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NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Student Name Capella University NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health Prof. Name Date Implementing Evidence-Based Practice for Promoting Exercise Among Cancer Survivors Hey everyone.. I am Jessica. Cancer is one of the most lethal diseases that prevails in our society, with a low mortality and survival rate. Usually, cancer is diagnosed in the late stages, when radiation and chemotherapy become evident for the patient’s survival. The American Cancer Society has just recently announced the updated cancer incidence and death rates in the United States, which revealed a significant decline in the overall cancer mortality trend from 1991 to 2017 by a total of 29% (Siegel et al., 2019). There were an expected 19.3 million new instances of cancer (18.1 million excluding non-melanoma skin cancer) and roughly 10.0 million (9.7–10.2 million) deaths from cancer (9.9 million excluding non-melanoma skin cancer) globally in 2020. The uncertainty interval for this estimate is from 19.0 to 19.6 million (Hanahan, 2022). The term “cancer” refers to a wide variety of diseases, each of which has its own set of symptoms, approach to therapy, and outlook on survival. Cancer has a tremendous effect on the physical, emotional, and social well-being of individuals who are affected by it, beginning at the moment a diagnosis is made and continuing through the road of treatment and survival. The prognoses of a large number of cancer patients have greatly improved as a result of recent developments in research, prevention methods, diagnostic procedures, and treatment modalities. NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice On the other hand, there is still a continuous need for additional research, early detection, effective medications, and extensive support systems in order to further improve cancer prevention and management and, ultimately, to improve the quality of life for people whose lives have been damaged by this disease. The aim of this poster presentation is to fill the gap between evidence-based practice and clinical practice and help the clinician have information that is embedded in the scientific findings and based on background information. PICOT Question  Cancer requires a lifestyle change that helps manage a cancer-free life. Dietary habits, exercises, medications, and food choices have to be changed to manage bodily counts and spaces. The PICOT question seeks to investigate the impact of the exercise programs on the quality of life of cancer survivors as compared to standard care or non-exercise programs within 6 months of the intervention. If we open up the PICOT, The population in question is the cancer survivors, while the intervention that is being implemented is an exercise program, which is being compared to standard care or no exercise program, and the outcome is an improvement in the quality of life within the timeline of 6 months. Action plan  Exercise has a significant role in bringing about active change in our lives. Similarly, incorporating exercise programs into the regimen of a cancer patient gives the ultimate hands-on assistance in bringing about change in one’s life. This program is based on a course of six months where the recently cancer-free patients were given a regimen of walking and doing low-paced exercises that would help them feel energetic and active. The action plan for this was to ensure that people who have recently survived cancer were encouraged to engage in physical activities such as walking and low-pace exercise to encourage them to develop healthy habits. Studies have highlighted that exercise has a significantly positive impact on cancer survivors and has been characterized as one of the most frequently advised activities to have in the patients’ regimen. Also, a study based on a breast cancer survivor revealed that exercise in the follow-up routine had a significantly positive response among patients. Similarly, a systematic review aggregated information regarding the benefit of exercise through a systematic review of existing systematic reviews in the cancer exercise literature (Stout et al., 2017). The review came to the conclusion that exercise is useful before, during, and after treatment for cancer, for all different forms of cancer, and for a range of impairments that are associated with cancer. When it comes to enhancing physical function and reducing the negative effects of cancer-related impairments, the optimal degree of exercise intensity is moderate to vigorous physical activity (Cormie et al., 2017). NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice An additional systematic review was conducted to provide a thorough summary of the information that is currently available from epidemiologic and randomized controlled trials evaluating the function of exercise in the management of cancer. Patients who exercised following a diagnosis of cancer were found to have a decreased relative risk of cancer mortality and recurrence in comparison to patients who engaged in no exercise or less exercise. Furthermore, patients who exercised following a diagnosis of cancer were reported to have experienced fewer or less severe adverse effects (Ferioli et al., 2019). NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice Stakeholders and Potential Barriers  The following stakeholders would hold an important place in the implementation of the project: Similarly, the following are examples of potential barriers to the implementation of the project: Outcome Assessment:  The outcome criteria can be evaluated through multiple sources, such as: Value and relevance  The evidence that supports the necessity for a practice change to incorporate exercise into the treatment of cancer survivors is compelling and extremely pertinent. Exercise has been shown to offer numerous benefits for cancer survivors, including better physical function, quality of life, and cancer-related outcomes, and these benefits have been the subject of a number of systematic reviews and meta-analyses (Czosnek et al., 2021). As such, the findings of one systematic review indicated that exercise is beneficial before, during, and after therapy for cancer, for each and every form of cancer, and for a range of impairments that are associated with cancer (Campbell et al., 2019). Patients who exercised following a diagnosis of cancer were shown to have a decreased relative risk of cancer mortality and recurrence, and they reported fewer or less severe

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Student Name Capella University NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health Prof. Name Date Evidence-Based Population Health Improvement Plan – Type 2 Diabetes Type-2 Diabetes Mellitus is a prevalent health problem among the adult community of Florida. It often develops in people over 45 and impacts their physical, emotional, and mental health (CDC, 2019). This chronic condition can be well-managed within the older community by implementing evidence-based interventions. In this presentation, I will discuss the environmental and epidemiological data on diabetes in the adult community of Florida and the healthcare issues they encounter. Furthermore, I will develop an ethical health improvement plan followed by a communication plan to encourage the implementation of the plan within the community. Lastly, I will explain the value and relevance of resources utilized in developing a health improvement plan and how they are appropriate to improve the community’s health. Community Data Evaluation Indicators Findings Prevalence of Diabetes in Florida About 2,164,009 people in Florida are diabetics, which makes up 12.5 % of the adult population. Every year, 148,613 people in Florida are diagnosed with diabetes (ADA, 2018). Type 2 diabetes accounts for 90-95 % of total diagnosed cases (Florida Department of Health, 2022).  Costly Treatment Diabetics have 2-3 times higher medical expenses than non-diabetics. The direct medical costs involved in treating diabetes in Florida are $19.3 million (ADA, 2018). Complications Chronic kidney disease cases nationally (37 million)Vision loss cases (5,57,000) NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan Environmental factors such as access to unhealthy food, poor socioeconomic status, and lack of adequate parks and recreational areas for physical activity impact the health of community residents. The population with diabetes will be unable to maintain a healthy lifestyle when they have access to processed food and a diet rich in carbohydrates. Moreover, the lack of knowledge and awareness on diabetes care and its potential consequences due to poor health literacy also contributes to poor management of diabetes, leading to secondary complications such as chronic kidney disease and vision loss. Additionally, low socioeconomic status among community members deprives them of accessing basic medical facilities to monitor their blood glucose levels and control them by complying with prescribed medication therapy (Bodhini et al., 2023). The lack of appropriate parks also leads to a sedentary lifestyle with no physical activity, essential to maintaining a healthy lifestyle and managing diabetes. About 30.6 % of the older population above 65 has been reported to do no physical activity or exercise in Florida (America’s Health Rankings, n.d.). Lastly, geographic disparities persist within Florida with low participation rates in the Diabetes Self-Management Education and Support (DSMES) program (Khan et al., 2021). The sources referred are reliable and validated as they were published within the last five years, showing the current studies and derived from databases like Google Scholar and Governmental websites like CDC, the Florida Department of Health, and the American Diabetes Association (ADA) and American Health Rankings. Health Improvement Plan – Meeting Community Needs Considering the community challenges in Florida, the health improvement plan comprises expanding the DSMES program, where people from diverse cultural backgrounds with culturally sensitive diabetes education and self-management guidelines will be provided in multiple languages to ensure the culturally diverse population of Florida equally acquires diabetes management care (Goff et al., 2020). This is done by developing diabetes education materials in culturally appropriate ways, free of stereotypes, and providing culturally competent training to healthcare providers to rule out any misunderstandings that may arise due to a lack of knowledge of different cultures.  Furthermore, the improvement plan involves enhancing the medical coverage of diabetes self-management education and support (DSMES) by collaborating with Medicaid health insurance coverage. This will reduce health inequities experienced by people from low socioeconomic backgrounds (Powers et al., 2020). By providing diabetes self-management education and support in a culturally competent and ethically correct way, diabetics can improve their health outcomes and quality of life by acquiring healthy lifestyles and medication adherence. Furthermore, it will reduce the onset of diabetes-related complications and mortalities as the population with diabetes has adequately controlled their blood glucose levels. To overcome geographic disparities, integrating telehealth-based DSMES programs is another strategy for health improvement plans (Litchman et al., 2022). This will ensure the diabetic community of Florida with high diabetes prevalence rates acquires this service at home and overcomes the geographical barriers that cause geographical disparities. Implementing DSMES will consider an ethical code of conduct where patient privacy and confidentiality will be taken into account, along with informed consent and honesty in delivering patient-centered care.  Criteria to Evaluate Achievement of Plan’s Outcomes The criteria to evaluate the achievement of the plan’s outcomes are as follows: The proposed criteria are helpful and appropriate ways of measuring the success of our proposed plan as they directly estimate the efficacy of the health improvement plan. These criteria are directly relevant to the goals of our health improvement plan. When the plan is successfully implemented, the criteria of improved health outcomes, reduced diabetes prevalence, enhanced access to care, and cultural inclusivity will be fulfilled.  Communication Plan To effectively apply the strategies for communicating with community stakeholders and community members in an ethical, culturally sensitive, and inclusive way about the development and implementation of a health improvement plan for diabetics of Florida, it is essential to devise a communication plan and implement it. The communication plan is as follows:  Identification of Key Stakeholders  The critical stakeholders for developing and implementing this health improvement plan include the Diabetes Advisory Council of Florida’s Department of Health, community health centers, healthcare providers, physicians, pharmacists, nurses, and relevant organizations such as the Florida Diabetes Alliance. These specific stakeholders must collaborate to ensure diabetes prevalence in Florida can be diminished and health outcomes of diabetes in adults and older populations. They can effectively develop and implement the proposed plan with valuable resources and skillful expertise in managing the community health of diabetics.  Communication Strategy The communication strategy is so devised that it covers ethical, cultural,

NURS FPX 6011 Assessment 1 Evidence-Based Patient-Centered Concept Map

Student Name Capella University NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health Prof. Name Date Evidence-Based Patient-Centered Concept Map Patient Scenario: Winnie is a 45-year-old Asian American Woman. Winnie was diagnosed with heart disease 4 years ago. She reported that she was diagnosed with coronary heart disease when she went to the hospital with complaints of pain in the shoulder, heavy breathing and pain in the back. She reported when she was diagnosed with heart disease, she was in shock and thought her life had ended. Winni got too serious regarding her health and started monitoring her diet and used to take all of her medication on time to avoid anything happening to her. Recently, Winni’s husband had a stomach issue due to which she had to go to the hospital with him and she started having anxiety associated with being ill and being admitted to the hospital again. After being discharged, Winnie got anxious regarding her husband’s health and got too preoccupied with taking care of him. She said she “used to manage all the work by herself without asking for anyone’s help”, and “had to take care of her husband’s health”. Due to being too preoccupied with her husband’s medication and care, she often forgets her medication and at times eats excessive junk food as she does not have the energy to cook diet food for herself. She also stated that “I feel so overwhelmed that I eat whatever is in front of me as I don’t have the energy to cook” and “I get too tired taking care of my husband therefore, I often oversight my health” NURS FPX 6011 Assessment 1 Evidence-Based Patient-Centered Concept Map As per her medical records, Winnie has missed her last two appointments has not administered her pending blood tests that were requested by the doctor, and is avoiding her hospital appointments as she feels too anxious. She also reported that she feels too tired and often feels breathless and has shared this with her husband and now he’s very concerned and has led her to visit her doctor but due to her daily routine she is unable to. Her medical records have indicated high levels of stress, high blood pressure, and muscle ache. She is being treated for her constant high blood pressure and has been given medication to manage her blood pressure.  The last time she visited the hospital, doctors advised her to reduce her stress or else it would be harmful to her.  References  Chauvet-Gelinier, J. C., & Bonin, B. (2017). Stress, anxiety, and depression in heart disease patients: A major challenge for cardiac rehabilitation. Annals of physical and rehabilitation medicine, 60(1), 6-12. https://doi.org/10.1016/j.rehab.2016.09.002 Hersberger, L., Dietz, A., Bürgler, H., Bargetzi, A., Bargetzi, L., Kägi-Braun, N., … & Schuetz, P. (2021). Individualized nutritional support for hospitalized patients with chronic heart failure. Journal of the American College of Cardiology, 77(18), 2307-2319. https://doi.org/10.1016/j.jacc.2021.03.232 Hotopf M. (2002). Psychological stress and cardiovascular disease. Rose’s questionnaire is not what it seems. BMJ (Clinical research ed.), 325(7359), 337. NURS FPX 6011 Assessment 1 Evidence-Based Patient-Centered Concept Map Jaarsma, T., Hill, L., Bayes‐Genis, A., La Rocca, H. P. B., Castiello, T., Čelutkienė, J., … & Strömberg, A. (2021). Self‐care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology. European journal of heart failure, 23(1), 157-174.  https://doi.org/10.1002/ejhf.2008 Pah, A. M., Buleu, N. F., Tudor, A., Christodorescu, R., Velimirovici, D., Iurciuc, S., Rada, M., Stoichescu-Hogea, G., Badalica-Petrescu, M., Georgescu, D., Nutiu, D., Iurciuc, M., & Dragan, S. (2020). Evaluation of Psychological Stress Parameters in Coronary Patients by Three Different Questionnaires as Pre-Requisite for Comprehensive Rehabilitation. Brain sciences, 10(5), 316. https://doi.org/10.3390/brainsci10050316