Benchmark – Part A Population Health Research and PICOT Statement NUR 550
Benchmark – Part A Population Health Research and PICOT Statement NUR 550
COPD is a condition that affects the majority of the American population. The primary cause is inhalation of tobacco smoke. According to statistics, COPD is the third largest cause of death in the United States. Frequently, patients present to the emergency room with cough, chronic dyspnea, and comorbidities, all of which can result in early mortality. The disease’s great incidence is related to the fact that it is frequently undetected. For example, it is estimated that 13 million persons with the condition remain undiagnosed in the United States (Mamary et al., 2018). The disease’s susceptibility has been proven to be significantly dependent on factors such as lung function, education level, depression, and exercise capacity (Martinez et al., 2017).
Comorbidities such as congestive heart failure, diabetes, obstructive sleep apnea, and chronic renal disease all contribute to functional impairment and death in people with COPD (Putcha et al., 2014). There are large racial disparities among COPD patients. According to Putcha et al. (2014), African-Americans with COPD had a higher chance of dying from the condition than other ethnic groups. Additionally, they have the lowest quality of life in comparison to non-Hispanic Whites. African-Americans have a higher prevalence and mortality rate of COPD as a result of other chronic illnesses such as cardiovascular disease, stroke, and diabetes (Putcha et al., 2014). As such, this study will focus on chronic obstructive pulmonary disease among African-American patients. The analysis will assist in the development of a PICOT statement that will guide the entire study effort. This analysis is necessary as a result of the increased emphasis on providing evidence-based care to people in need of healthcare.
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Population Description
African-Americans are considered part of the ethnic minorities in the US. According to data by The African American Population, the population of African-Americans was 47.8 million in the year 2018. This number represented 14.6% of all of the population of America (Black Demographics, 2018). The Hispanic-Latinos are considered the leading population of ethnic minorities in the state. The disproportionate distribution of the African-Americans v. white Americans make African-Americans the leading ethnic minority while the White Americans comprises the ethnic majority in the state. The prevalence rate of COPD among the African-American population is significantly high when compared to other ethnicities. According to (Ejike et al., 2019), the mortality rate in the US among African-American populations has been rising significantly over the years. The high rate of mortality is attributed to the fact that their susceptibility to the health effects of tobacco is more than in other ethnicities (Ejike et al., 2019). Benchmark – Part A Population Health Research and PICOT
Nurses play an important role in providing care to patients suffering from COPD. They embrace the use of evidence-based practice in ensuring that their health care needs are met. Nurses engage in the critical analysis of the best available evidence to ensure that the patients with COPD receive optimal care that meets their needs. Nurses also explore the different determinants of health affecting the patients affected by COPD. Accordingly, patients from ethnic minorities have been shown to experience challenges in healthcare due to socio-economic factors. These factors include the access to low quality care that does not meet their needs and low insurance coverage among them. There is also the fact that individuals from ethnic minorities have challenges in access to high quality and affordable care that addresses their needs (Korpershoek et al., 2016). Therefore, it is the responsibility of the nurses to ensure that the different determinants of health among the patients suffering from COPD are explored and addressed for equity and equality in healthcare.
The management of COPD also relies mainly on the use of health promotion activities. Nurses utilize their knowledge in science of nursing in ensuring that that the patients are empowered to engage in activities that will promote their health. For instance, nurses provide health education on the need for the patients to avoid the factors that increase their risk of COPD. The most critical factor is educating them on the need for smoking cessation since it increases their risk of further respiratory health problems. Nurses also work with other healthcare providers to ensure that the healthcare needs of these patients are met (Khan et al., 2017). An example is referring such patients to smoking cessation clinic where they will be assisted with ways of ceasing from smoking. Therefore, the nurses’ science knowledge is important in facilitating effective management of these patients. Benchmark – Part A Population Health Research and PICOT
Potential Solution
The management of COPD is largely dependent on the use of pharmacological interventions. As shown by Voorham et al., (2019) in their research, long-acting inhaled bronchodilators are administered to reduce the symptoms as well as exarbetions of the disease to improve the wellbeing of the patient. The long-acting bronchodilators can be either long-acting inhaled beta agonists or long-acting muscarinic antagonists. However, there is an increased use of combined long-acting muscarinic antagonists and long-acting inhaled beta agonists in cases where the control of COPD is unsatisfactorily. There is also the evidence that inhaled corticosteroids can be included in the therapy, as a way of improving the health outcomes of these patients. The addition of the corticosteroids is referred to as the use of triple therapy in the management of COPD. The available clinical evidence has shown that the use of triple therapy (corticosteroids, long-acting beta agonists, and long-acting muscarinic antagonists) is more effective than dual therapy (long-acting muscarinic antagonists and long-acting beta agonists) (Voorham et al., 2019). However, there is an acute shortage of evidence relating to its efficacy or response rate among patients of different ethnicities (Zheng et al., 2018). The need for examining the response rate across ethnicities arises from the fact that the use of corticosteroids in the management of COPD increases the risk of other problems such as immune system suppression, bone loss, easy bruising, and pneumonia. Therefore, it raises the need for further analysis that will be guided by the following PICOT statement:
In African-American patients with COPD, will the use of triple therapy result in faster recovery and reduced complications when compared with dual therapy within a period of six months?
How the Solution Supports Healthcare Equity
As shown earlier, patients from ethnic minorities such as African-Americans have been shown to be highly vulnerable to various health conditions and have a high risk of experiencing challenges in seeking healthcare they need. As a result, it is important to engage in clinical research that aims at exploring the clinical response among them to the current methods of disease management. The study findings will inform the need for the provision of patient-centered interventions that not only addresses their physiological needs but also promote their empowerment and satisfaction with care. Through this, the concept of equity in healthcare will be promoted. The national focus of healthcare policies is to enhance increased access to high quality and affordable care for all the populations. Therefore, through this proposed intervention, the researcher aims at ensuring that healthcare equity is promoted by ensuring that the management of COPD is appropriate to the needs of patients from ethnic minorities. Benchmark – Part A Population Health Research and PICOT
Benchmark – Part A Population Health Research and PICOT Statement NUR 550 Conclusion
Chronic obstructive pulmonary disease is a serious health problem that affects a majority of the population in the US. However, individuals from ethnic minorities are largely affected by the disease. The mortality rate among them is also high due to various determinants of health among them. The management of COPD mainly relies on either the use of triple therapy or dual therapy. However, there is a shortage in the evidence-based data on the efficacy of these interventions in patients from ethnic minorities, hence, the proposed interventions.
Benchmark – Part A Population Health Research and PICOT Statement NUR 550 References
Black Demographics. (2018).2018 Black Population: 47.8 million, 14.6% of USA. Retrieved on 10th October 2019 from https://blackdemographics.com/
Ejike, C. O., Dransfield, M. T., Hansel, N. N., Putcha, N., Raju, S., Martinez, C. H., & Han, M. K. (2019). Chronic Obstructive Pulmonary Disease in America’s Black Population. American journal of respiratory and critical care medicine, (ja).
Khan, A., Dickens, A. P., Adab, P., & Jordan, R. E. (2017). Self-management behaviour and support among primary care COPD patients: cross-sectional analysis of data from the Birmingham Chronic Obstructive Pulmonary Disease Cohort. NPJ primary care respiratory medicine, 27(1), 46.
Korpershoek, Y. J., Bos-Touwen, I. D., De Man-Van Ginkel, J. M., Lammers, J. W., Schuurmans, M. J., & Trappenburg, J. C. A. (2016). Determinants of activation for self-management in patients with COPD. International journal of chronic obstructive pulmonary disease, 11, 1757.
Mamary, A. J., Stewart, J. I., Kinney, G. L., Hokanson, J. E., Shenoy, K., Dransfield, M. T., … & COPDGene® Investigators. (2018). Race and gender disparities are evident in COPD underdiagnoses across all severities of measured airflow obstruction. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, 5(3), 177.
Martinez, C. H., Murray, S., Barr, R. G., Bleecker, E., Bowler, R. P., Christenson, S. A., … & Curtis, J. L. (2017). Respiratory symptoms items from the COPD assessment test identify ever-smokers with preserved lung function at higher risk for poor respiratory outcomes. An analysis of the subpopulations and intermediate outcome measures in COPD study cohort. Annals of the American Thoracic Society, 14(5), 636-642.
Putcha, N., Han, M. K., Martinez, C. H., Foreman, M. G., Anzueto, A. R., Casaburi, R., … & Make, B. J. (2014). Comorbidities of COPD have a major impact on clinical outcomes, particularly in African Americans. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, 1(1), 105.
Voorham, J., Corradi, M., Papi, A., Vogelmeier, C. F., Singh, D., Fabbri, L. M., … & Price, D. (2019). Comparative effectiveness of triple therapy versus dual bronchodilation in COPD. ERJ open research, 5(3), 00106-2019.
Zheng, Y., Zhu, J., Liu, Y., Lai, W., Lin, C., Qiu, K., … & Yao, W. (2018). Triple therapy in the management of chronic obstructive pulmonary disease: systematic review and meta-analysis. bmj, 363, k4388.
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The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
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Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
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Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
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Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
- Your response needs to be a minimum of 150 words (not including your list of references)
- There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
- Include in-text citations in your response
- Do not include quotes—instead summarize and paraphrase the information
- Follow APA-7th edition
- Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
- A minimum of 6 responses per week, on at least 3 days of the week.
- Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
- Each response needs to be at least 75 words in length (does not include your list of references)
- Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
- Follow APA 7th edition
- Points will be deducted if the above is not followed
- Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
- Here are some helpful links
- Student paper example
- Citing Sources
- The Writing Center is a great resource