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