urinary tract infections (UTIs) necessitates thoroughly investigating reliable sources. The five credible sources for UTI treatment and management include medical journals and websites such as the “International Journal of Urological Nursing,” “American Urological Association (AUA),” “American Journal of Kidney Diseases,” “Clinical Kidney Journal,” and the “Centers for Disease Control and Prevention (CDC).” These resources are ranked from most useful for nurses to least. Among these sources, the International Journal of Urological Nursing, American Urological Association (AUA), and American Journal of Kidney Diseases are particularly relevant to the selected diagnosis of urinary tract infections. They provide specialized insights and evidence specific to UTI care and management, making them valuable resources for nurses seeking evidence-based information on UTIs.

 The Reasons for These Five Sources to Be the Best Evidence

All five of the above online medical databases are excellent sources of evidence for treating urinary tract infections (UTIs). Nurses can utilize them to obtain evidence-based data on managing this condition. The credibility and relevance of these resources can be assessed using the CRAAP criteria, which examines Currency, Relevance, Authority, Accuracy, and Purpose (Kalidas, 2021). To meet these criteria, a resource must be up-to-date, pertinent to the topic, authored by qualified experts, accurate, and clear in its intent. Each of the five sources fulfills these requirements. For example, medical databases or journals such as the “International Journal of Urological Nursing,” “American Journal of Kidney Diseases,” and “Clinical Kidney Journal” concentrate on urological and kidney-related research, providing comprehensive information on UTIs and their treatment. 

Nurses can gain sufficient knowledge of UTI care and treatment by exploring their research content. Similarly, the American Urological Association (AUA) offers detailed guidelines and educational resources on urological health and diseases, including UTIs (AUA, n.d.). The Centers for Disease Control and Prevention (CDC) provides extensive health information to healthcare providers and the public on various diagnoses, including UTIs (Centers for Disease Control and Prevention, 2021). Therefore, nurses seeking credible and evidence-based knowledge on UTIs and their management should prioritize these five resources.

Conclusion

As a senior nurse in a hospital, it is essential to guide new nurses on diagnoses such as urinary tract infections (UTIs) through effective communication and collaborative research efforts. Utilizing hospital libraries or computer labs is ideal for conducting and completing this research. The five recommended databases for finding evidence on UTIs are the “International Journal of Urological Nursing,” “American Urological Association (AUA),” “American Journal of Kidney Diseases,” “Clinical Kidney Journal,” and the “Centers for Disease Control and Prevention (CDC).” These sources are highly relevant and provide the most reliable evidence for UTI diagnosis, adhering to the CRAAP criteria.

References

AUA. (n.d.). AUA – home – American Urological Association. Www.auanet.org. https://www.auanet.org/ 

Bergstedt, K., & Wei, H. (2020). Leadership strategies to promote frontline nursing staff engagement. Nursing Management (Springhouse), 51(2), 48–53. https://doi.org/10.1097/01.numa.0000651204.39553.79 

Centers for Disease Control and Prevention. (2021, October 6). Urinary tract infection. Centers for Disease Control and Prevention. https://www.cdc.gov/antibiotic-use/uti.html 

Mijares, A. H., & Radovich, P. (2020). Structured mentorship and the nursing clinical ladder. Clinical Nurse Specialist, 34(6), 276–281.  https://doi.org/10.1097/nur.0000000000000558 

Scott, R. J. (2021). A best-fit solution: Transforming an NHS library and knowledge service in readiness for a new hospital building without a traditional library space. Journal of the Medical Library Association, 109(3). https://doi.org/10.5195/jmla.2021.1167

NURS FPX 4030 Assessment 1 Locating Credible Databases and Research

Davies, N. G., Barnard, R. C., Jarvis, C. I., Russell, T. W., Semple, M. G., Jit, M., & Edmunds, W. J. (2020). Association of tiered restrictions and a second lockdown with COVID-19 deaths and hospital admissions in England: A modelling study. The Lancet Infectious Diseases, 21(4). https://doi.org/10.1016/s1473-3099(20)30984-1

Doyle, L., McCabe, C., Keogh, B., Brady, A., & McCann, M. (2020). An overview of the qualitative descriptive design within nursing research. Journal of Research in Nursing, 25(5), 174498711988023. NCBI. https://doi.org/10.1177/1744987119880234 

Kalidas, A. J. E. (2021). The effectiveness of CRAAP test in evaluating credibility of sources. International Journal of TESOL & Education, 1(2), 1–14. http://i-jte.org/index.php/journal/article/view/25