Evidence-Based Practice Project: PICOT Paper

The burden of cardiovascular diseases or the wide array of conditions affecting the heart and blood vessels on the healthcare system is increasing, hence requiring evidence-based interventions to foster patient education for better outcomes (Roth et al., 2020). According to Melnyk & Fineout-Overholt (2019), evidenced-based practice helps healthcare providers ensure that their interventions are informed by sound scientific evidence that has shown improvements in outcomes. In this EBP project, the author seeks to improve the clinical outcomes of people with cardiovascular diseases by implementing nurse-led education. This paper intends to discuss the population demographics, proposed evidence-based intervention, and its relation to research, expected outcomes, implementation time, and application of nursing science to support population health management.

The PICOT Question is: In patients with cardiovascular disease (P), does nurse-led education (I), compared to standard patient education (C) affect clinical outcomes (O) within 9 months (T)? Evidence-Based Practice Project: PICOT Paper

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Population’s Demographics and Health Concerns

Cardiovascular diseases are common among adults with comorbid conditions such as obesity, hypercholesterolemia, uncontrolled hypertension, diabetes mellitus, and other lifestyle diseases (Petrie et al., 2018). The most common cardiovascular disease among the population is coronary heart disease, affecting adults aged 20 years and above. However, most patients develop complications upon discharge to continue with home treatment. The health concerns among the population included the need for more knowledge for controlling and stopping the conditions and practical strategies to abate the development of complications. Our healthcare facility has witnessed increased readmissions among the patient population. The assessment of patients’ knowledge following treatment and usual patient education by nutritionists and clinicians reveal low knowledge levels. The healthcare facility has witnessed two mortalities from coronary heart disease in the last six months. The trend is unacceptable and requires effective interventions.

Proposed Evidence-Based Intervention

The proposed solution in this EBP project for improving the outcomes for people diagnosed with cardiovascular diseases is implementing nurse-led patient education. Nurse-led patient education on cardiovascular diseases encompasses counseling, education, and systematic follow-up of patients to evaluate them while on treatment (Bagheri et al., 2022). Nurses are appropriate for patient education because of their expertise in nursing education, managing health conditions, and maintaining therapeutic relationships. Thus, the proposed intervention will focus on patient-driven self-management for cardiovascular disease and offer patient support through thorough education. The intervention would be implemented through in-person meetings in groups or individuals, phone calls, and online meetings. The focus topics will include medication management, proper nutrition, reduction of risk factors, exercise promotion, and others to abate complications and mortality.  Evidence-Based Practice Project: PICOT Paper

The current recommendations and policies about controlling and managing cardiovascular diseases include the surveillance of cases, proper nutrition among the population, regulating tobacco use, education on physical activity, availing preventive services, and increasing screening, among others (Roger et al., 2020). The proposed intervention incorporates health policies because it focuses on adopting the guidelines in patient education and support to be offered. Besides, the intervention includes goals that support health care equity for the patient population because it seeks to advance cardiovascular health for all patients, including increasing knowledge levels to promote self-management.

Comparison of Intervention to Previous Practice or Research

Previous studies have demonstrated that nurse-led patient education effectively reduces cardiovascular complications and risks among the population. In a survey by Nurmeksela et al. (2021), the researchers investigated the impact of nurse-led education on the cardiovascular risk of patients, and significant reductions were noted in the levels of cholesterol, triglycerides, and low-density lipoproteins as compared to baseline data. In their study, Nurmeksela et al. (2021) found that nurse-led education, follow-up, and counseling significantly reduced waist circumference for overweight and obese patients. Qualitative data reported by the patients revealed that the education session was very good, educative, and effective in changing their opinions about the diseases. A systematic review of studies by Son et al. (2020) also revealed that nurse-led education on self-care significantly reduced all-cause mortality and readmission in most studies.  Thus, comparing the proposed intervention to previous research suggests effectiveness in improving patient outcomes and reducing the overall risk.  Evidence-Based Practice Project: PICOT Paper

Expected Outcome

The project manager, now the MSN student, in this case, expects that implementing the proposed intervention will result in reduced complications reported among the targeted group. Besides, the project manager expects that no mortalities directly related to inadequate management and health education about cardiovascular conditions will be reported during the implementation. Further, it is expected that nurse-led education will improve patients’ knowledge of self-management hence increasing their self-efficacy, meaning that patients will believe in their capacity to execute appropriate behaviors to improve care outcomes.

Time for Implementing the Intervention and Evaluating the Outcome

Implementing nurse-led education to improve the clinical outcomes for patients with cardiovascular diseases will take nine months, during which nurses will cover various topics to impart the necessary knowledge, attitude, and skills. During the implementation period, the project manager, with the assistance of the project team and care providers, will carry out two-weekly mini-outcome checks to determine the immediate impact of the project. The mini-check will help the project manager assess the intervention’s influence during the implementation process. During the last two weeks of implementation, the project manager will evaluate the overall impact of the interventions on patients’ knowledge, self-management, and self-efficacy.

Application of Nursing Science, Social Determinants of Health, And Epidemiologic Data

Implementing nurse-led education to support population help management in this project applies nursing science because intervention adopts knowledge from nursing education methods to help promote learning among the target population. Also, the project employs nursing science knowledge related to principles underpinning nursing practice. The implementation of the project also applies the understanding of the social determinants of health (patients’ education, social and community, economic stability, health, health care, neighborhood, and built environment) to understand the potential influence of health outcomes among the target population. Epidemiologic data is applied in the project as the project manager seeks to identify cardiovascular disease risk factors and complications among the study population.  Evidence-Based Practice Project: PICOT Paper

References

Bagheri, H., Shakeri, S., Nazari, A. M., Goli, S., Khajeh, M., Mardani, A., & Vlaisavljevic, Z. (2022). Effectiveness of nurse‐led counselling and education on self‐efficacy of patients with acute coronary syndrome: A randomized controlled trial. Nursing open, 9(1), 775-784. https://doi.org/10.1002/nop2.1129

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. https://b-ok.africa/dl/5010066/6e27c8

Nurmeksela, A., Pihlainen, V., Kettunen, T., Laukkanen, J., & Peltokoski, J. (2021). Nurse‐led counseling for coronary artery disease patients: A 1‐year follow‐up study. Nursing & Health Sciences, 23(3), 678-687. https://doi.org/10.1111/nhs.12852

Petrie, J. R., Guzik, T. J., & Touyz, R. M. (2018). Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. The Canadian journal of cardiology, 34(5), 575–584. https://doi.org/10.1016/j.cjca.2017.12.005

Roger, V. L., Sidney, S., Fairchild, A. L., Howard, V. J., Labarthe, D. R., Shay, C. M., … & American Heart Association Advocacy Coordinating Committee. (2020). Recommendations for cardiovascular health and disease surveillance for 2030 and beyond: a policy statement from the American Heart Association. Circulation, 141(9), e104-e119. https://doi.org/10.1161/CIR.0000000000000756

Roth, G. A., Mensah, G. A., Johnson, C. O., Addolorato, G., Ammirati, E., Baddour, L. M., … & GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group. (2020). Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. Journal of the American College of Cardiology, 76(25), 2982-3021. https://doi.org/10.1016/j.jacc.2020.11.010

Son, Y. J., Choi, J., & Lee, H. J. (2020). Effectiveness of Nurse-Led Heart Failure Self-Care Education on Health Outcomes of Heart Failure Patients: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 17(18), 6559. https://doi.org/10.3390/ijerph17186559 Evidence-Based Practice Project: PICOT Paper

Appendix

PICOT Question

In patients with cardiovascular disease, does nurse-led education, compared to standard patient education, affect clinical outcomes within 9 months?

Refer to the PICOT you developed for your evidence-based practice project proposal.

PICOT Question: In patients with cardiovascular disease, does nurse-led education when compared to standard patient education affect clinical outcome within a 9-month period?

Write a 750-1,000-word paper that describes your PICOT.

Describe the population’s demographics and health concerns.
Describe the proposed evidence-based intervention and explain how your proposed intervention incorporates health policies and goals that support health care equity for the population of focus.
Compare your intervention to previous practice or research.
Explain what the expected outcome is for the intervention.
Describe the time for implementing the intervention and evaluating the outcome.
Explain how nursing science, social determinants of health, and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population.

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Create an Appendix for your paper and attach the PICOT. Be sure to review feedback from your previous submission and revise your PICOT accordingly.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite at least four to six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Evidence-Based Practice Project: PICOT Paper

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