NURS FPX 9902 Assessment 3: Literature Synthesis
Literature Synthesis
Chronic obstructive pulmonary disease (COPD) is a disabling disease that creates immense problems for patients, families, and healthcare organizations (Siu & Lachter, 2024). This assessment will focus on reviewing the literature to discuss mobile and telehealth approaches that can be used to increase COPD care outcomes reduce readmissions, patient self-management, and increase the patient’s knowledge. By examining methods like the teach-back approach, visual supports, and matrix self-care interventions from research findings and practice, this synthesis is intended to narrow the gap. NURS FPX 9902 Assessment 3: Literature Synthesis Particularly relying on such studies as Buhr et al. (2020) which showed the efficiency of the hospital readmission reduction program (HRRP) this assessment pays emphasis to the importance of the innovative approaches in the improvement of the COPD patients’ care.
Search Strategy
This means that while doing doctoral research there is a need to make an understanding of the fact that there is always a formulation of an approach on how to identify literature. Such a process ensures that the references provide robust evidence to fit a given healthcare issue and precise enhancement of quality intervention. The research began with the development of a PICOT question that captured a clinical problem at the practicum site. Specifically, the study aimed to address: For caregivers of patients with COPD, how does the intervention of teaching disease education through the teach-back method compared to the current practices influence their client’s 30-day medication compliance and hospitalization rates in the next 10 weeks? This PICOT question and quality improvement initiative have been reviewed and accepted by the research site and Capella University’s Institutional Review Board (IRB).
A literature search was conducted using four primary databases: CINAHL, Nursing and Allied Health, Pub Med, and Capella Library. First, the search was made with the keywords “COPD readmissions,” which produced over 1,500 hits. Applying filters for the studies published in the last five years limited the studies to only peer-reviewed sources still, it did not address the PICOT question completely. Another broader search was conducted using medication adherence and the teach-back method as keywords, which produced 15 papers that were incorporated into the study. To provide evidence for practice, these articles were reviewed using a hierarchy of evidence and classified based on their hierarchy. To obtain further literature, the reference lists of the identified articles were scanned and examined as well. Applying this approach, two more articles indexed by the Web of Science and five related websites were identified. Thus, the search used a diversified approach which enabled to avoidance of certain pitfalls and shortcomings in the evidence base of the search.
Synthesis of the Literature
Reducing Readmissions
Chronic obstructive pulmonary disease (COPD) is a slowly progressive disease affecting the respiratory system and it has an astounding incidence and mortality rate. COPD is a lifelong disease in which most people get hospitalized after the exacerbation and most of the population gets readmitted hence straining the health and compensation facilities. The hospital readmissions reduction program (HRRP) was established by the Centers for Medicare & Medicaid Services (CMS) to encourage the recognition of practices that can reduce readmission rates in hospitals (Psotka et al., 2020). Regarding its benefits, previous findings on educational intervention strategies for patients along with care practices and early signs of deteriorating status are useful.
A study done by Buhr et al. (2020) established that the modified HRRP had paved the way for the reduction of COPD readmissions by reducing the fraction from 19 percent to 17 percent within 6 years of the program. These consultations centered on the aspects of self-care and reporting to one’s plan as well as actions. Another study by Hawthorne et al. (2022) confirmed another valuable early signal of COPD episodes, which is an accelerated respiratory rate, increased by two times per minute. The literature survey emphasizes that COPD readmissions may be prevented by educational programs and timely interventions. Integrated use of technology, patient engagement concepts, and predictive models provide one potential solution.
Self-Care
COPD management involves educating patients to undertake activities that would prevent them from relapsing and continuing with their daily lives. Policies such as cigarette smoking, modifying physical surroundings, and adjustments in treatment compliance are core aspects of self-management. Evaluations have shown that tangible efforts on these issues can produce huge changes in patient success rates. According to Pham et al. (2024), it is observed that taking into account both direct health and productivity costs of COPD are considerably significant in low- and middle-income countries.
Siu & Lachter (2024) identified three innovative approaches to overcome barriers in COPD care: such as telemedicine besides community interventions and personalized health education programs. When examining asthma patients, Listyoko et al. (2024) learned that the presence of chronic comorbidities dramatically affects clinical outcomes and that combining treatments is necessary. However, the study gave useful information and recommendations; still, the study was constrained by issues of sample size and generality. Self-care interventions across educational programs are effective in preventing COPD exacerbations. Long-term success is contingent upon the ability to impart the needed knowledge and skills that would eventually empower the patient.
Teach-Back Method
The teach-back technique is an adult learning approach that confirms that the patient, or any individual, has understood and can recall specific information relating to their management and treatment. Healthcare providers expound on concepts they want the patients to understand, and then the patient is expected to explain in their terms. Interventional studies such as Oh et al. (2023) identified a teach-back method in the development of a discharge education program focused on heart failure patients where there was an increased disparity in self-care knowledge and reduced readmissions among patients.
Talevski et al. (2020) established that using the teach-back method enhances knowledge, health statuses, and compliance with prescribed processes and protocols in patient care across ecosystems. The findings of the study provided evidence that trained providers had better ability to respond to a patient’s question and understanding. The teach-back method by Kaseb et al. (2024) depicted that education delivered via the teach-back technique improves self-care practices and life in heart failure patients. The teach-back method is a great engagement of the patient because it is a thoughtful process rather than just simply informing the patient. The general plan, provided patients are more actively involved in their treatment, the healthcare givers would in one way or another enhance the care and probably reduce the rate of hospital admissions.
Visual Delivery
Technical detail of education about learning style improves the understanding and implementation processes. People get easily engaged by visual aids like video clips, illustrations, and lively demonstrations, as well as, user-friendly interphase in reaching out to a variety of patient groups. Talevski et al. (2020) identified that the knowledge of the capabilities of patients admitted to the healthcare facility may be inadequate because healthcare providers tend to overestimate patient’s communication skills when developing an education plan for them. The study recommended the use of visuals to help in filling these gaps. The research work of Mancone et al. (2024) evaluated the effectiveness of e-learning modules, which enhance patient’s health literacy, and reported better knowledge scores and learning interest for chronic diseases.
The National Heart, Lung, and Blood Institute, an organization that focuses on promoting COPD management, uses aids like videos and other online tools to assist in the proper handling of COPD. In their study, Schnieders et al. (2022) showed that the use of interactive e-learning modules greatly enhanced the attainment of more knowledge by the medical students as well as their level of interest in whatever they are learning especially COPD than the noninteractive e-learning modules. They are most beneficial in the areas of low health literacy as a way of overcoming its difficulties.
Conclusion
COPD readmissions and outcomes may be reduced by increasing education, early intervention, and incorporating patient-centered processes, as evident in the literature synthesis. The teach-back method has shown to be a powerful knowledge translation tool when used with the visual aids and self-management techniques needed by COPD patients. When delivered within clinical environments, it becomes possible to enable patients to modify their behavior. Therefore managing their disease state optimally and thus improving their quality of life while putting less demand on the healthcare system.
References
Buhr, G., Jackson, J., Kominski, F., Dubinett, M., Mangione, M., & Ong, K. (2020). Readmission 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. https://doi.org/10.1007/s11606-020-05958-0
