Competencies 73821 Foundations Of Inquiry The Learner Differ ✓ Solved
Competencies73821foundations Of Inquirythe Learner Differentiates B
Discuss the impact of a clinical practice problem on the patient or patients and the organization it affects. Identify each of the following PICO components of the clinical practice problem: \n• P : patient, population, or problem\n• I : intervention\n• C : comparison\n• O : outcome\nDevelop an evidence-based practice (EBP) question based on the clinical practice problem discussed and the PICO components identified. Select a research-based article that answers your EBP question, not more than five years old, and analyze it by discussing its background, methodology, level and quality based on the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, data analysis, ethics, and how its results answer your EBP question. Similarly, select a peer-reviewed non-research article from the past five years, describe its background, type of evidence, level, quality, and how its recommendations help answer your EBP question. Recommend a practice change addressing your EBP question, involving key stakeholders, discussing potential barriers, strategies to overcome them, and measurable outcomes. Ensure proper citation of sources and demonstrate professional communication throughout your submission.
Sample Paper For Above instruction
Title: Implementation of Nurse-Led Hypertension Management Program to Improve Patient Outcomes
Introduction
Hypertension remains a significant public health concern, affecting a substantial proportion of the adult population worldwide. The clinical problem identified is the suboptimal management of hypertension in primary care settings, leading to increased risks of cardiovascular events and hospitalizations. This issue impacts both patient health outcomes and healthcare organization resources, including increased costs due to preventable complications. Addressing this problem through evidence-based interventions can improve blood pressure control and reduce morbidity and mortality rates.
PICO Components
- P: Adults aged 40-65 with uncontrolled hypertension in primary care clinics
- I: Nurse-led hypertension management education and follow-up program
- C: Standard care without additional nurse-led interventions
- O: Improved blood pressure control and patient adherence to treatment
EBP Question
In adults aged 40-65 with uncontrolled hypertension (P), does a nurse-led management education and follow-up program (I), compared to standard care (C), improve blood pressure control and medication adherence (O)?
Research-Based Article Analysis
Background and Purpose
The selected article, published in 2021, investigates the impact of nurse-led hypertension counseling on blood pressure outcomes. The purpose was to evaluate whether targeted education and follow-up could significantly improve hypertension management in primary care patients.
Methodology
This quantitative study used a randomized controlled trial (RCT) design involving 200 adult patients divided into intervention and control groups. The intervention group received structured counseling sessions and monthly follow-ups, while the control group received usual care. Data collection included blood pressure measurements and medication adherence assessments over six months.
Level of Evidence
According to the JHNEBP model, this study is classified as Level I evidence, given its RCT design, which provides the highest quality evidence for testing the efficacy of interventions.
Data Analysis
The researchers employed statistical analysis using ANOVA and chi-square tests to evaluate differences in blood pressure control and adherence rates between groups, confirming the intervention's effectiveness.
Ethical Considerations
The study obtained institutional review board (IRB) approval, ensured informed consent from all participants, and maintained confidentiality, aligning with ethical standards for human subjects research.
Quality Rating
Based on JHNEBP criteria, the study received a quality rating of 'Good' due to rigorous methodology, appropriate statistical analysis, and clear documentation of procedures.
Results and Conclusions
The intervention group demonstrated significantly better blood pressure control and higher medication adherence compared to controls. These findings support implementing nurse-led educational programs to manage hypertension effectively, aligning with my EBP question.
Non-Research Article Analysis
Background and Purpose
The selected non-research article, a clinical practice guideline published in 2020, provides evidence-based recommendations for hypertension management, aiming to standardize care and improve patient outcomes across healthcare settings.
Type of Evidence
The article is a clinical practice guideline, representing a synthesis of current research and expert consensus-driven evidence to guide clinical decision-making.
Level of Evidence
According to JHNEBP, this type of guideline is classified as Level V evidence, as it consolidates existing evidence to inform practice.
Quality Rating
The guideline was rated as 'Excellent' because it incorporated comprehensive literature review, multidisciplinary expert input, and clear recommendations aligned with current best practices.
Recommendations and Application
The guideline advocates for lifestyle modifications, medication adherence strategies, and regular blood pressure monitoring—all of which support the proposed nurse-led management program. Implementing these recommendations can standardize interventions, enhancing the quality of hypertension care.
Practice Change Recommendation
Based on the evidence, I recommend implementing a nurse-led hypertension management program in primary care clinics. Engaging stakeholders such as physicians, nursing staff, and patients in planning and execution is crucial. For instance, physicians can provide referral pathways, nurses can deliver education, and patients can be involved through shared decision-making. One barrier may be resistance to change due to workload concerns among staff; employing strategies such as staff training and demonstrating the program's benefits can facilitate adoption. The measurable outcome could be the percentage of patients achieving blood pressure control (
References
- Johnson, M., et al. (2021). Nurse-led hypertension counseling and blood pressure management: A randomized controlled trial. Journal of Nursing Care, 50(4), 300-310.
- American Heart Association. (2020). Guidelines for the management of hypertension. Hypertension, 75(1), e1-e10.
- Smith, L., & Jones, R. (2019). Effectiveness of nurse-led interventions for blood pressure control. International Journal of Nursing Studies, 95, 123-130.
- World Health Organization. (2022). Hypertension: Key facts. WHO Publications.
- Brown, A., et al. (2018). Strategies to improve medication adherence. Nursing Clinics of North America, 53(2), 165-177.
- Kumar, S., & Clark, M. (2020). Clinical medicine (9th ed.). Elsevier.
- Carter, P., et al. (2021). Developing and implementing clinical guidelines: A systematic review. Journal of Evidence-Based Practice, 21(3), 160-171.
- National Institute for Health and Care Excellence. (2019). Hypertension in adults: Diagnosis and management. NICE Guideline [NG136].
- Lee, H., & Kim, S. (2022). Barriers and facilitators to implementation of clinical practice guidelines. Implementation Science, 17(1), 45.
- World Medical Association. (2013). Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194.