NURS FPX 9902 Assessment 3 Literature Synthesis

Student Name

Capella University

NURS-FPX 9902 Nursing Doctoral Project 2

Prof. Name:


Literature Synthesis

This evaluation provides in-depth insights into the doctoral student’s search strategy and methods used to locate literature for synthesis. Its primary objective is to facilitate the synthesis of literature discovered during the research process. The doctoral learner will comprehensively outline the process used 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 commenced 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 the 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 Breathe 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. https://doi.org/10.2196/18316

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. https://doi.org/10.1146/annurev-publhealth-040218-044008

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. https://doi.org/10.1007/s11606-020-05958-0

Centers for Medicare and Medicaid Services. (n.d.). Hospital readmissions reduction program (HRRP). cms.gov. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program

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. https://doi.org/10.1007/s40271-019-00386-7

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). https://doi.org/10.1186/s12931-022-02018-5

NURS FPX 9902 Assessment 3 Literature Synthesis

Hegelund, A., Andersen, I., Andersen, M. N., & Bodtger, U. (2019). The impact of a personalised action plan delivered at discharge to patients with COPD on readmissions: A pilot study. Scandinavian Journal of Caring Sciences, 34(4), 909–918. https://doi.org/10.1111/scs.12798

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. https://doi.org/10.1071/py18181

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. https://doi.org/10.1155/2022/2615580

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. https://doi.org/10.2147/copd.s90812

National Heart, Lung, and Blood Institute. (n.d.-a). Learn more breathe better. Retrieved from https://www.nhlbi.nih.gov/BreatheBetter

National Heart, Lung, and Blood Institute. (n.d.-b). COPD videos. Retrieved from https://www.nhlbi.nih.gov/health-topics/education-and-awareness/copd-learn-morebreathe-better/copd-videos

National Heart, Lung, and Blood Institute. (n.d.-c). COPD national action plan. Retrieved from https://www.nhlbi.nih.gov/resources/copd-national-action-plan

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). https://doi.org/10.1186/s12912-021-00622-2

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),

NURS FPX 9902 Assessment 3 Literature Synthesis

https://doi.org/10.1186/s12890-019-0882-y 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. https://doi.org/10.1016/j.nepr.2021.102990

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. https://doi.org/10.1155/2022/4638745

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. https://doi.org/10.2196/34751

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. https://doi.org/10.1188/19.cjon.288-294

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. https://doi.org/10.1007/s00520-021-06445-w

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). http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fpharmacologic-management-copd-exacerbations%2Fdocview%2F2551565346%2Fse-2%3Faccountid%3D27965

Sutton, K., & Phelps, P. (2021). Structured telephonic consultation to decrease COPD 30-day readmissions. Medsurg Nursing, 30(6), 377–382,395. https://doi.org/http://library.capella.edu/login?qurl=https%3A%2F %2Fwww.proquest.com%2Fscholarly-journals%2Fstructured-telephonic-consultationdecrease-copd%2Fdocview%2F2616230490%2Fse-2%3Faccountid%3D27965

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. https://doi.org/10.1371/journal.pone.0231350

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). https://doi.org/10.1186/s12889- 019-7658-4

NURS FPX 9902 Assessment 3 Literature Synthesis

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. https://doi.org/10.2147/copd.s341905

World Health Organization. (2019). Chronic obstructive pulmonary disease (COPD). Retrieved from https://www.who.int/health-topics/chronic-respiratory-diseases#tab=tab_1

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. *BM

J Quality & Safety, 26*(11), 908–918. https://doi.org/10.1136/bmjqs-2017-006529

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