Capella University - NURS FPX 4025 Assessment

Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 3 Applying the PICO(T) Process

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NURS FPX 4025 Assessment 3 Applying the PICO(T) Process Student Name Capella University NURS-FPX4025 Research and Evidence-Based Decision Making Professor’s Name Submission Date Applying the PICO(T) Process The proper use of medications plays an important role in both the treatment process and the future well-being of AMI patients. A combination of such factors as healthcare disparities, the lack of medication adherence, and the lack of patient education gives rise to heart attack and heart failure recidivism among patients (Kalantarzadeh et al., 2022). The effectiveness of patient care that is centered around patient education about the process of taking medications is proven by clinical studies carried out by nurses. In this regard, the purpose of the current review is to address the issue of healthcare disparities concerning the consequences of AMI, focusing on the effect of patient education initiated by nurses. AMI Risks, Complications, and Disparities Being diagnosed with myocardial infarction (MI) or acute coronary syndrome (ACS) increases the chances of developing severe complications observed among patients with specific features. If a patient receives an accurate diagnosis and effective therapy, they will have great opportunities for survival. Treatment provided late leads to serious health problems like heart failure, cardiac rhythm disorders, and even sudden cardiac death (Yow et al., 2024). Every year, 805,000 individuals experience a heart attack in America; of this number, 605,000 are new patients with myocardial infarction, whereas 200,000 are repeat occurrences in those who have had heart attacks before (Centers for Disease Control and Prevention, 2024). Being exposed to health inequity with regard to accessing healthcare services results in inadequate patient diagnostics and poor prognosis, since they lack prevention due to health inequalities and related risk factors. Proper patient diagnostics and timely treatment according to guidelines, as well as lifestyle modifications, help patients survive and significantly increase their chance of living a healthy life. Delayed treatment leads to multiple heart attacks, heart dysfunction, and permanent disability related to heart conditions (Handelsman et al., 2023). Impact of the Disparities Health inequality has several adverse impacts that can be seen, such as the delay in MI and AMI diagnosis and treatment process, and a lack of healthcare services that negatively impact the health of people. The restricted availability of health services, such as issues of finances and society, results in problems that increase mortality and illness durations for disadvantaged communities (Schwarz et al., 2022). Health disparities have causes like the prolonged duration of seeking emergency health services by the rural population, minority groups, and financially poor people, since they do not get proper care because of the lack of education or financial difficulties (Agency for Healthcare Research and Quality, 2021). Health disparities have resulted in admission rates to hospitals and worsening chronic heart conditions in the target community. PICOT Question In patients with acute myocardial infarction (P), how does nurse-led medication education (I), compared to current standard discharge practices (C), affect medication adherence (O) within three months (T)? P (Population): Patients with acute myocardial infarction (AMI) I (Intervention): Nurse-led medication education C (Comparison): Current standard discharge practices (Outcome): Medication adherence T (Timeframe): Within three months PICOT Criteria Breakdown PICO(T) research question This is a PICO(T) question because it adheres to the format of asking questions as outlined by PICO(T). The P in this case refers to the population targeted in this research, who are patients with heart attacks with critical symptoms, where there is poor adherence to medication. The interventions to be used are educating the patient regarding medication through the guidance of nurses because nurses help to ensure patients take their medications, according to Berardinelli et al. (2024). In the proposed study, modern discharge standards (C) act as sources for this new intervention and can be measured. The outcome (O) for this research is medication adherence, as it prevents rehospitalization as well as complications. The time (T) frame of three months will provide accurate data regarding changes in patient compliance for the development of appropriate healthcare interventions. Literature Search Process In terms of research data sources, some databases, including PubMed, CINAHL, Google Scholar, Cochrane Library, and ScienceDirect, were utilized to gather information regarding nurse-led medication education among AMI patients. Some of the critical terms used in the study analysis included nurse-led education, medication adherence, and patient outcomes. Using the research filters among all clinical guidelines and publications, the peer-reviewed research selected was filtered by the past five years and ensured credibility (Heath et al., 2021). The assessment of resources that go into choosing material is based on the assessment of the level of evidence that is provided in the journal and the professionalism of the author. This approach was given a special preference by guidelines by the American Heart Association (AHA) and the National Institutes of Health (NIH) (Heidenreich et al., 2022). The sources gathered indicate the evidence-based knowledge regarding the nursing interventions that might be enhanced to improve the outcomes of AMI patients. Our findings are evidence-based using various studies that suggest nurse-led intervention as an effective method of creating successful outcomes in medication adherence practices. The PubMed studies also found that the outcomes would be improved medication adherence and fewer errors when any nursing patient education is performed (PubMed, 2025). CINAHL made available the evidence regarding the joining of the nursing interventions to help the self-management of patients and bedside adherence (Elton B. Stephens Company, 2024). Scholarly articles were used in Google Scholar, which showed a reduced hospital admission due to the increased medication adherence because of nurse education (Google Scholar, 2025). The Cochrane Library is publishing news of systematic reviews on systematic reviews of the proposed ways of structured nursing interventions with AMI patients, which have high adherence levels (Puga & Atallah, 2020). ScienceDirect is an information source that indicates evidence about the evidence-based nurse-prescription medication teaching that decreases readmission rates in hospitals (Science Direct, 2025). Such Boolean operators as “AND or OR assisted the researchers either to mix certain words in their search or to filter the results, or not to display certain

Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

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NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers Student Name Capella University NURS-FPX4025 Research and Evidence-Based Decision Making Professor Name Submission Date Presenting Your PICO(T) Process Findings to Your Professional Peers Hello, my name is…, and I would like to share my PICO(T) process findings with you today on improving care coordination for children with sickle cell disease. In professional nursing practice, a significant responsibility today is sharing evidence-based findings as a means to improve patient outcomes and provide coordinated, evidence-based care for those impacted by sickle cell disease (SCD) – a condition that has a major impact on the health and well-being of children. Collaborative decision-making to provide the best care for patients is possible when nurses share research. PICOT research also contributes to building the evidence base needed to support nursing practice by assisting nurses in delivering high-quality care to vulnerable populations. Explanation of Diagnosis: Acute Heart Failure Sickle cell disease (SCD) is an inherited blood disorder in which the red blood cells take on an irregular, sickle shape, leading to blockage of blood vessels. This blockage also contributes to the pain crises, resulting in organ damage and significantly reduced quality of life. As Tebbi. As has been pointed out by (2022), complications of SCD include stroke, infection, and major delays in growth and development in children. So, the risks of SCD are high and long-term, and will necessitate proactive, consistent, and comprehensive management approaches to reduce risks. Children with SCD may have frequent pain crises, which lead to high levels of hospitalizations and school absence, affecting the emotional, family, and health outcomes of each child. According to Jain et al. (2026), inadequate pain management along with the lack of adequate care delivery from diverse populations of individuals living with SCD will significantly lead to worsening health outcomes and overall emotional well-being. It is crucial, therefore, for nurses to be aware of these potential risks and complications so that they can care for the patient in an effective, patient-centered way. PICO(T) Research Question Research Question: Does an improvement in care coordination (I) over standard care (C) reduce the number and severity of pain crises and improve health outcomes (O) in children with sickle cell disease (P) after 6 months (T)? PICO(T) Components P (Population): Children with sickle cell disease I (Intervention): Improved care coordination C (Comparison): Standard care (Outcome): Frequency and severity of pain crises and health outcomes T (Time): Over 6 months Explanation of PICO(T) Criteria Application An evidence-based practice begins with the use of clinical questions that are based on evidence to produce reliable research and enhance patient outcomes. PICO(T) provides nurses with a systematic method of recognizing the various patient populations, interventions used with the patient populations, and accepted measures that result from the intervention. Albertson et al. (2021) agree on this idea that “structured questions to coordinate care will result in better intervention with patient groups that are consuming excessive healthcare resources. This question addresses the main barriers that people with SCD have to accessing timely and coordinated health care services. Evidence Summary Several reliable sources have been considered by various sources to provide an answer to the PICO(T) question on Pediatric Sickle Cell Disease (SCD) patient care. Each source offers a different insight or evidence into improving care coordination and/or delivering better outcomes. Schlenz et al. (2025) conducted a National Institutes of Health (NIH) funded, peer-reviewed, qualitative research study that discusses barriers and facilitators to comprehensive pediatric SCD care; this is a very reliable and relevant source to identify challenges experienced by children with SCD when accessing care. Schieve et al. (2022) conducted quantitative research, which has shown that adherence to preventive care recommendations influenced the reduction in complications among children with SCD. Freitas et al. (2025) performed a rapid review that confirms nurses play an important role in coordinating patient care, educating patients, and advocating for patients. Moreover, Ge et al. (2023) offer additional findings that community nurses play an important role in the continuity of care and effective coordination of chronic disease management for patients. These sources offer a good amount of evidence, credibility, and relevance when defining evidence-based nursing practice for children with SCD. Analysis of Evidence and Answer to PICO(T) Question A wide range of research indicates that better care coordination for children with sickle cell disease (SCD) has a positive impact on their outcomes. Better coordination of care will improve the quality of health care, enhance family involvement in their children’s care, and decrease the incidence of pain crises. The study by Khatri et al. (2023) demonstrates that continuity and coordination of primary health care (PHC) have a significant positive impact on outcomes of patients with chronic diseases across populations. Therefore, coordinated care is one of the most evidence-supported interventions to optimize the care of children with SCD. Moreover, care coordination lowers system barriers, like transportation, lack of provider knowledge, and missed appointments, which result in missed timely treatment and unexpected complications and hospitalizations. Schlenz et al. (2025) highlighted the importance of establishing good provider relationships and providing support services as factors that enhance the outcomes of SCD patients. In summary, these studies show that coordinated and supportive care significantly enhances the health and well-being of SCD children. Assumptions Underlying the Analysis Assuming that perceived barriers to care among various pediatric populations with sickle cell disease (SCD) will be similar regardless of clinical setting/location, it should be noted that the current analysis assumes that care coordination interventions can be feasibly implemented within existing healthcare systems/resources, and additionally, based on the evidence cited by Connor. (2023), evidence-based practice (EBP) models show consistent evidence of improving patient outcomes and providing a return on investment for health care. While these assumptions are reasonable, it is important to keep them in mind when applying any of the study’s findings to other clinical/community settings. Key Steps of Care Based on Evidence Evidence exists that some key nursing care measures can make a significant difference to the outcomes of children with sickle

Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 2 Applying an EBP Model

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NURS FPX 4025 Assessment 2 Applying an EBP Model Student Name Capella University NURS-FPX4025 Research and Evidence-Based Decision Making Professor Name Submission Date Applying an EBP Model Sickle cell disease (SCD) is a blood condition that is passed down through families, causing red blood cells to become stiff and sickle-shaped. This leads to clogged blood vessels, painful episodes, organ damage, and reduced quality of life (QOL) (D’ Costa et al., 2023). A 10-year-old with pain crises should be treated throughout life and as a whole. The goal of evidence-based practice (EBP) in nursing is to improve patients’ safety and care. This takes into account evidence, practitioner, and patient values/preferences to deliver the desired outcomes. The paper discusses the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model to resolve problems in the SCD child’s care and enhance his pain control experience. Description of the Diagnosis and Associated Issue Sickle cell anemia is a long-term disease that is commonly experienced by children. Pain (pain crises) has been noted to be a common symptom of the disease in childhood, with multiple hospital visits and requiring a multidisciplinary team for their management (Jain et al., 2026). One of the problems with SCD is the time gap between the onset of the disease and symptoms and complications (pain crises). Further, issues with the coordination of services and access to health services, such as transport issues, lack of knowledge and skills among health care providers, can affect care; these issues impact complications and the quality of life. This is where an EBP approach may help, because care may be provided in a different way than a standard care approach, and may not be based on the best available evidence. Without the availability and consistency of using evidence-based approaches, there’s a potential for a delay in timely pain and supportive care interventions. The EBP model assists health care practitioners in planning care, preventing delays in care, and improving quality and outcomes with the best and latest evidence at their fingertips (Connor, 2023). As such, it is essential to adopt an EBP model to help improve these issues and health outcomes in children with SCD. Selection of the Evidence-Based Practice Model The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model was chosen for this discussion as it is an easy way to integrate and use to support decision-making (Bissett et al., 2025). This model is made up of three parts: Practice Question (P), Evidence (E), and Translation (T). The model offers a framework for nurses to identify evidence problems, find evidence, and change practice to use evidence. The JHNEBP model is suitable to tackle issues related to sickle cell disease as it is practice-focused. It helps nurses to develop practice questions, identify and use evidence. It also ensures better patient outcomes and has the other advantages of standardization and uniformity of nursing care (Gaber et al., 2025). The simplicity of the models enables them to be utilized in complicated problems like delays in care and treatment of children with SCD. Description of the Evidence-Based Practice Model Steps The first step of the JHNEBP model is the Practice Question (P), which begins with identifying a problem and formulating an evidence question. This can be done by considering Population (P), Intervention (I), Comparison (C), Outcome (O), and Time (T) factors (PICOT). Again, with regard to sickle cell disease, the practice question is to coordinate care and expedite treatment for pain in children. Step 2 is Evidence (E); in this step, nurses apply evidence, looking for studies and evaluating the validity and applicability of the studies. The nurses conduct an exhaustive search of reliable databases (such as PubMed, CINAHL, and Google Scholar) for credible evidence in the area. Also, the nurses review the evidence for validity, reliability, and strength of the evidence used to guide our practice. The third step is Transformation (T) or translating our evidence into our practice. This is when we can provide strategies to support change (such as better health care provider communication, patient education, and eliminating these treatment barriers) (Ainslie et al 2024). These strategies are put to the test to determine how effective they are for the patient. Steps are included as they provide a strategic approach to the model and apply best practices in health care. Application of the Evidence-Based Practice Model to the Issue A particular issue impacted by using the JHNEBP model was the delayed treatment and lack of coordination of care in the case of childhood sickle cell disease. A PICOT question was formed during the Practice Question phase: How does improved care impact the prevention and treatment of pain crises and patient outcomes in children with sickle cell disease versus standard care? The question was used as a search tool when looking for literature. In the Evidence phase, peer-reviewed literature from the past 5 years was identified using search engines PubMed, CINAHL, and Google Scholar. We searched for the terms “Sickle cell disease”, “children”, “childhood”, “pain crisis”, “coordination of care”, and “barriers to care”. Articles were chosen based on research findings that have outcomes in children and barriers to care over the past several years. We identified barriers to care, with few studies focused on children, and problems getting the full-text of certain studies. We were able to search a few studies. We worked during the Translation phase on strategies to improve care, taking into account the information from studies. These involve communication with the health care team and families, support services (including transport services), and protocols for pain management (Baker et al., 2024). These strategies are aimed at reducing delays in care and enhancing care. Analysis of Evidence The first paper (Schlenz et al., 2025) is a qualitative paper that describes the barriers and facilitators to care in children with sickle cell disease. This study is reliable due to the backing by the National Institutes of Health (NIH), which secured a guaranteed way of conducting research, and the publication in a peer-reviewed journal. It’s also relevant as it relates directly

Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 1 Analyzing a Research Paper

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NURS FPX 4025 Assessment 1 Analyzing a Research Paper Student Name Capella University NURS-FPX4025 Research and Evidence-Based Decision Making Professor Name Submission Date Analyzing a Research Paper Criteria Analysis Type of Study Qualitative study using interviews. Data analyzed with content analysis. Moderate level evidence. Credibility Peer-reviewed journal. NIH-funded. IRB approved. Conducted by healthcare researchers. Importance of Diagnosis Focuses on sickle cell disease in children. Identifies barriers and facilitators to care. Application to Patient (Jamie) Applies to Jamie’s pain crisis. Highlights care barriers (access, delays) and supports better care coordination and education. Sickle Cell Disease (SCD) is a genetic disorder characterized by the presence of abnormal, sickle-shaped red blood cells and some abnormalities in the mobility of the blood cells. This leads to complications, which cause pain, damage to organs, and decrease the quality of life. Early diagnosis in childhood and the need for specialist care throughout childhood are essential to avoid complications later in life. Children with SCD need tailored care, as this allows children to have a better quality of life and reduce complications (Schieve et al., 2022). This assignment will explain one of the journal articles on “Barriers and facilitators of holistic care for children with sickle cell disease, to care for a 10-year-old boy, Jamie Hampton, with SCD pain. Overview of the Research Article We have chosen Barriers and facilitators to pediatric sickle cell care: a qualitative descriptive study, Schlenz et al (2025), which is a qualitative descriptive study of barriers and facilitators for holistic care of children with sickle cell disease. The authors analyzed data from semi-structured interviews of 27 parents of sickle cell children. Directed content analysis was done using the Conceptual Framework of the Access to Care Model. Qualitative studies such as these provide a detailed description of the patient/caregiver experience of a problem; they can be used to understand barriers to access. Qualitative research isn’t as rigorous as quantitative research, but it does provide you with some knowledge of the problem, and you can learn from this to better care. Credibility of the Article For one, it’s a believable piece of writing for a couple of reasons. First, because they have published their article in a peer-reviewed journal about the topic, Pediatric Blood & Cancer. First, because it’s an NIH-sponsored study, which means it’s a measure of the quality of the study (Schlenz et al., 2025). Second, because it has received approval from the Institutional Review Board (IRB), the authors of the study have published other studies on pediatrics or hematology. Also, the study consists of data from a number of sites, making the study authentic. Key Findings of the Study This study highlighted that there were several factors that facilitated and obstructed sickle cell care. This was due to the positive relationship, support, and education between the parent and provider. This resulted in increased satisfaction with and engagement in health care (Schlenz et al., 2025). Need for support and support services (such as appointments, transport). The study revealed that there were issues. The issues in the health system were the lack of awareness regarding health care providers, waiting time, and appointments. The personal issues mentioned were transport, financial issues, ‘no shows’ (not showing up), and availability for employment/study (Sang et al 2025). These may impact health and health care. The most frequent power outage impacting health care was public transport. Relevance to Sickle Cell Disease This is significant in developing innovative solutions to the problem of sickle cell disease because sickle cell disease is a disease that needs long-term and comprehensive management. With no treatment, the signs and symptoms of the disease are pain, complications, and hospitalization. Children with SCD have a range of quality of life (QoL) needs and complications that require a range of health care services, as identified (Schlenz et al 2015). They spotlighted barriers and facilitators in accessing health care that are affecting the lives of SCD patients. Application to Patient This study can be used to treat Jamie Hampton’s 10-year-old child, who has sickle cell disease in crisis. Jamie suffers from pain attacks that need to be treated. Jamie might experience delays and problems with coordinating and receiving care. May not be able to make it to appointments. The study demonstrates ways to enhance the care. These include communication, education, and coordination. He’s in the care of nurses. They make sure he’s not in pain, educate him, and coordinate care (Ge et al, 2023). Therefore, with education and removing barriers and offering enablers, we can enhance the care and experience of Jamie. Application to Practice This research can give us some insight. This can work to help health workers (particularly nurses) address healthcare barriers. This means there will be support for transportation, and parents will be informed and supported in their health care journey. Healthcare professionals can also be more humble and practice cultural humility to care for the patient by being reflective of the patient or family (Hernandez et al., 2021). Barriers and facilitators will help the healthcare system provide the optimum health and well-being for the child with sickle cell disease. Conclusion The article looks at the barriers and facilitators of health care for sickle cell disease. This emphasizes the need for proper health care, communication between the patient’s family and health care professionals, and social health care support. These data help to tell Jamie Hampton’s story of barriers to care – and the importance of patient-centered care. This will help healthcare practitioners identify the barriers and facilitators to healthcare for children with SCD. Reference Ge, J., Zhang, Y., Fan, E., Yang, X., Chu, L., Zhou, X., Yan, Y., & Liu, W. (2023). Community nurses are important providers of continuity of care for patients with chronic diseases: A qualitative study. Inquiry, 60(1). https://doi.org/10.1177/00469580231160888 Hernandez, N. C., Leal, L. M. R., & Brito, M. J. M. (2021). Building culturally competent compassion in nurses caring for vulnerable populations. Journal of Holistic Nursing, 40(4), 359–369. https://doi.org/10.1177/08980101211062708 Sang, E., Hirschman, K. B., Stawnychy, M. A., Bin You, S., Pitcher, K. S., O’Connor, M., Oh, S.,