Constructing the Written Evidence-Based Proposal: Nursing Education

Subject:	Nursing
Pages:	19
Words:	6056
Reading time:	23 min
Study level:	PhD

Abstract

Based on statistical data gathered from the Internet and up-to-date literary sources, the question about the effectiveness of nursing education and practical skills of caregivers has been raised. Nursing is the sphere that requires constant improvements and innovations to provide patients with the necessary support and care. It has been defined that not all nurses are ready to find practical application to their theoretical knowledge and treat patients with COPD (chronic obstructive pulmonary disease) in a right way.

This is why it is necessary to create program with the help of which the communication between nurses/caregivers and patients/patients’ families can be properly developed and the quality of care will be improved. Patients with COPD are in need of special care that may help them overcome personal emotional and physical challenges, and nurses should find the most appropriate ways of treatment. Implementing a program that is based on the idea to educate nurses and caregivers considering the current conditions and show the right ways of how people with COPD should be treated. The desire to improve personal skills is required from nurses, and participation of caregivers should be a voluntary basis.

Patient care quality is the issue that should bother the nurses and other representatives of the medical staff, and this paper aims at disclosing the theme of poor nursing education and inabilities to improve practical skills and the necessity to take some actions to contribute the sphere of caregiving so that the patients will be satisfied with the services offered in hospitals. Educational backgrounds should be appropriate in all hospitals, and it is necessary to implement the programs which may improve caregiving and attract more attention to the question.

Introduction

A chance to practice at an appropriate medical institution helps students to understand the main principles of nursing and caregiving. There are a number of steps which have to be taken regularly to provide patients in need with the required care and treatment (Simmons & Simmons, 2004). The decision to use the PICO model in clinical practice is usually made. COPD (chronic obstructive pulmonary disease) has been identified in several patients; and in spite of the fact that it is usually defined as a fatal disease, some treatment and care are still possible.

Any kind of treatment has to be properly grounded and supported by the evident facts. This is why nurses have to be aware of their duties, their possibilities, and their roles in the life of any patient. It is not an easy thing to provide a patient with COPD with an appropriate treatment due to a variety of existing problems like lack of identity or poor background knowledge, still, certain improvements in the educational system and encouragement of nurses to improve their abilities in the form of a clearly implemented educative program on a voluntary basis may be a rather helpful and effective tool.

Problem Description

During the process of education, the students have to learn new material and identify the problems which are observed in the sphere of nursing. However, the theoretical aspect of the problems is not always similar to the practical one. An intensive care unit (ICU) is the department where some fast decisions and properly based actions are required. When the time to demonstrate students’ best skills and knowledge comes, it seems to be a very difficult task for students.

The main problem is based on the lack of identity and a kind of educational creep (Puffer & Rashidian, 2004). There are so many young people who are eager to devote their lives to nursing and help those patients who are in need. However, not much attention is paid to their personal readiness to cope with the duties set in ICU. Beginning nurses have to find practical application to their theoretical knowledge.

They do not have enough time to observe how professional nurses take care of patients with COPD (Warren, 2009); as a result such nurses are not always ready to cope with the duties they have. In addition, the educational creep promotes unfair selection of nurses. There are many young people who are eager to become professional nurses and spend as much time as necessary to achieve good results in the chosen field. Their limited financial resources deprive them of the opportunity to enter the institution.

The impact of the above-mentioned problem is great indeed: much attention should be paid to nursing practice and development of the situations under which beginning nurses are to use their knowledge. Nurses are not always ready to help patients with COPD and follow the instructions given (Chalmers, Gupton, & Katz, 2004). This is why the identified problem is an important issue: some nurses just do not have special backgrounds to perform their work on a good level. The problem of poor education and lack of identity in nursing deserves certain attention. Its gravity is all about the quality of the services offered. Nowadays more people are in need of in time and credible help, and beginning nurses are not sure of the duties they have to perform.

To comprehend how nursing practice may be improved and treatment be properly offered to patients with COPD, it is obligatory to work out a working hypothesis and follow how nurses are able to meet its conditions. PICOT is a perfect method to use in this care.

Population of Focus. White female smokers with the smoking stage over 10 years and complaints of shortness of breathing are taken into consideration. It is a well-known fact that during the last decade’s women smokes a lot and, in comparison to men’s one, women passion to smoking is hard to control; this is why female smokers are under a threat of having COPD with the consequences of different levels. Due to the current symptoms and pain, COPD is the only right diagnosis of the women with the above-described complaints that has been already treated.
Intervention. Due to their activeness, some women prefer to use of bronchodilators, anticholinergics in particular, to promote the relaxation of the muscles and improve the air flow. However, patients are not completely satisfied with the treatment offered and want to use some other alternative methods.
Comparison. In addition to the already used methods of treatment, patients need to be prescribed to pass pulmonary rehabilitation to solve the existing chronic respiratory problems and improve the physical and psychological conditions.
Outcome. Previous treatment was not as successful as it was expected, certain improvements and additional methods should positively influence women’s health. Patients with COPD have to give up smoking or, at least, try to reduce the portions of tobacco in the organism. Unfortunately, regular smokers with COPD have lower chances to be fully recovered.
Time. Taking into consideration the fact that women have been taken bronchodilators for about one year and the results are not that positive, it is required to pass the chosen rehabilitation for one week taking the same anticholinergics and observe the outcomes. In case there are no negative outcomes, it is required to follow the prescribed treatment for about 6 months.

White women smokers (> 10 years) over 65 years of age with COPD and shortness of breathing (P) are prescribed with pulmonary rehabilitation (I) in addition to the already used drug regimen (C) in order to affect the shortness of breathing and stable the sense of emotions’ control (O); the chosen treatment is prescribed for over 6 month trial period (T).

Solution Description

Nursing practice should perform the leading role in the educational process. It is not enough to provide students with the required portion of knowledge but also check how beginning nurses can cope with their duties and provide patients with COPD with the required treatment. Practice in nursing should become a leading factor by means of which beginning nurses could start working. This is why the financial status of a student or his/her theoretical readiness should never define his/her personal readiness to caregiving.

To achieve good results, government should follow the methods used by the tutors during the educational process and offer the required financial help if necessary in emerging cases, and tutors have to set clear and reasonable goals in order to help students become true professionals in ICU or other departments and help patients with COPD on different levels.

COPD is caused by the combination of individual and environmental factors, including cigarette smoking and air pollution. As it is stated by Stahl, Lindberg & Jansson (2005), the severity of this disease and its rate depends upon the health-related quality of people’s life. Taking into account the peculiarities of this disease and its preventable character, it can be stated that Havelock’s theory of change would be the most appropriate for implementing the chosen solution of shifting the emphasis from individual treatment of the patients with symptoms of COPD to community-based interventions.

The main components of Havelock’s theory of change include establishing the relationship between the phenomena, defining the problem, collecting the resources, selecting the solution, achieving acceptance and self renewal. The choice of this theory can be explained with the significance of nurses’ understanding of the problem and acceptance of the solution for the effective implementation of the project. The stages of the theory coincide with the succession of measures which need to be imposed for making the necessary changes in the curriculum and enhancing the nurses’ knowledge on the most effective intervention strategies, effectively working to support the proposed solution.

Implementation of Havelock’s theory of change will be helpful for realization of the chosen solution, supporting it with substantial theoretical basis for preventing professional mistakes which are inadmissible in the sphere of nursing. Integrating this theory into the project by dividing its implementation into separate steps will allow disseminate the necessary information and maintain change in practice.

Implementation Plan

Current investigations prove that COPD, its causes, and treatment methods are serious issues to analyze: within a short period of time, this disease becomes one of the main reasons of human deaths, and the most terrible fact is that the number of female deaths is increasing (Ilgin, Ozalevli, Arif, & Ucan, 2010; Stahl, Lindberg, & Jansson, 2005). Nurses have to define clearly their duties and abilities, patients should be aware of the required precautionary methods and follow the suggestions to avoid the most terrible outcomes, and professionals should focus on the development of the strategies which will help to promote cooperation between nurses and smoking patients and define the most effective treatment.

Methods of obtaining necessary approval and securing support

Evaluation of the current literature sources, statistical data, and real-life example should prove the urgency of the chosen problem and define COPD as a serious disease to investigate and diagnose as soon as possible;
Identification of personal readiness to develop a powerful project and presentation of independent works with the help of which captivating and urgent themes are discussed;
The creation of a special group the members of which are ready to protect the same ideas and methods will help to secure support from the fellow staff and prove that the chosen strategy may be effective (I will perform the functions of the chair who will offer to organize a group in order to protect nurses and patient’s rights, provoke the donation to get a financial basis for the program, and consider the statistical data that will prove the importance of some changes in caregiving; it is enough for the participants of the program to spend 1-2 hours after work);
The dates have to be clearly investigated: this implementation plan should show the results in one week as more people will know about the activities helpful to the patients with COPD and the necessity to find appropriate alternatives to smoking;
Investigations of the current technological achievements will help to define electronic cigarettes as the best alternative for patients with COPD: their dependence on smoking may be controlled by nurses, and government has to consider the importance of financial support to provide the patients in need with the required number of electronic cigarettes;
The introduction of a program for caregivers and patients to improve the conditions under which people with COPD have to live.

Description of the current issue

COPD is the disease that is not easy to diagnose at its early stages, still, its spreading throughout the human organism is fast and irreversible, this is why people have to know its main symptoms and special precautionary methods to decrease the chances to suffer from COPD;
Smoking is one of the major and the most dangerous causes of COPD, and women are under a threat to be diagnosed with COPD more frequently than men are;
Many women die because of COPD and overdue treatment as a result of their death birth rates are decreased considerably within a short period of time;
Air pollution is another significant cause of COPD, this is why people have to take the necessary measures to protect themselves and their generations and fight against the possibilities of being sick with COPD;

Detailed explanation of the proposed solution

The essence of the program is all about the education for caregivers and nurses; caregiving is the activity that requires constant improvements and innovative approaches for communication with patients, and nurses should get a chance to enlarge their knowledge and understand what kind of treatment is appropriate for particular situations;
The program under consideration should clearly identify the duties of caregivers and the activities which have to be taken on daily basis: nurses should not smoke or remind their patients about the idea of smoking, take care of media available for patients that may remind about smoking, and focus on the healthy actions with the help of which patients may promote their treatment;
The program looks like a training for caregivers and abilities for nurses to demonstrate their gained knowledge: first, nurses are informed about the treatment methods to rely on while caregiving (one week); second, cooperation between nurses and patients is under evaluation of the chair and the coordinator whose duties will be discussed later (next two weeks); questionnaires are offered to all the participants of the program (nurses, caregivers, and patients); and finally, the evaluation of the achievements and outcomes takes place (a coordinator and the chair of the program analyze whether some improvements are identified);

Rationale for selecting proposed solution

To manage treatment for patients with COPD, nurses and other medical staff have to be trained properly and improve their knowledge from time to time considering new ideas, inventions, and offers, this is why the chosen program that is based on nursing education and up-to-date modifications and requirements should be in demand;
The medical staff is not the only responsible part of care giving, families of patients with COPD should also understand their duties and impact on a human life, this is why such activities like telephone contact between nurses, physicians, and family members is an integral part of a program;
Computer databases should be organized accordingly so that each member of a family or a nurse could find the required portion of information and help to provide a person with the necessary care;
It is important to develop this program gradually so that nurses and other caregivers may evaluate their skills, the situation, and the required steps;
Certain equipment is required (electronic cigarettes which may decrease the level of tobacco in the organism without some psychological changes, computer hardware, etc);
A nurse coordinator should is hired on a voluntary basis in order to organize the work accordingly and evaluate the results achieved at the end of the program; the main duties of coordinator are all about the presentation of new material, evaluation of how nurses understand information, and analysis of the achievements made.

Evidences from literature sources

High quality of care depends on how nurses understand their duties and are aware of the guidelines prescribed by a particular institution, the work by Puffer & Rashidian (2004) may help to define the priority of the nurse’s role in treatment;
Smoking is the reason of why so many people die because of COPD; this is why some attention should be paid to smoking cessation and the ways of how nurses could be helpful to patients (Hakesley-Brown, 2009).
Unfortunately, smoking is not the only reason of why so many people with COPD die, and it is urgent to focus on air pollutants and people’s participation in such kind of pollution.

Description of implementation logistics

The chosen program will be offered to 5 nurses and 5 caregivers who are ready to donate money to develop a program on a voluntary basis in order to check the effectiveness of possible improvements in the sphere of nursing and 10 patients who are ready to implement some new achievements in caregiving;
Nurses and family members should be aware of the importance to understand their duties and care for people with COPD;
Special training programs should take place two times per week (at the beginning of the week – to set purposes and define the activities, and at the end of the week – to analyze the results and discuss possible improvements); coordinator hired on a voluntary basis is responsible for the development of new strategies in caregiving by means of evaluation of statistical data and personal ideas on how caregiving should be organized;
There are several people who take care of the development of the strategy: the coordinator who works with nurses and check the quality of their work, and the chair who will perform the functions of the leader and inspire nurses and caregivers improve their skills;
The program may be taken during the whole month, after the period is over, the outcomes are discussed and new goals are set.

Resources which are required for implementation

Staff: it is necessary to divide nurses into groups where the program is implemented and not to identify the effectiveness of the ideas;
Educational Material: PowerPoint presentations are more effective to attract the attention of the audience, make nurses and family members participate in discussions, and get credible guides to follow.
Technology: several electronic cigarettes for the patients with COPD (emotional aspect will be evaluated) and special database that aims at providing helpful tips for caregivers;
Funds: PowerPoint presentations are created by students independently to share their ideas and methods (such decision will help to save money), 10 e-cigarettes (their price is about $15-30; money gathered as a result of donation should be used).

The outcome measure of the chosen program is all about the opinions of its participants and the ways of how current medical care is offered to patients. With the help of the written reports and questionnaires (Appendixes B and C), it is possible to comprehend how the current system is improved and why additional measurements are important. It is not enough to change some aspect of nursing care for some period of time, still, it seems to be more effective to provide nurses with the required training courses to improve their skills and patients with a possibility to share their opinions and suggestions on how nursing care may be improved.

Evaluation Plan

Methods used to evaluate effectiveness of the proposed solution

The proposed solution to the problem that is based on lack of identity and appropriate nursing practice and students’ inabilities to use and develop their skills in a right way has to be evaluated thoroughly as evaluation and improvement of the outcomes is an important step that defines the quality of care giving offered by nurses (Fineout-Overholt & Johnston, 2007).

For a long period of time, lack of identity and possibilities to apply theoretical knowledge to practice is considered to be one of the main problems that has to be discussed (Kreml, 2003), this is why it seems to be rational to use the following methods in order to analyze whether the strategies chosen are effective: surveys of patients’ attitudes to care provided by nurses, beginning nurses’ opinions about the working conditions, and evaluation of the situation before and after the implementations of the working system are made.

Variables to be assessed when evaluating project outcomes

There are several variables in the project under consideration, and each of them plays an important role in the analysis of theoretical and practical aspects (Melnyk & Fineout-Overholt, 2010). They are: the nature of patients’ problems (some patients with COPD may face various psychological or social challenges), nurses’ attitudes (the importance of how future nurses define their roles in society and hospital), and quality of education offered by medical institutions (it happens that not all academic institutions provide students with the required portion of knowledge and abilities to develop their professional skills).

The assessment will be performed by the coordinator who will use the reports and patients’ answers and reflections. Positive and negative answers will be counted and introduced accordingly. Such assessment of variables is integral for the project because the quality of care giving depends of the way of how nurses understand their duties and what steps they are ready to take to improve the system.

Tools which are necessary to educate project participants

In this project, it is necessary to pay attention to the tools with the help of which the evaluation of the project outcomes is possible. The idea to focus on nursing practice during education is powerful indeed, and the following tools will help to improve the strategy: PowerPoint presentations (Appendix A) made by the participants of the program (each participant introduces the goals set, the methods used, and the attitude to the activities offered), questionnaires (Appendix B) offered to the nurses and patients (the evaluation of the opinion of each participant will help to define the weak and strong aspects of the strategy), and special training courses on a weekly basis by means of which nurses are free to discuss various situations, ways of treatment and communication with patients, and improve their knowledge considering the current innovations.

Assessment tool to evaluate project outcomes

One of the most effective and easy-to-create assessment tools for the strategy discussed in this paper is the creation of written reports (Appendix C). The main purpose of the strategy implemented is to define which activities may influence the quality of care provided by beginning nurses and professionals, to promote the cooperation between nurses who have already got the necessary portion of practice and who are in need of additional help. The evaluation of the reports and questionnaires made by the coordinator will help to define positive and negative aspects of the work done. In case there are more positive attitudes to the program implemented, the next stage of program development should be considered.

Dissemination Plan

A strategy for disseminating project results to key stakeholders

Dissemination of the results obtained is regarded as an important step of EBP as all participants should understand that their activities and ideas may change and make better the current system of caregiving. Key stakeholders like educators, nurses, and administrators perform the central role in the successful revision of the results. To involve these people into the project it is necessary to make use of statistics and real-life facts.

Plan to disseminate the results among key shareholders

Presentations by means of which the results of the interviews will show how medical care is provided to customers;
Staff meetings will encourage more people to focus on knowledge improvement and develop new strategies for caring patients with COPD;
Weekly updates will help to define the main aspects of caregiving and to choose more appropriate methods;
Ads within the frames of the hospital to attract more attention and involve more patients and nurses into investigations.

A strategy for disseminating project to greater nursing community

Without any doubts, nurses should have solid backgrounds to provide patients with different types of care. However, personal problems, uncertainty, and lack of practice may prevent the process of care delivery, this is why nursing community has to be involved into the project offered.

Plan to disseminate the results among the community

Presentations where key information is presented to prove that nurses have chances to improve their skills and gain better practical skills as a result of the program offered;
Weekly meetings during which nurses are free to share their experience and possible ideas for caregiving;
Illustrative ads where nurses are welcome to get a clear idea of current conditions and their roles in the community; nurses should realize that they may change the situation and help patients with COPD be properly treated.

Nurses should allow themselves expensive education and training programs with the help of which they may improve their skills and become sophisticated nurses. And the program under consideration is one of the voluntary examples of how medical care may be improved by means of personal desire, fresh ideas, and innovations.

Conclusion

Nursing is the sphere that does not forgive some human weaknesses or mistakes. It is all about human lives and care provided accordingly. Humanity and professionalism are the two important aspects in this field, and in order to solve the problem of lack of identity and educational backgrounds, the government and institutions have to pay attention to the quality of future nurses’ work. Nurses have to define clearly their duties and abilities, patients should be aware of the required precautionary methods and follow the suggestions to avoid the most terrible outcomes, and professionals should focus on the development of the strategies which will help to promote cooperation between nurses and smoking patients and define the most effective treatment.

Annotated Bibliography

Barnett, M. (2005). Caring of patient with COPD: A reflective account. Nursing Standard, 19 (36), 41-46.

The author of the article explores the advantages of using a reflective account for treating the patients with chronic obstructive pulmonary disease (COPD) for establishing the interpersonal contact with every patient and enhancing the effectiveness of the chosen intervention strategies by taking into account the psychological aspect.

The research defines the concept and the main principles of reflective practice, relating it to the particular professional implications for the patients with COPD. Emphasizing the importance of therapeutic nurse-patient relationship, Barnett (2005) provides real life examples and statistics data for supporting the claim concerning the significant role of reflection and empathy in developing the intervention strategies for the patients with COPD.

Chalmers, K., Gupton, A., & Katz, A. (2004). Issues and innovations in nursing practice: The description and evaluation of a longitudinal pilot study of a smoking relapse/reduction intervention for perinatal women. Journal of Advanced Nursing, 45 (2), 162-171.

This pilot project was aimed at developing and implementing a community-based intervention strategy for persuading women to quit smoking during pre- and postnatal periods. The research methods included a detailed literature review and the experiment itself for receiving the women’s feedback and evaluating the actual impact of smoking cessation on their condition.

The core components of the described intervention strategy can be used for treatment of the patients with COPD. The main advantages of this pilot study include the focus on the community-based strategies and account of the gender specific reaction to smoking cessation.

De Torres, J., Casanova, C., & Abreu, J. (2006). Gender associated differences in determinants of quality of life in patients with COPD: A case series study. Health & Quality of Life Outcomes, 4, 72-77.

The researchers explored the influence of gender and the quality of life parameters upon the expression of COPD symptoms in various categories of patients. According to the results of the study, the health status as well as the associated psychological variables differed in men and women, while women had worse results in all domains.

Taking into account these gender peculiarities, the researchers concluded that special attention should be put upon the quality of life determinants in women with COPD.

Hakesley-Brown, R. (2009). Brief interventions to reduce tobacco-related diseases. Nursing Standard, 23 (28), 43-47.

The study examines the levels of morbidity and mortality among the UK citizens associated with tobacco-related diseases. Using the detailed literature review as the main research method, the authors consider the socioeconomic factors as the main underlying reasons for the high rates of smoking in the community.

Getting to the roots of the problem, researchers offer an effective community-based smoking cessation strategy aimed at reducing the threat of tobacco-related diseases and improving the current condition of the public health domain. Summarizing the brief interventions, this article explores the core elements of an effective intervention strategy which can be implemented for preventing or treating patients with COPD.

Ilgin, D., Ozalevli, S., Arif, C., & Ucan, E. (2010). Gender effect on the use of Modified Borg and Visual Analog Scales in the evaluation of dyspnoea in chronic obstructive pulmonary disease. Pakistan Journal of Medical Sciences, 26 (1), 76-81.

This study was aimed at evaluating the impact of gender parameter upon the results of tests measuring dyspnea, one of the symptoms of COPD. Fifty two patients of both sexes with heavy symptoms of COPD participated in the experiment.

The results of the study have shown that the gender parameter has a significant impact upon the patient’s perception of the symptoms and their testing and need to be taken into consideration for selecting the most appropriate testing patterns and making the evaluation more effective.

Magfiret, K. (2005). Preparing nurses for the global pandemic of chronic obstructive pulmonary disease. Journal of Nursing Scholarship, 27 (2), 127-133.

The purpose of this study is to enhance the nurses’ awareness of the main underlying causes of COPD and the most effective intervention strategies with the special emphasis upon the changes which need to be made in nursing training. Using the method of an integrative literature review, this article explores various perspectives upon the struggle against COPD for shedding light upon both positive and negative implications of various strategies and preparing nurses for situations which can occur in their professional practice.

The main conclusion of the research is the importance of shifting the emphasis from individual intervention strategies to community-based preventative measures.

McCann, T., Clark, E., Rowe, K. (2005). Undergraduate nursing students’ attitudes towards smoking health promotion. Nursing & Health Sciences, 7 (3), 164-74.

The study explores the significance of the nurses’ smoking status for evaluating the attitude towards participation in smoking cessation programs. Recognizing the key role played by nurses in health promotion, the authors point at the importance of nurses’ personal life style and position.

The main conclusion of the study is the importance of consistency between personal and professional beliefs because this factor can have a significant impact upon the end outcome of the health promotion strategies.

Practice nurse numbers linked to better outcomes. (2010). Nursing Standard, 24 (19), 11.

This study focuses on the importance of developing nurses’ professional skills for improving the end outcomes of the intervention strategies. Providing valuable statistic data, the article covers the issues of professional training of nurses as one of the most important factors having impact upon the effectiveness of treatment and the patients’ well-being.

Taking into account the complexity of symptoms and processes associated with COPD, the study concludes that nurses’ awareness and professionalism are of paramount importance for the effective treatment with this kind of tobacco-related disease. Enhancing the awareness of the medical workers on the latest achievements in the sphere is the only way for increasing the effectiveness of intervention strategies.

Puffer, S. & Rashidian, A. (2004). Practice nurses’ intentions to use clinical guidelines. Journal of Advanced Nursing, 47 (5), 500-509.

The study focuses on the place of clinical guidelines in the performance of the nursing staff. Acknowledging the fact that most nurses try to follow these instructions, the researchers evaluated the different levels of the nurses’ adherence to them in relation to the effectiveness of corresponding interventions.

Using the method of a cross-sectional survey, this study concludes that the intentions to offer smoking cessation can vary up to 40 % in nurses depending upon their personal position and adherence to following the clinical guidelines in their professional practice.

Schaffer, S., Yoon, S., Zadezensky, I. (2009). A review of smoking cessation: Potentially risky effects on prescribed medications. Journal of Clinical Nursing, 18 (11), 1533-1540.

This study is aimed at establishing the links between the smoking cessation and patients’ response to particular types of medications. Pointing at the advantages of quitting smoking, the researchers emphasized the various changes in the patient’s organism. Using a method of a comprehensive literature review, this study explores the variety of physiological changes taking place in the patient’s organism after smoking cessation and requiring the appropriate modifications in the intervention strategies, including those of medication plan adjustment.

The main conclusion of this research is the importance of taking into consideration the factor of smoking cessation while starting or continuing the treatment program for the patients with COPD.

Schikowski, T., Ranft, U., Sugiri, D., & Harth, V. (2010). Decline in air pollution and change in prevalence in respiratory symptoms and chronic obstructive pulmonary disease in elderly women. Respiratory Research, 11, 113-123.

Analyzing the consequences of the recent decline in air pollution, the researchers investigated the variety of consequences on the symptoms in patients with COPD. Using the comparative method, the study compares similar findings in various countries for making the results of the investigation more comprehensive.

Exploring the link between the air pollution and the rates of COPD among the population, the researchers conclude that it may have various implications and need to be taken into consideration by nurses working with COPD patients.

Simmons, P. & Simmons, M. (2004). Informed nursing practice: The administration of oxygen to patients with COPD. MEDSURG Nursing, 13 (2), 82-86.

This study uses a retrospective approach for exploring the recent shifts in nursing practice of treating the patients with COPD. Implementing the research method of a comprehensive literature review, the researchers point not only at the main advantages of the methods of oxygen administration but various implications which this type of intervention may have for the patient’s condition.

It is significant that dividing theory of oxygen administration into separate components, the researchers shed light upon the positive and negative sides of each of them, emphasizing the importance of enhancing the nurses’ awareness of the complexity of the processes and developing their practical skills for close tracking of the patients’ response to the chosen intervention.

Stahl, E., Lindberg, A., & Jansson, S.A. (2005). Health-related quality of life is related to COPD disease severity. Health & Quality of Life Outcomes, 3, 56-59.

This study investigated the most influential factors which are significant for measuring the severity of COPD symptoms in various categories of patients. Using the method of empirical research, the researchers put the results of clinical investigation into the basis of the study. The researchers concluded that the health-related quality of life and the age parameters are the most influential factors having impact upon the severity of COPD in various categories of patients.

Exploring the relationship between the health related quality of life and severity of COPD symptoms, the study enhances nurses’ awareness of one more side of processes in patients with COPD.

Warren, E. (2009). The patient with COPD. Practice Nurse, 38 (9), 17-22.

The study implements the research method of a comprehensive literature review for exploring various symptoms and processes in patients with COPD. Evaluating various views upon the most effective intervention strategies, the study enables nurses to be in the know of the latest achievements in the sphere and choose the most appropriate intervention strategy in every particular case.

Shedding light upon the complexity of the processes, this article emphasizes the importance of taking into consideration the variety of symptoms and responses to treatment for selecting the most effective intervention strategy for every patient with COPD.

Wu, H.S., Wu, S.C., Lin, J.G., & Lin, L.C. (2004). Issues and innovations in nursing practice: Effectiveness of acupressure in improving dyspnoea in chronic obstructive pulmonary disease. Journal of Advanced Nursing, 45 (3), 252-259.

This study offers an innovative method of relieving particular symptoms in patients with COPD. The methods of an empirical experiment and analysis of clinical data are used for evaluating the effectiveness of acupressure for relieving dysnopea in patients with COPD. The research findings have shown that this brief intervention strategy can have a significant positive impact upon the well-being and condition of the patients.

The main conclusion of this article is an offer to use acupressure for relieving dysnopea in patients with COPD as an effective treatment method.

References

Barnett, M. (2005). Caring of patient with COPD: A reflective account. Nursing Standard, 19 (36), 41-46.

De Torres, J., Casanova, C., & Abreu, J. (2006). Gender associated differences in determinants of quality of life in patients with COPDL: A case series study. Health & Quality of Life Outcomes, 4, 72-77.

Hakesley-Brown, R. (2009). Brief interventions to reduce tobacco-related diseases. Nursing Standard, 23 (28), 43-47.

Magfiret, K. (2005). Preparing nurses for the global pandemic of chronic obstructive pulmonary disease. Journal of Nursing Scholarship, 27 (2), 127-133.

McCann, T., Clark, E., Rowe, K. (2005). Undergraduate nursing students’ attitudes towards smoking health promotion. Nursing & Health Sciences, 7 (3), 164-74.

Practice nurse numbers linked to better outcomes. (2010). Nursing Standard, 24 (19), 11.

Puffer, S. & Rashidian, A. (2004). Practice nurses’ intentions to use clinical guidelines. Journal of Advanced Nursing, 47 (5), 500-509.

Schaffer, S., Yoon, S., Zadezensky, I. (2009). A review of smoking cessation: Potentially risky effects on prescribed medications. Journal of Clinical Nursing, 18 (11), 1533-1540.

Simmons, P. & Simmons, M. (2004). Informed nursing practice: The administration of oxygen to patients with COPD. MEDSURG Nursing, 13 (2), 82-86.

Stahl, E., Lindberg, A., & Jansson, S.A. (2005). Health-related quality of life is related to COPD disease severity. Health & Quality of Life Outcomes, 3, 56-59.

Warren, E. (2009). The patient with COPD. Practice Nurse, 38 (9), 17-22.

Appendix A

Appendix B

Example of a Questionnaire for Patients

Are you satisfied with care given in a hospital?
What activities are more preferable to you in a hospital?
Are you aware of the ethical norms set in an institution?
Do all nurses and medical staff follow the norms set?
Are there the cases when nurses avoid or misunderstand their duties?

Example of a Questionnaire for Nurses

Do you think your background knowledge is appropriate for a particular institution?
What types of activities you like to do? Why?
Are you satisfied with the working conditions? (3 pros and 3 cons should be identified)
What were your activities during your practice and work in the hospital?
Who takes responsibility of your activities? Do you find this person a true professional?

Appendix C

Structure of a Written Report to Be Filled out by a Nurse

Name

Address

Education

Place of practice

Place of work

First days of practice were…

My first work day was …

My first impressions

First challenges

The ways of how to cope with challenges

Ideas on how to improve the existing system of caregiving.