NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach

Capella University NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach– Step-By-Step Guide

This guide will demonstrate how to complete the Capella University  NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach

Whether one passes or fails an academic assignment such as the Capella University  NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for  NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach 

The introduction for the Capella University  NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for  NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach

After the introduction, move into the main part of the  NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach  assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for  NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for  NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach

Health care professionals work hard to address patient needs as situations necessitate. Despite their commitment to delivering quality and patient-centered care, health care professionals face many challenges that hinder them from achieving the desired outcomes. Such challenges need to be analyzed in-depth and suitable interventions adopted to address and prevent them in the future. The outcomes depend on the approaches used to address a care issue. The purpose of this paper is to develop a PICOT question for a specific care issue and evaluate the evidence that could be used to answer the question.

Practice Issue to Explore via a PICOT Approach

Nurses play an instrumental role in health care delivery as primary care providers. They are involved in most processes regarding patient care, implying that patient outcomes always depend on how effectively nurses deliver their work. As a result, they should be mentally and physically healthy to execute their roles as professionally and ethically expected. To ensure continuity of care, new graduate nurses join the practice at different times. They are expected to get maximum support from their colleagues to execute their mandate confidently. However, they are typical targets of workplace incivility, with many experiencing bullying at some point during the transition from education to practice (Anusiewicz et al., 2019). Such nurses should be prepared to cope with practice challenges to adapt comfortably.

The impacts of workplace incivility cannot be overlooked at any point of care. Shi et al. (2018) found that graduate nurses transitioning to practice are highly vulnerable to workplace incivility due to inexperience and confidence problems. If not assisted, workplace incivility further affects their ability to provide patient care. For instance, workplace incivility has been found to cause distraction and emotional upset that put patients at risk (Khan et al., 2021). Bullied or intimidated nurses feel like they do not get the support needed, losing interest in their work. Such problems increase their vulnerability to medication administration malpractices, common among new graduate nurses (Armstrong, 2018). Patients should be protected from adverse outcomes by addressing workplace incivility effectively.

PICOT Question: In graduate nurses (P), can cognitive rehearsal training (I) compared to no intervention (C) empower graduate nurses to cope with workplace incivility (O) within six months?

The PICOT approach identifies the Problem/Population, potential Interventions, Comparison, Outcomes, and Timeline. It guides evidence search since the practice issue is known and proposed interventions identified. The process that follows primarily involves searching and appraising evidence on the proposed interventions to help address the practice issue.

Sources of Evidence to Answer the PICOT Question

The internet has a lot of information on workplace incivility and how to control it in health care settings. Information on the practicality of cognitive rehearsal is also extensive in websites, blogs, books, dissertations, and journal articles, among other sources. Reliable websites from government, health, and learning institutions can provide tips on workplace incivility control and help new nurses adapt to new climates. Books are also authoritative to a significant extent. However, journal articles are the most effective in answering the PICOT question among these sources.

When answering a PICOT question, nurses use the evidence-based approach to address a practice issue. They search for the best evidence from current, authoritative, accurate, and relevant sources. Accurate sources seek information from research studies. They are also peer-reviewed by experts in the same field. As a result, journal articles will be used to answer the PICOT question since they meet these criteria.

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

Findings from Articles

Health care research has explored the effectiveness of cognitive rehearsal in addressing workplace incivility, and findings vary depending on the studied population, the scope of research, and the objectives of the researchers. Armstrong (2018) recommended combining educational training about the workplace and effective responses to enable nurses to deal with uncivil behaviors. Cognitive rehearsal was proposed as part of the educational training to enable nurses to identify and report uncivil behaviors. Increased knowledge on identifying incivility issues ensures that nurses are not easily distracted.

Two more articles provide valuable information on the importance of cognitive rehearsal training as an empowerment method for new nurses. Kim et al. (2020) advised health care administrators to be committed to identifying incivility toward junior nursing students and develop targeted programs to reduce clinical incivility. Cognitive rehearsal training is among the targeted programs that can work effectively for nurses when learning and during practice. Zhang and Xiong (2019) found cognitive rehearsal an effective method for improving environments in which care is provided. Besides empowering nurses to identify, resist, and report incivility, it improves interpersonal relationships and decreases turnover intention. Overall, these articles meet the credibility criterion and can answer the PICOT question authoritatively. They share similar characteristics for nursing research evidence, including authority, relevance, currency, and reliability. Although their study designs vary, they are extensive and conclusive on how cognitive rehearsal can help new nurses cope with workplace incivility.

Relevance of the Findings

Research relevant to a PICOT question should help health care providers address a practice issue comprehensively. Armstrong (2018) conducted a systematic review specifically on applying workplace training techniques to enable nurses to deal with incivility. It is detailed on when, how, and why the training is essential. Kim et al. (2020) explained the importance of targeted programs in improving nurses’ well-being. The study illustrates the expected outcomes when cognitive rehearsal and other methods are used for addressing incivility. However, the article focuses primarily on junior nursing students. Zhang and Xiong (2019) provide evidence on cognitive rehearsal as a coping strategy. However, the study reviews the effectiveness of the approach among many other methods. It is right to deduce that all the articles are relevant as far as addressing workplace incivility is concerned.

Cognitive rehearsal is a psychological intervention. It ensures that nurses are prepared to face a problem and can identify and respond to it confidently. Among the findings, Kim et al.’s (2020) article recommendations are the most likely to lead to positive outcomes. Kim et al. (2020) explained the outcomes achieved through cognitive rehearsal, including behavior change, adjustment, and improving the work environment. The article also explains how cognitive rehearsal can be combined with other methods for better outcomes.

Conclusion

A healthy workplace is crucial for nurses to deliver comprehensive patient care. Such a workplace is characterized by high collaboration, support, and protecting nurses from abuse and intimidation. As an issue hampering patient safety and health care quality, workplace incivility among new graduate nurses can be addressed via a PICOT approach. The population of concern would be the graduate nurses experiencing incivility, the proposed intervention would be cognitive rehearsal, and the outcome is improving coping ability. Research should be sourced from current, authoritative, and credible resources. The selected articles address workplace incivility from multiple dimensions, but cognitive rehearsal dominates the proposed interventions.

References

Anusiewicz, C. V., Shirey, M. R., & Patrician, P. A. (2019). Workplace bullying and newly licensed registered nurses: an evolutionary concept analysis. Workplace Health & Safety, 67(5), 250-261. https://doi.org/10.1177%2F2165079919827046

Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410. https://doi.org/10.1177%2F2165079918771106

Khan, M. S., Elahi, N. S., & Abid, G. (2021). Workplace incivility and job satisfaction: Mediation of subjective well-being and moderation of forgiveness climate in health care sector. European Journal Of Investigation in Health, Psychology and Education, 11(4), 1107–1119. https://doi.org/10.3390/ejihpe11040082

Kim, S. A., Hong, E., Kang, G. Y., Brandt, C., & Kim, Y. (2020). Effect of Korean nursing students’ experience of incivility in clinical settings on critical thinking. Heliyon, 6(7), e04367. https://doi.org/10.1016/j.heliyon.2020.e04367

Shi, Y., Guo, H., Zhang, S., Xie, F., Wang, J., Sun, Z., … & Fan, L. (2018). Impact of workplace incivility against new nurses on job burn-out: A cross-sectional study in China. BMJ Open, 8(4), e020461. http://dx.doi.org/10.1136/bmjopen-2017-020461

Zhang, X., & Xiong, L. (2019). Impact of nurse horizontal violence and coping strategies: A review. Yangtze Medicine, 3(4), 289-300. https://doi.org/10.4236/ym.2019.34028

Sample Answer 2 for NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach

 Thank you for submitting your 3rd assessment! I hope you enjoyed applying the PICO(T) framework to your research question and found that it expedited the search process while giving you a systemic method.  You probably discovered that word choice regarding what terminology to include in the research process is vital.  I hope that this lesson will greatly benefit you in the future when the need to locate relevant and pertinent findings is required.  Nurses are the catalysts of and for change. You are learning the necessary tools to be successful with this responsibility. Kudos to you! You will do great things for our profession! Do you already see yourself making changes in practice? If so, are you learning how best to achieve this?   As you move on to the next assessment, please look at the scoring guide criterion that asks you to identify a specific evidence-based model to explain how the steps/stages/phases can be used to incorporate evidence-based changes into practice. Here are two links that will take you to the nursing evidence-based models from which to select from:   https://www.kau.edu.sa/Files/0004020/Subjects/EBP%20Changes%20project.pdf   https://connect.springerpub.com/content/book/978-0-8261-2759-4/back-matter/bmatter1

Sample Answer 3 for NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach

Chronic Obstructive Pulmonary Disease (COPD) is a common, avoidable, and manageable condition that is marked by ongoing respiratory symptoms and restricted airflow caused by anomalies in the airways or air sacs. According to Michas et al. (2020), around 30 million Americans are afflicted by this condition, making it the fourth most significant cause of mortality in the United States. The occurrence of severe worsening of COPD is a significant cause of hospitalization and subsequent return to the hospital, affecting both patients and the healthcare system. Implementing a discharge care bundle may effectively minimize the occurrence of Acute exacerbation of COPD and substantially decrease hospital readmissions. The objective of this paper is to formulate a PICOT Question that will serve as a guiding principle for researching the effects of discharge care bundle on patients with COPD.

PICOT Approach

            The PICOT Question that will guide this study is: In individuals 65 years of age or older who are hospitalized in a hospital’s acute care unit due to a sudden worsening of their COPD (P), does a protocol and discharge care bundle (I) compared to no protocol and no discharge care bundle (C) lower the 30-day readmission rate for COPD in hospitals (O) within eight weeks (T)? The objective of this research is to decrease the number of hospital readmissions for COPD in persons aged 65 and above who are hospitalized in a hospital acute care unit due to an acute exacerbation of their condition (Kendra et al., 2022). The intervention entails the implementation of a protocol and discharge care bundle, which has the potential to decrease readmissions substantially. The main objective is to achieve a decrease in the incidence of readmissions within 30 days. Additional objectives include promoting the use of smoking cessation and pulmonary rehabilitation programs, as well as enhancing patient education and inhaler technique. The project will be executed within eight weeks.

Identification of Sources of Evidence

An extensive review of existing literature will be undertaken to examine the effects of implementing a protocol and discharge care bundle on the percentage of senior patients (65 years of age or older) admitted to an acute care unit at a hospital for an acute exacerbation of COPD within 30 days. The study will utilize databases such as CINAHL, PubMed, and Ovid Emcare to conduct a comprehensive search for articles pertaining to rehospitalization or readmission, care bundle, and COPD (Zafar et al., 2019). Our selection criteria will only include research articles that have undergone the peer-review process and have been published in the English language. This study’s inclusion criteria will include publications that used a care bundle intervention with the goal of lowering readmission rates. On the other hand, duplicate publications or papers that did not support the intervention and did not center on COPD will be disregarded.

Findings from Articles

According to Michas et al. (2020), the research revealed that care complexity plays a crucial role in the successful implementation of COPD discharge bundles. Initiating early interaction between healthcare personnel and patients, along with effective communication across acute and post-acute care settings, may significantly improve the effectiveness of the bundle. In addition, the research conducted by Kendra et al. (2022) discovered that implementing both pre-intervention and post-intervention treatment resulted in a substantial decrease in readmission rates within 30 days, 60 days, and 90 days, as well as total readmission rates. The results indicate that implementing a care bundle is a very efficient and economical approach for institutions to ensure the delivery of consistent and high-quality healthcare. According to the research conducted by Zafar et al. (2019), it was discovered that after six months of repeated plan-do-study-act cycles, compliance with a COPD treatment bundle reached 90%. As a result, there was a decrease in the incidence of patients returning to the emergency department within 30 days from 49% to 30%. However, there was no notable change in the rate of hospitalization from the emergency department observation unit. The subject features were consistent across the baseline and post-bundle periods.

Kendra et al. (2023) conducted research that revealed that a care bundle for chronic obstructive pulmonary disease (COPD), led by an interprofessional team, resulted in a substantial decrease in hospital readmissions for any reason within 30, 60, and 90 days. The research further discovered that chemists provided consultation services to 68.5% of participants and facilitated access to outpatient drugs in 45.7% of participants in the COPD care bundle group. Finally, according to the research conducted by Shaw et al. (2020), healthcare workers typically have a favorable view of care bundles as they help standardize working methods and patient care. The likelihood of successful use was higher when there was a clinical champion and activities based on the system. Nevertheless, difficulties in precisely identifying COPD hindered the use of bundles. The research indicates that bundles may improve the overall experience of staff members. However, their effect on patient outcomes is yet unclear.

Relevance of Findings from Articles

According to the studies, rehospitalization for COPD is identified as one of the top costly and avoidable readmissions. Additionally, the hospital is not meeting the CMS benchmarks for 30-day COPD readmissions. According to a wealth of studies, patients who are having an acute exacerbation of COPD may benefit from a discharge care bundle, which may successfully reduce 30-day readmissions (Zafar et al., 2019). The adoption of a discharge care bundle improves patient care efficiency and has a favorable effect on this metric, according to the current research. The hospital is advised to implement this bundle in order to enhance the efficiency of patient care.

Utilizing a select few evidence-based interventions can yield greater effectiveness and efficiency compared to employing a multitude of techniques. These interventions encompass various aspects of treatment, such as proper inhaler technique, educational resources, personalized action plans, pulmonary rehabilitation programs, support for smoking cessation, and scheduled follow-up visits. Proper inhaler technique is crucial for patients to prevent future readmissions due to exacerbation of COPD. Patients can gain a better understanding of their disease and recognize their baseline symptoms through self-management education and the implementation of an action plan (Kendra et al., 2023). Participation in a pulmonary rehabilitation program enables the opportunity to make necessary medication adjustments in order to avoid future readmissions. Quitting smoking is highly effective and efficient in preventing COPD exacerbations and readmissions. An early follow-up visit after discharge allows for reassessment of health status, management of medications, and continuation of care.

Conclusion

The project investigates the effects of a protocol and discharge care bundle on the rate of hospital readmission within 30 days for adult patients aged 65 or older with COPD. The study concludes that the complexity of care plays a crucial role in the successful implementation of COPD discharge bundles. Additionally, establishing early engagement between healthcare providers and patients can significantly improve the effectiveness of these bundles. Readmission rates significantly decreased as a result of the use of both pre-and post-intervention treatment. Hospital readmissions for all causes decreased as a consequence of the interprofessional team-led COPD treatment bundle. The likelihood of success increased when there was a clinical champion and system-based initiatives in place.

References

Kendra, M. E., Kakwani, A., Uppala, A., Mansukhani, R., Pigott, D. K., Soubra, M., Jacobson, J., Cerrone, F., Farrell, M., Chiu, S., Lieder, K., Tonzola, D., Shah, C. V., & Cherian, S. (2023). Impact of a COPD care bundle on hospital readmission rates. Journal of the American Pharmacists Association, 63(1), 269–274. https://doi.org/10.1016/j.japh.2022.10.002

Kendra, M., Mansukhani, R., Rudawsky, N., Landry, L., Reyes, N., Chiu, S., Daley, B., Markley, D., Fetherman, B., Dimitry, E. A., Cerrone, F., & Shah, C. V. (2022). Decreasing hospital readmissions utilizing an Evidence-Based COPD care bundle. Lung, 200(4), 481–486. https://doi.org/10.1007/s00408-022-00548-9

Michas, M., Deuchar, L., Leigh, R., Bhutani, M., Rowe, B. H., Stickland, M. K., & Ospina, M. B. (2020). Factors influencing the implementation and uptake of a discharge care bundle for patients with acute exacerbation of chronic obstructive pulmonary disease: a qualitative focus group study. Implementation Science Communications, 1(1). https://doi.org/10.1186/s43058-020-00017-5

Shaw, A., Morton, K., King, A., Chalder, M., Calvert, J., Jenkins, S., & Purdy, S. (2020). Using and implementing care bundles for patients with acute admission for COPD: a qualitative study of healthcare professionals’ experience in four hospitals in England. BMJ Open Respiratory Research, 7(1), e000515. https://doi.org/10.1136/bmjresp-2019-000515

Zafar, M. A., Loftus, T. M., Palmer, J. P., Phillips, M., Ko, J., Ward, S. R., Foertsch, M., Dalhover, A., Doers, M. E., Mueller, E. W., Alessandrini, E. A., & Panos, R. J. (2019). COPD care bundles in the emergency department observation unit reduce emergency department revisits. Respiratory Care, 65(1), 1–10. https://doi.org/10.4187/respcare.07088