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

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

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Capella University

NURS-FPX4025 Research and Evidence-Based Decision Making

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Presenting Your PICO(T) Process Findings to Your Professional Peers

Chronic Obstructive Pulmonary Disease (COPD) significantly impairs lung function, reduces quality of life, and increases healthcare utilization. Smoking remains the primary risk factor for COPD, yet cessation represents the most effective intervention for slowing disease progression and improving patient outcomes. Despite this, patients face multiple challenges when attempting to quit, including nicotine dependence, psychological stress, and inadequate support systems (Choi et al., 2021). This study evaluates whether structured smoking cessation programs outperform standard counseling in promoting smoking cessation and enhancing pulmonary function over a six-month follow-up period.

Diagnosis: Outcomes, Risks, and Complications

COPD manifests as chronic airway obstruction, resulting in breathing difficulties, persistent cough, wheezing, and frequent respiratory infections. Extended exposure to irritants, particularly tobacco smoke, is the leading cause. In the United States alone, approximately 14 million individuals live with COPD (Boers et al., 2023). The disease progressively reduces pulmonary function, limits daily activities, and negatively affects overall quality of life.

COPD progression varies depending on disease severity and treatment effectiveness. Inadequate intervention increases hospitalizations due to exacerbations and worsens clinical outcomes. Comorbid conditions such as cardiovascular disease, osteoporosis, muscle wasting, and depression are common in patients with poorly controlled COPD. Advanced COPD may necessitate long-term oxygen therapy or mechanical ventilation (American Lung Association [ALA], 2024). Persistent smoking accelerates lung function decline, increases hospitalization frequency, and raises mortality risk. Integrating evidence-based treatment with structured smoking cessation programs can help control disease progression while improving patient health outcomes.

Research Question Using PICO(T) Criteria

To identify the most effective intervention for smoking cessation in COPD patients, the research question was structured using the PICO(T) framework:

Research Question: In adult patients diagnosed with COPD (P), how does a structured smoking cessation program incorporating behavioral counseling and pharmacotherapy (I) compared to standard smoking cessation counseling (C) affect smoking cessation rates and pulmonary function (O) within six months (T)?

This PICO(T) framework ensures a focused approach for evaluating the effectiveness of smoking cessation interventions in COPD patients.

Summary of Evidence from Peer-Reviewed Sources

A review of current literature demonstrates that structured smoking cessation interventions significantly improve COPD patient outcomes. Wang et al. (2024) conducted a meta-analysis of 11 trials with over 13,000 participants, revealing a 6.72% improvement in FEV1, a 64.46-meter increase in six-minute walk test (6-MWT) distance, and a 25% reduction in mortality risk (RR = 0.75). The study’s meta-analytic approach strengthens the reliability and generalizability of its findings.

Han et al. (2023) performed a randomized controlled trial (RCT) evaluating structured interventions combining cognitive behavioral therapy with pharmacotherapy. The results indicated higher quit rates in structured programs than standard counseling, highlighting the superior efficacy of multi-component strategies.

Fu et al. (2022) utilized the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model to implement structured smoking cessation in clinical practice. Evidence indicated that evidence-based interventions optimize pulmonary outcomes while controlling COPD progression. Hu et al. (2021) reported a 27.6% six-month smoking abstinence rate, confirming the effectiveness of structured programs within this timeframe. Collectively, these studies support the value of structured cessation interventions in improving both smoking cessation rates and pulmonary function in COPD patients.

Answer to the PICO(T) Question Based on Evidence Analysis

The analyzed evidence clearly indicates that structured smoking cessation programs outperform standard counseling in COPD management.

• Lung function and mortality: Wang et al. (2024) demonstrated improved FEV1 and reduced mortality risk with structured cessation programs.

• Quit rates: Han et al. (2023) confirmed higher cessation rates for structured interventions combining behavioral and pharmacologic approaches.

• Implementation in clinical practice: Fu et al. (2022) emphasized the importance of evidence-based practice models in facilitating program adoption.

• Timeframe validation: Hu et al. (2021) validated six months as an appropriate interval to evaluate sustained cessation success.

Patient adherence, socioeconomic factors, and access to healthcare may influence outcomes, suggesting a need for tailored interventions in future research.

Key Steps of Care Based on Evidence-Based Recommendations

Evidence-based strategies for enhancing smoking cessation and overall COPD management include:

This integrated approach maximizes patient engagement and enhances long-term cessation success.

Conclusion

COPD is a progressive disease with substantial health risks, particularly for individuals who continue smoking. Structured smoking cessation programs combining behavioral counseling and pharmacotherapy are consistently more effective than standard counseling alone. Implementation of evidence-based interventions improves quit rates, enhances pulmonary function, and reduces COPD-related complications and mortality. Healthcare professionals are encouraged to integrate structured cessation programs into routine care to improve patient outcomes and quality of life.

References

American Lung Association (ALA). (2024). Learn about COPD | American Lung Association. Lung.org; American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd

Boers, E., Barrett, M., Su, J. G., Benjafield, A. V., Sinha, S., Kaye, L., Zar, H. J., Vuong, V., Tellez, D., Gondalia, R., Rice, M. B., Nunez, C. M., Wedzicha, J. A., & Malhotra, A. (2023). Global burden of chronic obstructive pulmonary disease through 2050. Journal of the American Medical Association Network Open, 6(12), e2346598. https://doi.org/10.1001/jamanetworkopen.2023.46598

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

Choi, H. K., Vargas, J. A., Lin, C., & Singrey, A. (2021). The current state of tobacco cessation treatment. Cleveland Clinic Journal of Medicine, 88(7), 393–404. https://doi.org/10.3949/ccjm.88a.20099

Fu, Y., Chapman, E. J., Boland, A. C., & Bennett, M. I. (2022). Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review. Palliative Medicine, 36(5), 770–782. https://doi.org/10.1177/02692163221079697

Han, M. K., Fu, Y., Ji, Q., Duan, X., & Fang, X. (2023). The effectiveness of theory-based smoking cessation interventions in patients with chronic obstructive pulmonary disease: A meta-analysis. BioMed Central Public Health, 23(1). https://doi.org/10.1186/s12889-023-16441-w

Hu, Y., Xie, J., Chang, X., Chen, J., Wang, W., Zhang, L., Zhong, R., Chen, O., Yu, X., & Zou, Y. (2021). Characteristics and predictors of abstinence among smokers of a smoking cessation clinic in Hunan China. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.615817

Onwuzo, C. N., Olukorode, J., Sange, W., Orimoloye, D. A., Udojike, C., Omoragbon, L., Hassan, A. E., Falade, D. M., Omiko, R., Odunaike, O. S., Momoh, P. A. A., Addeh, E., Onwuzo, S., & Erameh, U. J. (2024). A review of smoking cessation interventions: Efficacy, strategies for implementation, and future directions. Cureus, 16(1). https://doi.org/10.7759/cureus.52102

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

Wang, Z., Qiu, Y., Ji, X., & Dong, L. (2024). Effects of smoking cessation on individuals with COPD: A systematic review and meta-analysis. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1433269