NURS-FPX4025 - NURS FPX 4000 Assessment

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 FPX4025 Professor’s Name Submission Date Sharing Your PICO(T) Process Results with Your Colleagues Good morning, my name is and I am going to present you with an evidence-based plan which will prove to be helpful to the patients with acute decompensated heart failure (ADHF) and particularly those who could be at risk of having an ischemic stroke during their hospitalization. The concept of evidence-based practice (EBP) is extremely important in the work of nurses since EBP involves the application of clinical skills, personal preferences of the patient, as well as the most relevant research findings, which results in better patient outcomes. The application of the PICOT model in this scenario is a big assist as it assists nurses in developing the appropriate questions about clinical practice. The aim of the given presentation is to elaborate on the diagnosis, formulate a PICOT question, locate the evidence concerning the topic in the academic literature, and outline key stages in EBP. Diagnosis According to the Outcomes, Risks, and Complications The ADHF is the extreme weakening of the power of the heart to convey sufficient portions of oxygenated blood in support of the metabolism of the organism. ADHF is linked to a large amount of fluid in the body, leading to congestion of the lungs and inadequate supply of blood to different body organs. According to a report by the Centers for Disease Control and Prevention (2024), almost 14.6% of deaths are caused by ADHF in adults aged 20 or older, resulting in 6.7 million adults with heart diseases in the United States. Shortness of breath, weakness, leg edema, and poor tolerance to physical activity are the most prevalent symptoms of ADHF. ADHF is characterized by high morbidity and mortality rates and is considered one of the most urgent clinical issues that hospitalized patients have. The presence of ADHF leads to long hospital stays, cardiac dysfunction, and low quality of life. The hemodynamic abnormalities, heart rhythm disorders including atrial fibrillation, clot formation, and end-organ perfusion dysfunction are some of the complications of ADHF (Milhem et al., 2025). One of the possible complications of ADHF, which is evident in practical situations, is ischemic stroke. It could also happen that the heart can develop blood clots, and the blood supply cannot reach the brain. Some of the complications that might arise as a result of ADHF include cardiogenic shock and respiratory failure as a result of pulmonary edema. Examples The problems of ADHF can be explained by a situation when a patient gets admitted to the hospital due to a case of congestive heart failure, and finds out that he is experiencing irregular heartbeats, which is known as atrial fibrillation. Atrial fibrillation complication also causes the accumulation of blood in the atrium of the heart. Thus, there is the possibility of the formation of blood clots. The clots of blood move to the brain, resulting in a stroke. Finally, the patient also acquires a neurological problem in the form of hemiplegia and aphasia. One more problem that can be identified with ADHF is evident when people experience fluid retention and decreased cardiac output, thereby resulting in hypoxemia due to pulmonary congestion. PCIO(T) Question In adult patients with acute decompensated heart failure (P), how does nurse-led early stroke risk assessment and prevention (I), compared to standard care with no risk assessment (C), influence the incidence of ischemic stroke (O) in the hospital (T)? PICOT Breakdown P (Population): adults with acute decompensated heart failure. I (Intervention): Preventive risk assessment and intervention in stroke at an early age. C (Comparison): Standard care in the absence of stroke risk assessment. O (Outcome): Affect the occurrence of ischemic stroke T (Time): In hospitalization (within 30 days) Alignment with PICOT Framework All the elements of the PICOT question apply to the particular clinical issue of ADHF. In relation to the first element, the population would be comprised of patients with ADHF who are at risk of developing thromboembolism. The intervention element entails the identification of the various risk factors that lead to stroke among patients. The comparisons would be between the status quo, where the risks have not been detected before the onset of stroke, and where the risk has been detected before the stroke has occurred. The outcome element would be geared towards ensuring that no ischemic stroke takes place as this could be lethal. Overview of Content of More Than Three Sources of Evidence Multiple quality scientific papers have been reviewed to identify the effectiveness of early risk assessment of ischemic stroke in ADHF patients. In their research, Iguchi et al. (2021) carried out an observational study among more than 4,000 patients and concluded that ischemic stroke is one of the main complications that occur during hospitalization for ADHF. The study found that BNP, atrial fibrillation, and acute coronary syndrome are significant predictors of the condition of a patient. Yamazaki et al. (2026), in their turn, have conducted an observational study involving over 5,000 participants. They came to the conclusion that ischemic stroke occurs the most in the first 30 days of hospitalization and the onset of the sickness. Also, the alterations of hemoglobin and the cardioembolic mechanism are the factors that are believed to raise the chance of having a stroke considerably. Ran et al. (2025) included 2,994 people and systematically reviewed and analyzed 11 clinical studies. The authors of this paper found NT-proBNP to be an excellent biomarker in assessing the patient’s outcome, including ischemic stroke. This article is extremely important because a number of sources are analyzed. Therefore, this research paper presents high-level evidence, and the role of biomarkers in assessing risks should be taken into account in medical practice. In Lucki et al. (2025), the study was an observational one that focused on the hospitalization outcomes of ADHF patients. The authors concluded that the more serious nature of the disease and long-term hospitalization are risk factors

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

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

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NURS FPX 4025 Assessment 3 Using the PICO(T) Process Student Name Capella University NURS FPX 4025 Professor’s name Submission Date Using the PICO(T) Process The acute decompensated heart failure (ADHF) is one of the most problematic cardiovascular issues due to its rapid progression, during which the amount of accumulated fluid, cardiac output, and the ability to supply tissues sufficiency increase. The issue in question is a healthcare emergency that has a high morbidity and mortality. Hence, evidence-based practice (EBP) can be used for the treatment of ADHF since EBP enables specialists to merge the experience of the health care provider, preferences of the patient, and empirical data (Ghorpade & Salvi, 2024). EBP tools are numerous, but PICO(T) is the most potent tool. This approach is based on population, intervention, comparison, outcomes, and time. By using PICO(T), clinicians will have the ability to generate pertinent questions, conduct a literature review, and make a decision regarding the treatment actions. Using the PICO(T) model to address the problem of ADHF will assist nurses in preventing such complications as ischemic stroke. ADHF Acute decompensated heart failure is said to be a potentially fatal complication as they do not produce enough output of the heart that, in turn, is incapable of supplying the body with the necessary oxygen in the form of tissue perfusion, resulting in systemic and pulmonary edema. Shortness of breath, exhaustion, fluid overload, and inability to maintain good physical performance are some of the common symptoms that are experienced in ADHF. More so, ADHF today needs emergency medical care since it is highly likely to be put into the hospital. The untreated ADHF is associated with numerous health issues, including prolonged hospitalization, frequent hospitalization, low quality of life, and mortality (Milhem et al., 2025). In addition, ischemic stroke is among the numerous diseases that are regularly observed with ADHF. This can be attributed to the fact that ADHF is surrounded by such hemodynamic changes as stagnation of blood, hypercoagulability, and inadequate cerebral perfusion. The impacts of ADHF and the risks associated with the complexities of ADHF are tremendous to certain population segments. The elderly, underprivileged individuals, and those with no easy access to healthcare services are more likely to be affected by ADHF and its complications. For example, the poor can face issues such as delayed diagnosis and treatment of their conditions, as well as poor prevention techniques, such as anticoagulation treatment (Milhem et al., 2025). Such disparities might be the reasons why individuals have bigger opportunities of experiencing complications, including strokes. Secondly, minority groups are usually confronted with various issues when they receive appropriate medical attention. Formulating a PICOT Question The clinical question should be developed during the EBP practice as it will help the professionals to determine the most effective interventions in improving patient outcomes. Regarding ADHF patients, the most significant problem that arises in this group of patients when dealing with complications encountered during hospitalization is an escalation in the risk of ischemic stroke, which is associated with serious outcomes, including morbidity, mortality, and disabilities. Using PICOT to generate the clinical question can be helpful since it offers valuable guidelines for creating the right question (Jahanshahlou et al., 2024). The clinical question formulated using this process involves aspects of the problem that need to be solved, the population of patients, the intervention used, the comparative intervention, desirable outcomes, and time. As for the issue in question, it may be worthwhile for nurses to focus on early risk assessments of stroke among ADHF patients in order to prevent stroke. Based on this, it is clear that nurses will be very important in effecting the suggested interventions. PICOT-Formatted Research Question In adult patients with acute decompensated heart failure (P), compared to standard care with no risk assessment (C), how does nurse-led early stroke risk assessment and prevention (I) versus standard care (C) influence the incidence of ischemic stroke (O) in the course of hospitalization (T)? PICOT Breakdown · Population: Non-communicable, acutely decompensated heart failure in adult patients. · I (Intervention): EPS (Early stroke risk assessment and prevention) · C (Comparison): Standard care: no stroke risk assessment. · O (Outcome): Have an impact on the prevalence of ischemic stroke. · T (Time): In hospital (in 30 days) The Effect of the PICOT Approach on the ADHF Management Evidence-based practice will necessitate the use of the PICOT model, and through it, the healthcare professionals will be in a position to test various interventions in order to give the patients sufficient treatment. When it comes to the treatment of ADHF, it is rather clear that early detection of the risk of stroke along with adequate response is required. Assessing the risks of strokes, nurses and other medical workers will be empowered to identify risky patients and make the right recommendations related to their care (Milhem et al., 2025). For instance, monitoring of at-risk patients and administration of anticoagulants in case it is needed will be the two steps that should be undertaken. Evaluation of the risks of stroke can be regarded as the most prominent difference between evidence-based practice and standard practice. Eventually, through the PICOT model, health care professionals will be in a position to enhance the outcomes of the patients. Search of the Literature Noting Search Engines, Key Words, and Factors of Credibility The literature was extensively searched with the help of scholarly sources that can be used in this PICOT question. The databases like PubMed, CINAHL, Google Scholar, and ScienceDirect were used. The selected databases have been used due to their credibility of information since they consist of only evidence-based and peer-reviewed information regarding health care. Some of the keywords that will be used during the search procedure are: acute decompensated heart failure, risk of ischemic stroke, stroke prevention in heart failure patients, BNP monitoring, and complications of heart failure. To make sure that valuable evidence is presented, the search procedure included certain filters such that all sources whose content has not been reviewed by peer reviewers or was published

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 Professor’s Name Submission Date Applying an EBP Model Sickle cell disease (SCD) is a hereditary blood disorder that causes the red blood cells to stiffen into a sickle shape. This leads to obstruction in the blood vessels, pain crisis, organ damage, and a drop in the quality of life (QOL) (D’Costa et al., 2023). Children such as a 10-year-old with a pain crisis require holistic and lifetime care. Evidence-based practice (EBP) in nursing is an effort to improve patient safety and care. This takes into account evidence, practitioner and patient values/preferences in order to realize the intended results. 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-lasting condition 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). A problem with SCD is that there is a gap between the development of the disease and symptoms and complications (pain crisis). In addition, care can be influenced by problems with the coordination of services and access to health services, including transportation problems, lack of knowledge and skills in health care providers. These affect the quality of life and complications. It is here that an EBP approach can assist, where care can be provided in a different way compared to the typical care approach and not 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, avoiding delays in care, and enhancing quality and outcomes with the top and current evidence at their fingertips (Connor, 2023). This means that an EBP model will need to be adopted to aid in alleviating these problems 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 divided into three general steps: Practice Question (P), Evidence (E), and Translation (T). The model provides a framework that nurses can use to recognize evidence problems, seek evidence, and transform practice to utilize evidence. The JHNEBP model is suitable to tackle issues related to sickle cell disease as it is practice-focused. It assists nurses in forming practice questions and finding and utilizing evidence. It also results in better patient outcomes and the added advantages of standardisation and uniformity of nursing care (Gaber et al., 2025). The simplicity of the models enables them to be used in complicated issues, including delays in the treatment and care of SCD kids. Description of the Evidence-Based Practice Model Steps The JHNEBP model’s first step is the Practice Question (P), and it starts with recognising a problem and developing an evidence question. This may be achieved by taking into account 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. The second step is Evidence (E), as nurses apply evidence by searching for studies and analysing the validity and applicability of the studies. The nurses search credible databases (for example, PubMed, CINAHL, and Google Scholar) for peer-reviewed evidence in the area. And the nurses also critique the evidence for validity, reliability, and strength to ensure that the evidence used to guide our practice is reliable. The third step is Transformation (T), or putting the evidence into our practice. This is when we introduce strategies to facilitate change, such as improved communication between health care providers, education of the patient, and removing these barriers to treatment (Ainslie et al., 2024). These strategies are tested to assess the impact it has on the patient. Steps are important as they outline the strategic approach of the model by using 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. In the Practice Question phase, a PICOT question was developed: What is the effect of enhanced care on the prevention and treatment of pain crises, and on patient outcomes in kids who suffer from sickle cell disease compared to usual care? This question was applied in searching 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 conducted a search based on the following terms: Sickle cell disease, children, childhood, pain crisis, coordination of care, and barriers to care. Articles we have chosen were based on the research findings within the past few years, with results in children and barriers to care. We identified barriers to care, with few studies focused on children, and problems getting the full text of certain studies. We had the opportunity to search a couple of studies. At the Translation stage, we formulated care improvement strategies based on the data in the research. These strategies involve communication with the health care team and families, support services like transport services, and protocol use to manage pain (Baker et al., 2024). The goals of these strategies are to reduce delays in care as well as enhance treatment. Analysis of Evidence The first one – Schlenz et al. (2025) – is a qualitative study that explains the impediments and enablers of care in children with sickle cell disease. The research is credible, since it appears in a peer-reviewed journal and

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 Professor’s Name Submission Date Analyzing a Research Paper Criteria Analysis Type of Study This is a qualitative descriptive study because it conducts semi-structured interviews with parents of children who have sickle cell disease, and then describes their experiences using content analysis. Using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, this study has a Level VI rating on the evidence pyramid. That means it is almost on the bottom of the pyramid (and Level I is the top and Level VII the bottom). It is Level VI because it doesn’t involve experiments, control groups, or statistical tests, nor does it include scientific measurements. This is still valuable, despite its placement at Level VI, because it informs us of the problems people face and how to make health care more patient-centered. 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 condition causing red blood cells to be in a sickle shape and affecting the mobility of the blood cells. This leads to complications that cause pain, organ damage, and loss of quality of life. It is an early childhood disease diagnosed early on, and the child should undergo specialist care to avoid complications in later life. Children with SCD need tailored care, as this allows children to have a better quality of life and reduces complications (Schieve et al., 2022). This assignment will elaborate on one of the journal articles on barriers and facilitators of holistic care in children with sickle cell disease, to treat a 10-year-old boy, Jamie Hampton, with SCD pain. Abstract of the Research Article Our chosen article is Barriers and facilitators to paediatric sickle cell care: a qualitative descriptive study, Schlenz et al (2025), a qualitative descriptive study that provides the barriers and facilitators to holistic care of children with sickle cell disease. The authors analysed data from semi-structured interviews of 27 parents of sickle cell children. The Conceptual Framework of the Access to Care Model was used to do a directed content analysis. Such qualitative studies provide a detailed account of what it is like as a patient or a carer to go through an issue; they can be helpful in determining access barriers. 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. The study provides Level VI evidence, which is especially helpful in patient experience and enhancing patient-centered care, albeit being lower on the hierarchy of evidence. Article Credibility It is a plausible article for a few reasons. First, because they have published their article in a peer-reviewed journal about the topic, Pediatric Blood & Cancer. First, since it is a study sponsored by NIH, and thus a measure of the quality of the study (Schlenz et al., 2025). Two, it has been endorsed by the Institutional Review Board (IRB). The authors of the study have published other studies on pediatrics or hematology. In addition, the research contains information on various locations, thereby rendering the study genuine. Significant Results of the Research This paper has brought out the fact that there were a number of factors that supported and hindered sickle cell care. This was by way of positive parent-provider relations, support, and education. This led to greater health care satisfaction and engagement (Schlenz et al., 2025). The support and support services (e.g., appointments, transport). There were problems, the study found. The lack of knowledge of health care providers, waiting times, and appointments was the issue in the health system. The individual issues were transportation, money, no-show (failure to attend), and employment/studying opportunities (Sang et al 2025). These may have an influence on health and health care. The most prevalent power outage in health care was in public transport. Relevance to Sickle Cell Disease The work is also relevant in coming up with innovative solutions to tackle sickle cell disease since sickle cell disease needs to be handled on a long-term and comprehensive basis. The disease symptoms and signs without effective treatment are pain, complications, and hospitalizations. The identified children with SCD have various quality of life (QoL) needs and complications, which necessitate a variety of health care services (Schlenz et al 2015). They underscored the health care barriers and facilitators to enhance the quality of life of SCD. Application to Patient The presented study can be used in the case of the crisis of sickle cell disease in a 10-year-old child of Jamie Hampton. Jamie has pain crises that require treatment. Jamie may face delays and difficulty coordinating and getting care. He might have problems getting to appointments. The experiment demonstrates ways to enhance care. These are communication, education, and coordination. He has nurses who are looking after him. They can make sure that he is free of pain, educate, and coordinate (Ge et al, 2023). Therefore, with education, removing barriers, and offering enablers, we can enhance the care and experience of Jamie. Application to Practice This study can provide us with an idea. This can assist in empowering health care providers, including nurses, so as to overcome the health barriers. That is, parents will be assisted in transportation and well-informed and supported in their healthcare journey. Health-care 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 ensure that the health-care system can offer the most efficient health and well-being to the child with sickle cell disease. Conclusion The article looks at the barriers and facilitators of health care for sickle cell diseases. This points to the significance of proper health care,