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NURS FPX 9902 Assessment 3 Literature Synthesis

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    NURS FPX 9902 Assessment 3 Literature Synthesis

    Student Name

    Capella University

    NURS-FPX 9902 Nursing Doctoral Project 2

    Prof. Name


    Literature Synthesis

    This assessment offers detailed insights into the doctoral student’s search strategy and methodologies employed for literature synthesis. Its primary aim is to facilitate the synthesis of literature discovered throughout the research process. The doctoral learner will comprehensively outline the process employed to identify literature sources, elucidate the interrelations among these sources, and discern commonalities and differences in research questions, methodologies, and findings.

    Search Strategy

    The development of a literature search strategy is crucial for the success of a doctoral project. The references obtained offer evidence-based support to define patient problems and suggest improvements in quality. The literature search began after identifying a patient-related problem at the project site and formulating a PICOT question for caregivers of chronic obstructive pulmonary disorder (COPD) patients. The project site and Capella Institutional Review Board (IRB) approved this PICOT and quality improvement project.

    Four databases, including Cumulative Index of Nursing and Allied Health (CINAHL), Nursing and Allied Health, PubMed, and the Capella Library, were utilized for evidence gathering. The search initially focused on “COPD readmission,” narrowing down results to peer-reviewed articles within the last five years. Fifteen articles meeting the search criteria were selected, printed, and assessed according to the hierarchy of evidence.

    Subsequently, each database was individually utilized for literature searches, such as “COPD Readmissions” and the “teach-back method.” Articles meeting criteria were retained and used in the project and synthesis. The overall literature search process involved careful consideration of relevance, publication date, and hierarchy of evidence. A total of 1,500 articles were assessed, resulting in 15 retained for the project, supporting the PICOT question and intervention.

    Synthesis of the Literature

    COPD Readmissions

    COPD is a chronic inflammatory lung disease with a global impact on mortality. Initiatives like the Learn More Breath Better campaign by the National Heart, Lung, and Blood Institute (NHLBI) aim to reduce hospitalizations. The Hospital Readmission Reduction Program (HRRP) by the Centers for Medicare & Medicaid Services (CMS) addresses financial implications. Studies, including randomized control trials, cohort studies, and systematic reviews, explore strategies such as personalized action plans, telephonic consultations, and predictive modeling to decrease COPD readmissions.


    Risk factors, including smoking and environmental influences, contribute to COPD. Screening for socioeconomic issues is crucial, aligning with guidelines for controlled COPD and acute exacerbations. Education focusing on smoking cessation, symptom management, and proper inhaler use is essential. Systematic reviews and randomized control trials emphasize tailoring education strategies to individual needs, including multiple evidence-based approaches.

    Teach-Back Method

    The teach-back method emerges as a pivotal tool for educating COPD patients, promoting self-management skills, and reducing readmissions. Studies advocate for training healthcare professionals as educators, emphasizing the importance of assessing patient readiness to learn. Electronic learning, national action plans, and healthcare provider training contribute to a comprehensive approach to education delivery. The teach-back method proves effective in enhancing patient knowledge and decreasing hospitalizations.


    The literature synthesis uniformly supports the efficacy of the teach-back method in improving COPD patient outcomes. Quality improvement projects incorporating this method show positive results in patient knowledge, self-management, health literacy, and overall well-being, thereby contributing to the reduction of COPD readmissions. The multifaceted approach to education, including various learning styles and delivery methods, ensures a comprehensive and effective strategy for enhancing patient care.


    Aida, A., Svensson, T., Svensson, A., Chung, U.-I., & Yamauchi, T. (2020). Ehealth delivery of educational content using selected visual methods to improve health literacy on lifestyle-related diseases: Literature review. JMIR mHealth and uHealth, 8(12), e18316.

    Allegrante, J. P., Wells, M. T., & Peterson, J. C. (2019). Interventions to support behavioral self-management of chronic diseases. Annual Review of Public Health, 40(1), 127–146.

    Buhr, R. G., Jackson, N. J., Kominski, G. F., Dubinett, S. M., Mangione, C. M., & Ong, M. K. (2020). Rates for chronic obstructive pulmonary disease under the hospital readmissions reduction program: An interrupted time series analysis. Journal of General Internal Medicine, 35(12), 3581–3590.

    Centers for Medicare and Medicaid Services. (n.d.). Hospital readmissions reduction program (HRRP). cms.gov

    Gagné, M., Lauzier, S., Babineau-Therrien, J., Hamel, C., Penney, S.-E., Bourbeau, J., Moisan, J., & Boulet, L.-P. (2019). COPD-specific self-management support provided by trained educators in everyday practice is associated with improved quality of life, health-directed behaviors, and skill and technique acquisition: A convergent embedded mixed-methods study. The Patient – Patient-Centered Outcomes Research, 13(1), 103–119.

    NURS FPX 9902 Assessment 3 Literature Synthesis

    Hawthorne, G., Richardson, M., Greening, N. J., Esliger, D., Briggs-Price, S., Chaplin, E. J., Clinch, L., Steiner, M. C., Singh, S. J., & Orme, M. W. (2022). A proof of concept for continuous, non-invasive, free-living vital signs monitoring to predict readmission following an acute exacerbation of COPD: A prospective cohort study. Respiratory Research, 23(1).

    Hegelund, A., Andersen, I., Andersen, M. N., & Bodtger, U. (2019). The impact of a personalized action plan delivered at discharge to patients with COPD on readmissions: A pilot study. Scandinavian Journal of Caring Sciences, 34(4), 909–918.

    Hosseinzadeh, H., & Shnaigat, M. (2019). Effectiveness of chronic obstructive pulmonary disease self-management interventions in primary care settings: A systematic review. Australian Journal of Primary Health, 25(3), 195.

    Hu, Y., Lan, Y., Ran, Q., Gan, Q., & Huang, W. (2022). Analysis of the Clinical Efficacy and Molecular Mechanism of Xuefu Zhuyu Decoction in the Treatment of COPD Based on Meta-Analysis and Network Pharmacology. Computational and Mathematical Methods in Medicine, 2022, 2615580.

    Jolly, K., Majothi, S., Sitch, A., Heneghan, N., Moore, D., Riley, R., Bates, E., Turner, A., Bayliss, S., Price, M., Singh, S., Adab, P., Fitzmaurice, D., & Jordan, R. (2016). Self-management of health care behaviors for COPD: A systematic review and meta-analysis. International Journal of Chronic Obstructive Pulmonary Disease, 305

    National Heart, Lung, and Blood Institute. (n.d.-a). Learn more breathe better. Retrieved from

    National Heart, Lung, and Blood Institute. (n.d.-b). COPD videos. Retrieved from

    NURS FPX 9902 Assessment 3 Literature Synthesis

    National Heart, Lung, and Blood Institute. (n.d.-c). COPD national action plan. Retrieved from

    Oh, E., Lee, H., Yang, Y., Lee, S., & Kim, Y. (2021). Development of a discharge education program using the teach-back method for heart failure patients. BMC Nursing, 20(1).

    Pahus, L., Burgel, P. R., Roche, N., Paillasseur, J. L., Chanez, P., & Initiatives BPCO scientific committee (2019). Randomized controlled trials of pharmacological treatments to prevent COPD exacerbations: Applicability to real-life patients. BMC Pulmonary Medicine, 19(1).

    Pintz, C., Posey, L., Farmer, P., & Zhou, Q. (2021). Interprofessional care of people with multiple chronic conditions: An open-access resource for nursing educators. Nurse Education in Practice, 51, 102990.

    Rang, J., Peng, L., Wen, L., Zhou, Z., Xia, Y., Xie, C., Xie, T., & Tan, J. (2022). The effect of teach-back combined with king interactive standard mode on the life of COPD patients. Contrast Media & Molecular Imaging, 2022, 1–8.

    Schnieders, E., Röhr, F., Mbewe, M., Shanzi, A., Berner-Rodoreda, A., Barteit, S., Louis, V. R., Andreadis, P., Syakantu, G., & Neuhann, F. (2022). Real-life evaluation of an interactive versus noninteractive e-learning module on chronic obstructive pulmonary disease for medical licentiate students in Zambia: Web-based, mixed methods randomized controlled trial. JMIR Medical Education, 8(1), e34751.

    Scott, C., Andrews, D., Bulla, S., & Loerzel, V. (2019). Teach-back method: Using a nursing education intervention to improve discharge instructions on an adult oncology unit. Clinical Journal of Oncology Nursing

    Seonhwa, C., & Jahyun, C. (2021). Effects of the teach-back method among cancer patients: A systematic review of the literature. Supportive Care in Cancer, 29(12), 7259-7268.

    NURS FPX 9902 Assessment 3 Literature Synthesis

    Stevermer, J. J., Fisher, L., Lin, K. W., Liu, R., Goodenberger, D., Schellhase, K., Vaughan, B., & Bird, M. D. (2021). Pharmacologic Management of COPD Exacerbations: A Clinical Practice Guideline from the AAFP. American Family Physician, 104(1).

    Sutton, K., & Phelps, P. (2021). Structured telephonic consultation to decrease COPD 30-day readmissions. Medsurg Nursing, 30(6), 377–382,395.

    Talevski, J., Wong Shee, A., Rasmussen, B., Kemp, G., & Beauchamp, A. (2020). Teach-back: A systematic review of implementation and impacts. PLOS ONE, 15(4), e0231350.

    Tran, S., Bennett, G., Richmond, J., Nguyen, T., Ryan, M., Hong, T., Howell, J., Demediuk, B., Desmond, P., Bell, S., & Thompson, A. (2019). ‘Teach-back’ is a simple communication tool that improves disease knowledge in people with chronic hepatitis B – A pilot randomized controlled study. BMC Public Health, 19(1). 019-7658-4

    Vachon, B., Giasson, G., Gaboury, I., Gaid, D., Noël De Tilly, V., Houle, L., Bourbeau, J., & Pomey, M.-P. (2022). Challenges and strategies for improving COPD primary care services in Quebec: Results of the experience of the compas+ quality improvement collaborative. International Journal of Chronic Obstructive Pulmonary Disease, Volume 17, 259–272.

    World Health Organization. (2019). Chronic obstructive pulmonary disease (COPD). Retrieved from

    Zafar, M., Panos, R. J., Ko, J., Otten, L. C., Gentene, A., Guido, M., Clark, K., Lee, C., Robertson, J., & Alessandrini, E. A. (2017). Reliable adherence to a COPD care bundle mitigates system-level failures and reduces COPD readmissions: A system redesign using improvement science. *BMJ Quality & Safety,

    26*(11), 908–918.