LEARNER INSTRUCTIONS 

NURS FPX9100 Assessment 1 Topic Approval Form this screening form is intended to help you and your faculty ensure that the project topic and methods meet the requirements for the DNP final project. Include APA Citations where noted in this form. Please include an APA reference list at the end of the document. Links to relevant resources have been provided throughout the document. The Faculty/Reviewer will provide feedback directly on this form, along with recording the decision to endorse or defer the topic.

WORKING PROJECT TITLE: Nutritional and telehealth interventions for Improving lung function in COPD Patients

PROJECT DESCRIPTION

PICOT: In patients diagnosed with COPD (P), how do nutritional and telehealth interventions (I) compare to standard care without nutritional and telehealth interventions improve lung functioning and reduce readmission (O) in the time period of 2 to 3 months (T)?

Brief Summary

At my project site, there are rising cases of COPD (NURS FPX9100 Assessment 1 Topic Approval Form), and patients are being readmitted to the hospital due to inadequate management of COPD at home. The patients are unaware of COPD management through diet and other therapies. In 2021, there were 28,068 readmissions due to COPD in the hospital (Definitive Healthcare, 2021). Moreover, the national 30-day all-cause readmission rate by HRRP policies for AECOPD is approximately 20% (Buhr et al., 2020). COPD is a leading cause of death globally and has a high treatment cost per patient in the US, costing $9,800 per patient per year (Portillo et al., 2018). The high readmission rates can affect the hospital rapport and lower reimbursement services for the organization. A comprehensive care plan consisting of telehealth and nutritional intervention can reduce COPD readmissions in the hospital by improving lung functioning and COPD management (Scoditti et al., 2019). 

Primary Objective 

The primary objective is to reduce the readmission rate due to COPD in inpatient hospital settings

Secondary Objective

1. Improve lung functioning, which FEV1 can measure.
2. Improve staff compliance with nutritional interventions
3. Provision of cost-effective care service through telehealth.
4. NURS FPX9100 Assessment 1 Topic Approval Form

Proposed Evidence-based Intervention(s) 

1. Nutritional support for COPD (high protein dirt and use of nutritional supplements) (Collins et al., 2019) 
2. Telehealth interventions for reducing COPD re-admissions in hospitals (Chahdi et al., 2023) 
3. Video conferencing interventions for improved COPD outcomes (Bowman et al., 2023).

PROJECT DESIGN AND METHODS

Project Design: The project design will be a Quality Improvement initiative for COPD patients.

Model For Improvement: The model for improvement will be the PDSA cycle. This cycle is a better fit for this project as it is a quality improvement model that allows for iterative testing and refinement of intervention.

Target Population Undergoing the Practice Change: The target population for the project will be healthcare providers involved in the care of patients with COPD, such as nurses, respiratory therapists, and other ancillary staff. The project will also involve patients with COPD at risk for readmission and their caregivers. 

NURS FPX9100 Assessment 1 Topic Approval Form

Inclusion Criteria: All full-time available healthcare staff in the COPD care unit, which includes nurses, physicians, respiratory therapists, and nutritionists or Rds.

Exclusion Criteria: The project will exclude all the care providers who are not directly involved in the care of COPD.  

Estimated Project Length (weeks): The estimated project length for COPD is 10 weeks, which includes staff training and education, delivery of the intervention, and final data collection and analysis. The project will be implemented over 10 to 12 weeks, with two weeks allocated for data collection and analysis. 

OUTCOME MEASURES AND ANALYSIS

Primary Outcome Measures

The primary outcome measure for this project will be the following:

• Reduction in readmission rate due to COPD
• NURS FPX9100 Assessment 1 Topic Approval Form

Secondary Outcome Measures 

The possible secondary outcomes for the project will include the following:

• Improved staff compliance with nutritional interventions 
• Increased patient satisfaction and improved quality of life (QoL) with care 
• Decreased financial burden due to the provision of cost-effective care services through telehealth 
• Decreased length of stay in the hospital
• Increased knowledge among staff regarding COPD management

Data Analysis and Results Reporting:  Complete each measure’. Note the data type you will collect (nominal, ordinal, interval, ratio). 

References

Bowman, M., Jalink, M., Sharpe, I., Srivastava, S., & Don Thiwanka Wijeratne. (2023). Videoconferencing interventions and COPD patient outcomes: A systematic review. Journal of Telemedicine and Telecare, 1357633X2311581–1357633X2311581. https://doi.org/10.1177/1357633×231158140

Buhr, R. G., Jackson, N. J., Kominski, G. F., Dubinett, S. M., Mangione, C. M., & Ong, M. K. (2020). Readmission rates for the chronic obstructive pulmonary disease under the hospital readmissions reduction program: An interrupted time series analysis. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-020-05958-0

Chahdi, M., Bruchhäuser, A., von Gahlen-Hoops, W., & Nydahl, P. (2023). Interventions to reduce hospital readmission rates in patients with COPD: A systematic review. Medical Clinic, Intensive Care and Emergency Medicine. https://doi.org/10.1007/s00063-023-01003-0

Collins, P. F., Yang, I. A., Chang, Y.-C., & Vaughan, A. (2019). Nutritional support in chronic obstructive pulmonary disease (COPD): An evidence update. Journal of Thoracic Disease, 11(S17), S2230–S2237. https://doi.org/10.21037/jtd.2019.10.41

Definitive Healthcare. (2021). Top 10 hospitals with the highest COPD admissions. Definitive Healthcare. https://www.definitivehc.com/resources/healthcare-insights/hospitals-highest-copd-

Portillo, E. C., Wilcox, A., Seckel, E., Margolis, A., Montgomery, J., Balasubramanian, P., Abshire, G., Lewis, J., Hildebrand, C., Mathur, S., Bridges, A., & Kakumanu, S. (2018). Reducing COPD readmission rates: Using a COPD care service during care transitions. Federal Practitioner: For the Health Care Professionals of the VA, DoD, and PHS, 35(11), 30–36. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366592/

Scoditti, E., Massaro, M., Garbarino, S., & Toraldo, D. M. (2019). Role of diet in chronic obstructive pulmonary disease prevention and treatment. Nutrients, 11(6), 1357. https://doi.org/10.3390/nu11061357