Selecting a Practice Problem-Nursing Paper Examples

Project Site: Pediatric Primary Care Clinic in Urban Arizona (Selecting a Practice Problem)

The proposed project site is a pediatric primary care clinic in an urban Arizona area. The clinic will be designed to provide comprehensive medical care to children from infancy through adolescence. The focus of the clinic will be on promoting the health and well-being of children, with an emphasis on preventative care, early detection and treatment of illness, and the management of chronic conditions (Selecting a Practice Problem).

The clinic will employ a team of skilled healthcare professionals, including pediatricians, nurses, and medical assistants, who will work together to provide high-quality medical care to children in a safe and welcoming environment. The clinic will be equipped with state-of-the-art medical equipment and technology to support the diagnosis and treatment of a wide range of pediatric health conditions.

In addition to providing medical care, the clinic will also focus on educating parents and caregivers on best practices for promoting the health and development of their children. The clinic will offer resources and support for issues such as nutrition, safety, and developmental milestones to empower parents to take an active role in their child’s health. Overall, the pediatric primary care clinic in urban Arizona will be a vital resource for families in the community, providing accessible and high-quality medical care for children and promoting healthy habits and lifestyles (Selecting a Practice Problem).

Patient Practice Problem

a. The PICOT-D selection guidelines are as follows:

Patient/problem: Pediatric patients with uncontrolled asthma.

Intervention: Implementation of a standardized asthma management plan.

Comparison: Standard asthma management practices at the clinic.

Outcome: Improved asthma control, decreased asthma exacerbations and emergency department visits, and increased adherence to the treatment plan.

Timeframe: Within 8-12 weeks of implementing the intervention.

b. Pediatric patients with uncontrolled asthma are a practice problem at the proposed project site. According to the American Lung Association, asthma is a leading chronic disease in children, affecting approximately 6.2 million children under 18 in the United 10.9% of Arizona youth 17 years and younger) reported having asthma, compared to a national rate of 9.2%. This equates to more than 174,000 Arizona youth with asthma. Symptoms associated with increased healthcare utilization and decreased quality of life States (Hasegawa et al., 2021). The data can be obtained from the clinic’s electronic health records or by contacting the quality department (Selecting a Practice Problem).

Evidence-Based Intervention

a. search strategy to identify an evidence-based intervention

Start with identifying relevant keywords related to the patient practice problem: Pediatric asthma, Uncontrolled asthma, Asthma management, Asthma control, Asthma treatment, Asthma guidelines, Combine the keywords using Boolean operators: (Pediatric asthma OR Childhood asthma) AND (Uncontrolled asthma OR Difficult-to-control asthma) AND (Asthma management OR Asthma control OR Asthma treatment OR Asthma guidelines).

Use specific search filters to narrow down the results: Publication date: past 5 years. Study design: Randomized controlled trials (RCTs) or systematic reviews. Population: Pediatric patients with uncontrolled asthma. Search the following databases: PubMed, Cochrane Library, Embase, CINAHL (Selecting a Practice Problem).

b. Criteria for Acceptable Research

To ensure the proposed intervention and supporting research meet the required criteria for the DPI Project. The criteria ought to meet the following criteria for acceptable research; The research ought to remain evidence-based and relevant to the patient population and practice problem. Furthermore, The research must remain published in a peer-reviewed journal or other reputable source. The research must be conducted using a rigorous and appropriate research design and methodology. Consequently, the research must have an appropriate sample size and power to detect significant results.  The research must have ethical considerations for the protection of human subjects (Selecting a Practice Problem).

Levels of Evidence in Research

To assess the quality of the evidence, the research studies should remain categorized based on the levels of evidence: Level I: Systematic reviews or meta-analyses of RCTs. Level II: Individual RCTs. Consequently, Level III: Quasi-experimental studies or controlled before-and-after studies. Level IV: Non-experimental studies, such as cohort studies or case-control studies. Level V: Expert opinion or consensus statements (Selecting a Practice Problem).

• Three primary quantitative research articles that support the implementation of a standardized asthma management plan are as follows:

Hasegawa, K., Craig, S. S., Teach, S. J., & Camargo Jr, C. A. (2021). Management of asthma exacerbations in the emergency department. The Journal of Allergy and Clinical Immunology: In Practice, 9(7), 2599-2610.

Pudasainee-Kapri, S. (2021). Providers’ adherence to evidence-based asthma guidelines in pediatric primary care. Journal of Pediatric Nursing, 57, 18-24.

Rehman, N., Morais-Almeida, M., & Wu, A. C. (2020). Asthma across childhood: improving adherence to asthma management from early childhood to adolescence. The Journal of Allergy and Clinical Immunology: In Practice, 8(6), 1802-1807.

d. The evidence-based intervention is implementing a standardized asthma management plan, which includes an asthma action plan, regular follow-up visits, education on inhaler techniques, and environmental control measures. This intervention is supported by the three primary quantitative research articles listed above, demonstrating that a standardized asthma management plan can improve asthma control, decrease healthcare utilization, and increase patient satisfaction (Rehman et al., 2020) (Selecting a Practice Problem).

The proposed intervention is different from the current practice at the clinic, which does not have a standardized asthma management plan in place. The intervention remain realistic and feasible for the clinic, as it involves simple changes to the current practice and can be implemented with the help of nurses and other healthcare providers (Selecting a Practice Problem).

Implementation team (Selecting a Practice Problem)

The implementation team will include the clinic’s nursing staff, advanced practice nurses, and physicians. The team members will be responsible for implementing the standardized asthma management plan, including developing an asthma action plan, educating patients and their families on inhaler techniques and environmental control measures, scheduling follow-up visits, and monitoring patients’ asthma control (Pudasainee-Kapri, 2021) (Selecting a Practice Problem).

Expected measurable patient outcome

The expected measurable patient outcome of implementing the standardized asthma management plan is improved asthma control, as evidenced by a decrease in asthma exacerbations and emergency department visits and an increase in adherence to the treatment plan. The demographic data on the patient sample population can be obtained from the clinic’s electronic health records or by contacting the quality department. The measurable patient outcome data will also be obtained from the clinic’s electronic health records or the quality department (Selecting a Practice Problem).

The timeframe for all DPI Project

The DPI project can remain implemented within the 8-12 week timeframe using a phased approach. In the first phase, the implementation team will review the evidence-based intervention and assess the current practice at the clinic. The team will develop a standardized asthma management plan in the second phase, including an asthma action plan, education materials, and environmental control measures. In the third phase, the team will educate patients and their families on the new asthma management plan and schedule follow-up visits. In the fourth and final phase, the team will monitor the patients’ asthma control and evaluate the effectiveness of the intervention (Selecting a Practice Problem).

References

Hasegawa, K., Craig, S. S., Teach, S. J., & Camargo Jr, C. A. (2021). Management of asthma exacerbations in the emergency department. The Journal of Allergy and Clinical Immunology: In Practice, 9(7), 2599-2610. https://www.sciencedirect.com/science/article/pii/S2213219820313994

Pudasainee-Kapri, S. (2021). Providers’ adherence to evidence-based asthma guidelines in pediatric primary care. Journal of pediatric nursing, 57, 18-24. https://www.sciencedirect.com/science/article/pii/S0882596320306102

Rehman, N., Morais-Almeida, M., & Wu, A. C. (2020). Asthma across childhood: improving adherence to asthma management from early childhood to adolescence. The Journal of Allergy and Clinical Immunology: In Practice, 8(6), 1802-1807. https://www.sciencedirect.com/science/article/pii/S2213219820301604