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NURS FPX 8045 Assessment 1

Student Name Capella University NURS-FPX 8045 Doctoral Writing and Professional Practice Prof. Name Date

NURS FPX 8045 Assessment 7 Literature Review

Student Name Capella University NURS-FPX 8045 Doctoral Writing and Professional Practice Prof. Name Date Literature Review Distinctive Elements of the Proposed Quality Improvement (QI) Project Compared to a Research Study The literature extensively explores the incidence, prevalence, and pathogenesis of Type II Diabetes Mellitus (T2D) globally, with a specific focus on American society. However, limited research exists on non-drug adherence in T2D patients and potential interventions (Foley et al., 2021). Based on a five-year data analysis on drug adherence in T2D patients conducted under my preceptor’s guidance, a lack of clarity emerged on addressing non-drug adherence, leading to the focus of this QI project (Jensen et al., 2017). Journal articles, identified through electronic databases like PubMed, NCBI, and JSTOR, will be utilized to address the literature gap and the PICOT question. Anticipated outcomes include increased awareness among T2D patients regarding the importance of medication adherence, enhanced knowledge among clinical staff and physicians on managing T2D patients, and a significant reduction in T2D-related mortality rates. Topic Scope and Purpose This QI project aims to review literature on T2D patients, focusing on three central themes that reflect gaps in the literature within my current practicum facility. Each theme contributes to the major argument, targeting the T2D patient population (Jensen et al., 2017). The project will discuss strengths and weaknesses, present counterarguments, provide a rebuttal, and offer analytical recommendations. The conclusion will be evidence-based, outlining future prospects for T2D patients facing non-adherence issues. Identification of the Problem: Practice Gap Analysis of clinical data over the past five years in my practicum facility revealed a practice gap in non-adherence to diabetic medication among Type II diabetes patients. The consistent non-drug adherence behavior observed among T2D patients has been a significant factor in poor prognoses (Foley et al., 2021). Addressing this non-adherence issue is crucial for effective intervention at my practicum site (Jensen et al., 2017). Argument Theme 1: T2D Incidence and Prevalence T2D significantly impacts the global population, affecting 6.28% of the world population by 2017. In the U.S., the prevalence rate is 6059 people per 100,000 (Khan et al., 2020). Non-adherence to prescribed drugs among T2D patients ranges from 4 to 31%, contributing to avoidable deaths. This theme is essential for intervention as it addresses the awareness and adherence issues among T2D patients in my practicum facility. Argument Theme 2: Secondary Clinical Effects in T2D Patients Untreated or poorly managed T2D can lead to secondary clinical challenges, with 56% of patients facing difficulties due to non-adherence (Rezaei et al., 2019). This theme directly correlates with the problem statement, emphasizing the need for effective interventions to address non-adherence issues in T2D patients. Argument Theme 3: Proper Management of T2D Many T2D patients lack awareness of the importance of managing their condition. Non-drug interventions, including dietary changes and physical exercise, can complement medication adherence, contributing to optimal glycaemic control (Foley et al., 2021; Polonsky & Henry, 2016). This theme aligns with addressing non-drug adherence issues among T2D patients. Counterarguments Contrary views highlight the indispensability of adhering to prescribed drugs, especially in the face of rapid metabolic changes that could be life-threatening for diabetic patients (Al-Qerem et al., 2021). Recognizing the gap in age considerations for secondary clinical effects emphasizes the need for a comprehensive approach to non-drug adherence in the T2D population. Rebuttal: Intervention to Resolve the Problem To address the identified gap, predicting non-adherence to T2D drugs among patients is proposed as a strategy. Identification of predictors, such as lack of awareness, social and economic status, and age, will guide targeted interventions (Foley et al., 2021; Al-Qerem et al., 2021). Recommendations and Conclusions Physicians should develop educational programs, emphasizing the extreme effects of T2D and the importance of adhering to prescribed drugs. Government support for destitute individuals and addressing broader patient needs, including mental, emotional, social, spiritual, developmental, and cultural aspects, is crucial. These interventions aim to enhance adherence to T2D drugs and improve prognoses. References Al-Qerem, W., Jarab, A. S., Badinjki, M., Hyassat, D., & Qarqaz, R. (2021). Exploring variables associated with medication non-adherence in patients with type 2 diabetes mellitus. PLoS ONE, 16(8). https://doi.org/10.1371/journal.pone.0256666 Blackburn, D. F., Swidrovich, J., & Lemstra, M. (2013). Non-adherence in type 2 diabetes: Practical considerations for interpreting the literature. Patient Preference and Adherence, 7, 183–189. https://doi.org/10.2147/PPA.S30613 Foley, L., Larkin, J., Lombard-Vance, R., Murphy, A. W., Hynes, L., Galvin, E., & Molloy, G. J. (2021). Prevalence and predictors of medication non-Adherence among people living with multimorbidity: A systematic review and meta-Analysis. BMJ Open, 11(9). https://doi.org/10.1136/bmjopen-2020-044987 Jensen, M. L., Jørgensen, M. E., Hansen, E. H., Aagaard, L., & Carstensen, B. (2017). Long-term patterns of adherence to medication therapy among patients with type 2 diabetes mellitus in Denmark: The importance of initiation. PLoS ONE, 12(6). https://doi.org/10.1371/journal.pone.0179546 Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Kaabi, J. Al. (2020). Epidemiology of Type 2 diabetes – Global burden of disease and forecasted trends. Journal of Epidemiology and Global Health, 10(1), 107–111. https://doi.org/10.2991/JEGH.K.191028.001 Polonsky, W. H., & Henry, R. R. (2016). Poor medication adherence in type 2 diabetes: Recognizing the scope of the problem and its key contributors. Patient Preference and Adherence, 10, 1299–1306. https://doi.org/10.2147/PPA.S106821 Rezaei, M., Valiee, S., Tahan, M., Ebtekar, F., & Gheshlagh, R. G. (2019). Barriers of medication adherence in patients with type-2 diabetes: A pilot qualitative study. *Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 12*, 589–599. https://doi.org/10.2147/DMSO.S197159

NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

NURS FPX 8045 Assessment 6

Student Name Capella University NURS-FPX 8045 Doctoral Writing and Professional Practice Prof. Name Date Synthesis of the Evidence: Substantiating an Intervention for Obesity Obesity affects 42% of adults, resulting in healthcare spending of $3.8 trillion in 2019 (State of Nevada, 2021). Despite increased recognition as a chronic disease, obesity remains underdiagnosed and undertreated (Caterson et al., 2019). In obese female patients, the impact of screening for readiness to change, introduction of a weight loss bundle with diet and exercise education, and monthly check-ins compared to no intervention on weight loss education compliance during a primary care clinic office visit at 4 weeks and 8 weeks will be explored (American Diabetic Association, 2021; Sutton, 2022; ElSayed et al., 2022; Gaesser & Angadi, 2021; Lin & Li, 2021; Ruban et al., 2019; Samuel N & Megan, 2019; Wyatt, 2018). Critical Review of the Literature The American Diabetic Association (2021) emphasizes the need to assess patients’ readiness for behavioral changes related to weight loss. The transtheoretical model, comprising pre-contemplation, contemplation, preparation, action, and maintenance stages, offers a framework for understanding and promoting readiness for change (Sutton, 2022). ElSayed et al. (2022) highlight the link between obesity and the risk of type 2 diabetes, supporting the feasibility of long-term weight loss. Gaesser & Angadi’s (2021) meta-analysis underscores the mortality benefits associated with overweight BMI categories, providing insight into weight-neutral strategies. Lin & Li (2021) stress the importance of understanding the quality of food sources and nutrients in obesity management. Ruban et al. (2019) review various strategies, including dietary, pharmacological, and surgical approaches. Samuel N & Megan (2019) advocate for lifestyle counseling, diet, exercise, medications, and bariatric surgery in obesity management. Wyatt (2018) emphasizes the role of adherence to diet in predicting weight loss success. Synthesis of the Literature Obesity, a complex interplay of genetic and environmental factors, requires a comprehensive approach encompassing metabolic, social, cultural, behavioral, physiological, and genetic considerations (American Diabetic Association, 2021; Sutton, 2022; Lin & Li, 2021). Assessing readiness for change is crucial, involving an understanding of the benefits of behavior change (American Diabetic Association, 2021; Sutton, 2022). Screening for readiness to lose weight using theoretical models aids in tailoring interventions (Sutton, 2022). Various interventions, such as dietary modifications, calorie restriction, macronutrient composition, meal replacement, pharmacotherapy, exercise, and bariatric surgery, contribute to obesity management (Ruban et al., 2019; Samuel N & Megan, 2019; Wyatt, 2018). Evaluate the Quality of the Literature Using the Strength of Recommendations Table (SORT) and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, the literature exhibits varying levels of evidence. High-quality evidence from studies like ElSayed et al. (2022) and Gaesser & Angadi (2021) supports the feasibility and mortality benefits of weight loss interventions. Medium-grade evidence from Lin & Li (2021) emphasizes the role of food quality in obesity. Wyatt (2018) and Samuel N & Megan (2019) provide Level 1, SORT category A evidence, emphasizing the importance of diet adherence and the multifaceted approach to obesity management. Conclusion Obesity is a significant health and economic crisis, affecting 42% of adults. Readiness for change and tailored interventions, including dietary modifications, physical activity, and bariatric surgery, are crucial in addressing this complex issue. The literature, characterized by varying levels of evidence, underscores the need for a comprehensive approach in managing obesity. Future studies could further explore gender-specific interventions and long-term outcomes. References American Diabetic Association. (2021). Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of medical care in diabetes—2022. Diabetes Care, 45(Supplement_1), S113–S124. https://doi.org/10.2337/dc22-s008 BMJ Best Practice. (2023, January 12). What is grade? Retrieved January 14, 2023, from https://bestpractice.bmj.com/info/us/toolkit/learn-ebm/what-is-grade/ ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons, S. K., Perry, M., Prahalad, P., Pratley, R. E., Seley, J., Stanton, R. C., & Gabbay, R. A. (2022). Obesity and weight management for the prevention and treatment of type 2 diabetes. Diabetes Care, 46(Supplement_1), S128–S139. https://doi.org/10.2337/dc23-s008 Freeman, E. E., McMahon, D. E., Fitzgerald, M., Robinson, S., Frazer-Green, L., Hariharan, V., McMillen, A., Malik, S., Cornelius, L., Pak, H. S., Cronin, T. A., Bordeaux, J. S., & Cooper, K. D. (2020). Modernizing clinical practice guidelines for the American Academy of Dermatology. Journal of the American Academy of Dermatology, 82(6), 1487–1489. https://doi.org/10.1016/j.jaad.2019.12.075 Gaesser, G. A., & Angadi, S. S. (2021). Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience, 24(10), 102995. https://doi.org/10.1016/j.isci.2021.102995 Lin, X., & Li, H. (2021). Obesity: Epidemiology, pathophysiology, and therapeutics. Frontiers in Endocrinology, 12. https://doi.org/10.3389/fendo.2021.706978 Ruban, A., Stoenchev, K., Ashrafian, H., & Teare, J. (2019). Current treatments for obesity. Clinical Medicine, 19(3 ), 205–212. https://doi.org/10.7861/clinmedicine.19-3-205 Samuel N, G., & Megan, W. (2019). Approach to obesity management in the primary care setting. Journal of Obesity and Weight-loss Medication, 5(1). https://doi.org/10.23937/2572-4010.1510024 Sutton, J. (2022, October 13). How to assess and improve readiness for change. PositivePsychology.com. https://positivepsychology.com/readiness-for-change/ Wyatt, H. R. (2018). Update on treatment strategies for obesity. The Journal of Clinical Endocrinology & Metabolism, 98(4), 1299–1306. https://doi.org/10.1210/jc.2012-3115 NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Student Name Capella University NURS-FPX 8045 Doctoral Writing and Professional Practice Prof. Name Date Nursing Project Proposal & Communication Assessment  Synthesis of Obesity Evidence: An Overview Obesity is a multifaceted, progressive, and persistent chronic condition characterized by abnormal or excessive body fat, with adverse implications for health and well-being. Acknowledged as an escalating epidemic, obesity is defined by a body mass index (BMI) between 25 and 30 kg m^−2, and morbid obesity is classified as a BMI of 30 kg m^−2 or higher. The prevalence of obesity in the United States has increased from 4.6% in 1980 to 14.0% in 2019, affecting 42% of adults and contributing to healthcare expenditures of $3.8 trillion in 2019. Despite being recognized as a chronic disease, obesity remains significantly underdiagnosed and undertreated. This synthesis critically examines five articles related to obesity prevalence, incorporating a comprehensive table in the appendix and scrutinizing evidence for proposing an obesity-related project. The selected research articles include a 2022 update on obesity epidemiology by Boutari and Mantzoros (2022), a study on misalignment in perceptions, reality, and actions in obesity by Caterson et al. (2019), a systematic review and synthesis of qualitative studies on the lived experience of people with obesity by Farrell et al. (2021), a meta-analysis on sedentary behavior and physical inactivity by Silveira et al. (2022), and a study on trends in general and abdominal obesity in US adults by Sun et al. (2022). NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment The critical literature review reveals an escalating prevalence of obesity over the past decade, accompanied by musculoskeletal complications, metabolic effects, and an increased risk of various malignancies. Caterson et al. (2019) underscores the gap in care for obese patients, emphasizing the necessity for interventions beyond lifestyle changes. Silveira et al. (2022) highlights the prevalence of sedentary behavior and physical inactivity in individuals with obesity, suggesting screening for readiness to change. Farrell et al. (2021) emphasizes the lived experience of people with obesity, advocating for a holistic approach to address the complexities of this chronic disease. Sun et al. (2022) examines trends in general and abdominal obesity, reaffirming the persistent burden of obesity in the US. In conclusion, this synthesis underscores the urgency of addressing the obesity epidemic, emphasizing the need for comprehensive interventions beyond lifestyle changes. Understanding the lived experience of individuals with obesity and recognizing the impact of sedentary behavior are crucial aspects of developing effective strategies. The synthesis highlights the importance of a multifaceted approach to tackle the complexities of obesity and improve patient outcomes. References Boutari, C., & Mantzoros, C. S. (2022). A 2022 update on the epidemiology of obesity and a call to action: As its twin COVID-19 pandemic appears to be receding, the obesity and dysmetabolism pandemic continues to rage on. Metabolism, 133, 155217. Caterson, I. D., Alfadda, A. A., Auerbach, P., Coutinho, W., Cuevas, A., Dicker, D., Hughes, C., Iwabu, M., Kang, J., Nawar, R., Reynoso, R., Rhee, N., Rigas, G., Salvador, J., Sbraccia, P., Vázquez‐Velázquez, V., & Halford, J. C. (2019). Gaps to bridge: Misalignment between perception, reality and actions in obesity. Diabetes, Obesity and Metabolism, 21(8), 1914–1924. Farrell, E., Bustillo, M., le Roux, C. W., Nadglowski, J., Hollmann, E., & McGillicuddy, D. (2021). The lived experience of people with obesity: Study protocol for a systematic review and synthesis of qualitative studies. Systematic Reviews, 10(1). Silveira, E., Mendonça, C., Delpino, F., Elias Souza, G., Pereira de Souza Rosa, L., de Oliveira, C., & Noll, M. (2022). Sedentary behavior, physical inactivity, abdominal obesity and obesity in adults and older adults: A systematic review and meta-analysis. Clinical Nutrition ESPEN, 50, 63–73. Sun, J.-Y., Huang, W.-J., Hua, Y., Qu, Q., Cheng, C., Liu, H.-L., Kong, X.-Q., Ma, Y.-X., & Sun, W. (2022). Trends in general and abdominal obesity in US adults: Evidence from the national health and nutrition examination survey (2001–2018). Frontiers in Public Health, 10. NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment Citation Conceptual Framework Design/Method Sample/Setting Major Variables Studied and their Definitions Measurement Data Analysis Findings Appraisal: Worth to Practice Boutari, C., & Mantzoros, C. (2022). European Regional Report on Obesity by WHO (May 2022). Boutari & Mantzoros (2022): Evaluation division of the world into six regions: African, Americas, Eastern Mediterranean, European, South East Asian, and Western Pacific. Boutari & Mantzoros (2022): Analysis of preexisting data. Boutari & Mantzoros (2022): European Regional Report on Obesity by WHO (May 2022). Boutari & Mantzoros (2022): BMI > 25 kg/m² and obesity > 30 kg/m², age, gender (M/F), location. Boutari & Mantzoros (2022): WHO definition of overweight, prevalence rates (%) of overweight and obesity by sex, age, and region between 1980 and 2019. Boutari & Mantzoros (2022): Analysis of preexisting data. Boutari & Mantzoros (2022): America has one of the highest obesity rates. Prevalence higher in women. Increases with age up to 50-65 years. The age-standardized prevalence of obesity increased from 4.6% in 1980 to 14.0% in 2019. Boutari & Mantzoros (2022): – (Not specified). Caterson, I., et al. (2019). ACTIONIO study – Cross-sectional, noninterventional. Caterson et al. (2019): Adults with obesity and HCPs; Obesity considered a chronic disease. Caterson et al. (2019): Online survey in 11 countries; ACTIONIO study – Cross-sectional, noninterventional. Caterson et al. (2019): Adults with obesity and HCPs; 19,700 completed surveys. Caterson et al. (2019): BMI > 25 kg/m² and obesity > 30 kg/m², age, gender (M/F). Caterson et al. (2019): PwO assumed full responsibility for weight loss (81%), obesity considered a chronic disease by 68% of PwO and 88% of HCPs. Caterson et al. (2019): – (Not specified). Caterson et al. (2019): Obesity is a chronic disease; most PwO assume responsibility for weight loss. Caterson et al. (2019): – (Not specified). Silveira, E. A., et al. (2022). Investigate prevalence/incidence of sedentary behavior and physical inactivity: Systematic review and meta-analysis. Silveira et al. (2022): Associations between sedentary behavior, physical inactivity, and obesity. Silveira et al. (2022): Systematic review and meta-analysis. Silveira et al. (2022): 23 studies involving 638,000 adults. Silveira et al. (2022): BMI >

NURS FPX 8045 Assessment 4 Interpretation and Synthesis of Scholarly Sources

Student Name Capella University NURS-FPX 8045 Doctoral Writing and Professional Practice Prof. Name Date Interpretation and Synthesis of Scholarly Sources The effective management of pain and its associated symptoms in cancer patients remains a paramount concern in cancer pain management. Various approaches to pain management and control can enhance the overall well-being of cancer patients and their families. Pain not only leads to psychological and physical disorientation but also results in adverse effects such as sleep deprivation, fatigue, depression, anxiety, heightened irritability, and impaired cognitive function. Consequently, there is a need for research into the viability of alternative pain management methods to supplement or potentially replace conventional approaches. A crucial method in pain management is music therapy, which has been shown to contribute to improved pain management scores, reduced repression, and an enhanced quality of life for cancer patients. Article Summary Article 1: Music Therapy in the Psychosocial Treatment of Adult Cancer Patients: A Systematic Review and Meta-Analysis The objective of this article was to synthesize evidence on the effectiveness of music therapy across various phases of oncological treatment. A pre-registered systematic review and meta-analysis were conducted, encompassing thirty studies that investigated music therapy among adult cancer patients. The results indicated an overall positive impact on various outcomes during curative treatment, including anxiety, depression, improved quality of life, reduced pain medication intake, enhanced spiritual well-being, and decreased stress. The meta-analysis demonstrated significant effects on psychological well-being, physical symptom distress, and overall quality of life. The authors concluded that music therapy could improve health outcomes and be integrated into different phases of cancer treatment (Köhler et al., 2020). Article 2: Effects of Mindfulness-Based Stress Reduction Combined With Music Therapy on Pain, Anxiety, and Sleep Quality in Patients with Osteosarcoma This study aimed to assess the effects of combining music therapy with mindfulness-based stress reduction in patients with osteosarcoma. A total of 101 patients were enrolled and randomized into control and intervention groups. Eight sessions of combined mindfulness-based stress reduction and music therapy were administered to the intervention group, while the control group received no intervention. The results demonstrated a significant alleviation of psychological and physiological complications, including reduced pain and anxiety scores and improved sleep quality. The findings suggested that music therapy, when combined with other interventions, could enhance the quality of life for cancer patients (Liu et al., 2019). NURS FPX 8045 Assessment 4 Interpretation and Synthesis of Scholarly Sources Article 3: Effectiveness of Five-Element Music Therapy in Cancer Patients: A Systematic Review and Meta-Analysis This article aimed to systematically evaluate the effectiveness of five-element music therapy on anxiety, quality of life, sleep, and depression in cancer patients. The study involved 22 studies with 2053 cancer patients. The meta-analysis revealed significant differences in relieving pain, improving sleep quality, and reducing depression. However, no significant difference was observed in alleviating anxiety. The authors concluded that five-element music therapy positively impacted the quality of life, sleep, pain, and depression in cancer patients (Yang et al., 2021). Evidence Synthesis Pain is a pervasive symptom in cancer patients, significantly affecting their physical, physiological, and psychological well-being. Music therapy has been advocated as an effective intervention to improve mood, reduce anxiety, and alleviate suffering among cancer patients. Music has a measurable impact on physiological parameters such as heart rate, respiration, and blood pressure, reducing the stress hormone cortisol and promoting relaxation. It serves as an adjunct intervention to enhance the quality of life and pain management for cancer patients, as evidenced by various scholarly sources. Safety of Music Therapy Music therapy is a safe form of intervention with several advantages over conventional pain management methods. Unlike pharmacological interventions that may involve injections, music therapy requires no invasive procedures, reducing the risk of infection and interference with circulatory and muscular systems. Additionally, music therapy eliminates the dangers associated with overdosing, erratic medication, underdosing, and drug abuse. It is a safe and appropriate intervention that complements other pain management approaches, ultimately improving the overall quality of life for cancer patients. Conclusion In conclusion, the quality of life for cancer patients is profoundly impacted by the intense pain associated with the disease. Music therapy emerges as a significant, safe, and effective intervention that can be readily administered and surpasses some conventional pain-relieving methods. It not only reduces pain but also addresses associated symptoms such as depression, stress, and anxiety. Future research should focus on integrating music therapy into oncology practices to fully harness its potential positive impact. References Köhler, F., Martin, Z. S., Hertrampf, R. S., Gäbel, C., Kessler, J., Ditzen, B., & Warth, M. (2020). Music therapy in the psychosocial treatment of adult cancer patients: a systematic review and meta-analysis. Frontiers in Psychology, 11, 651. Liu, H., Gao, X., & Hou, Y. (2019). Effects of mindfulness-based stress reduction combined with music therapy on pain, anxiety, and sleep quality in patients with osteosarcoma. Brazilian Journal of Psychiatry, 41(6), 540-545. https://doi.org/10.1590/1516-4446-2018-0346 Yang, T., Wang, S., Wang, R., Wei, Y., Kang, Y., Liu, Y., & Zhang, C. (2021). Effectiveness of five-element music therapy in cancer patients: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice, 44, 101416. NURS FPX 8045 Assessment 4 Interpretation and Synthesis of Scholarly Sources

NURS FPX 8045 Assessment 3 Craft a PICOT question and a Search Research

NURS FPX 8045 Assessment 3

Student Name Capella University NURS-FPX 8045 Doctoral Writing and Professional Practice Prof. Name Date Crafting a PICOT Question and Developing a Search Strategy Introduction In healthcare, precision and focus in clinical questions are crucial for advancing evidence-based practice (Melnyk & Fineout-Overholt, 2019). This paper aims to generate a PICOT question relevant to professional interests, specifically focusing on a potential Doctor of Nursing Practice (DNP) project. The subsequent discussion will elaborate on the creation of a search strategy aligned with the assessment requirements. Crafting the PICOT Question In the context of a DNP project, it is crucial to formulate a PICOT question addressing a pertinent issue for a quality improvement endeavor. Utilizing the recommended format, the PICOT question is as follows: In patients undergoing cardiac surgery (P), how does the implementation of a structured postoperative care protocol (I) compared to standard care (C) influence the incidence of postoperative complications (O) within the first 30 days following surgery (T)? This question focuses on a specific patient population (those undergoing cardiac surgery) and compares the impact of implementing a structured postoperative care protocol to standard care regarding the incidence of postoperative complications within a defined timeframe. Search Strategy Development A comprehensive search strategy is imperative to effectively address the PICOT question. The following outlines key components of the search strategy: Electronic Databases: Utilizing reputable databases such as PubMed, CINAHL, and the Cochrane Library to access a diverse range of scholarly articles and systematic reviews. Key Search Terms: Employing a combination of relevant keywords and controlled vocabulary specific to the PICOT elements, such as “cardiac surgery,” “postoperative care,” “complications,” and “structured protocol” (Higgins & Green, 2011). Exclusion Criteria: Excluding studies that do not focus on the specified patient population (cardiac surgery) or do not report relevant outcomes within the stipulated timeframe. Literature Review: Reviewing articles to identify evidence-based interventions related to structured postoperative care protocols and their impact on postoperative complications. Source Selection: Choosing sources based on their relevance to the PICOT elements, methodological rigor, and the applicability of interventions in a DNP project context. The search strategy aims to gather evidence supporting the implementation of a structured postoperative care protocol in patients undergoing cardiac surgery, contributing to a targeted and effective DNP project. Results of the Search The search yielded a total of 75 articles from selected databases. After careful examination, 35 articles were retained based on their alignment with the PICOT question and relevance to the DNP project. Excluded sources primarily comprised studies focusing on different surgical populations or lacking detailed information on postoperative complications. Conclusion Crafting a PICOT question and developing a search strategy are pivotal steps in preparing for a DNP project. The question should be meticulously framed to address a specific problem, and the search strategy should be comprehensive to gather evidence supporting the proposed intervention. This process ensures that the subsequent DNP project is well-informed and evidence-based. References Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice. Wolters Kluwer. Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice. Wolters Kluwer. Higgins, J. P., & Green, S. (Eds.). (2011). Cochrane handbook for systematic reviews of interventions. Wiley. National Institute for Health and Care Excellence. (2012). Developing NICE guidelines: The manual. Retrieved from https://www.nice.org.uk/process/pmg20/chapter/introduction Agency for Healthcare Research and Quality. (2021). Methods Guide for Effectiveness and Comparative Effectiveness Reviews. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470399/ NURS FPX 8045 Assessment 3 Craft a PICOT question and a Search Research American Association of Colleges of Nursing. (2006). The Essentials of Doctoral Education for Advanced Nursing Practice. Retrieved from https://www.aacnnursing.org/DNP/Essentials Drummond, D., & Collin, C. (2001). Implementing evidence-based changes in healthcare. BMJ, 323(7317), 1025–1026. https://doi.org/10.1136/bmj.323.7317.1025 Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097

NURS FPX 8045 Assessment 2 Summarize a Passage

Student Name Capella University NURS-FPX 8045 Doctoral Writing and Professional Practice Prof. Name Date Summarizing a Passage Pulmonary Hypertension: A Comprehensive Analysis Pulmonary hypertension (PH), characterized by elevated blood pressure in the vessels connecting the heart to the lungs, is a grave medical condition associated with diverse cardiovascular and pulmonary complications (Brown et al., 2011). This article provides a comprehensive overview of pulmonary hypertension, covering its definition, causes, symptoms, prevalence, and preventive measures, drawing upon the research findings by Brown et al. (2011). Definition and Manifestations Brown et al. (2011) elucidate that pulmonary hypertension involves heightened pressure in the blood vessels between the heart and the lungs. This abnormal pressure elevation can lead to artery constriction, hindering the smooth blood flow from the heart to the lungs and subsequently causing oxygen deprivation in the lungs (Brown et al., 2011). Association with Diseases and Risk Factors The repercussions of pulmonary hypertension extend beyond immediate cardiovascular effects. According to Brown et al. (2011), it may coexist with various diseases affecting the heart, lungs, and kidneys. Its origins can be congenital or induced by connective tissue disorders, coronary artery issues, or liver cirrhosis (Brown et al., 2011). Notably, the prevalence of pulmonary hypertension is higher in females, individuals of Black ethnicity, and those aged 75 years or older (Brown et al., 2011). Symptoms and Recognition Early recognition of pulmonary hypertension is vital for timely intervention. Symptoms include difficulty in breathing, dizziness, and chest pain (Brown et al., 2011). However, Brown et al. (2011) highlight the prevalent issue of delayed recognition of pulmonary arterial hypertension, emphasizing the importance of increased awareness and early diagnosis. Preventive Measures and Treatment Options Although not all cases are preventable, controlling high blood pressure is a recommended preventive measure. Brown et al. (2011) suggest that maintaining optimal blood pressure levels is a valuable strategy. Various treatment options exist, but a definitive cure remains elusive (Brown et al., 2011). Conclusion: A Call to Action In conclusion, pulmonary hypertension poses a significant threat to cardiovascular and pulmonary health. Brown et al.’s (2011) findings underscore the importance of proactive measures, including lifestyle changes such as reducing tobacco and substance consumption. Through enhanced awareness, improved recognition, and implementation of preventive strategies, the incidence of pulmonary hypertension can be more effectively addressed. References Brown, L. M., Chen, H., Halpern, S., Taichman, D., McGoon, M. D., Farber, H. W., … Elliott, C. G. (2011). Delay in recognition of pulmonary arterial hypertension: Factors identified from the REVEAL registry. Chest, 140(1), 19–26. doi:10.1378/chest.10-1166 NURS FPX 8045 Assessment 2 Summarize a Passage