Dissemination of Evidence

Dissemination of Evidence

Introduction

Cases of respiratory diseases have significantly increased in the recent past in the United States. Asthma is a common respiratory disease that affects both children and adults. There is a need to come up with treatment strategies to control and eradicate asthma. This paper seeks to answer the following clinical question: among childhood asthmatic patients (P), does testing of peak expiratory flow (I) improve the monitoring of symptoms (C) to increase the possibility of positive outcome in the control of asthma (O)? The paper provides an appraisal and synthesis of evidence detailed in four articles to answer the clinical question and proposes a measure to control asthma.

Summary and Appraisal of Evidence

Chongmelaxme et al. (2019) researched the use of telemedicine as a means to improve outcomes in the treatment of asthma in adults. He undertook meta-analysis and analyzed several data to determine the effects of telemedicine on adults who have asthma. The study involved searching electronic databases to gather information on the effectiveness of telemedicine. The results revealed the combined use of teleconsultation and telemedicine helped in improving the quality of life of asthma patients.

Barnes et al. (2019) researched several literature to determine the impact of airway obstruction perception in the control of asthma. The authors also sought to highlight the clinical implications of using reliever medications in the treatment of asthma. The study revealed that unpleasant breathlessness that asthma patients experience is as a result of airway obstruction. However, patients that negatively perceive their airway obstruction tend to avoid seeking treatment. Barnes et al. (2019), sought to highlight the symptoms of airway obstructions to influence a positive perception among patients. The results revealed that individuals of different sex, age, and ethnic background suffer from underperception and overperception of airway obstruction. The authors noted that the result was due to knowledge gaps in the detection and treatment of asthma. Consequently, they concluded that poor perception of airway obstruction has negative impacts on the management of the disease.

Adams et al. (2018) sought to study the measurement of peak expiratory flow in asthma patients. The study aimed to compare the peak expiratory flow for adults measured while they are standing to one measured while they are seated. They used quota sampling to collected data from adults of different ages and sex. The results showed that peak expiratory flow was high participants were standing compared to while sitting. Adams et al. (2018) concluded there was a small difference in the results for peak expiratory flow measured while patients are sitting and while they are standing.

Harnan et al. (2015) studied the effectiveness of using hand-held electrochemical devices to measure fractions of exhaled nitric oxide (FeNO). The authors gathered information from several reputable databases, including EMBASE, Cochrane, and MEDLINE. They analyzed the data collected from the databases to assess the effectiveness of hand-held devices. The results showed that tests conducted using hand-held devices slightly altered the accuracy of FeNO in asthma patients. Harnan et al. (2015) concluded that hand-held electrochemical devices should be used in combination with other tests to improve the accuracy in the measurement of FeNO.

Synthesis of Evidence

All the analyzed articles address the PICO components in different ways. The results of the third article highlighted the intervention in the control of asthma by explaining the process of monitoring peak expiratory flow. Three articles, excluding the first article studied treatment strategies for childhood asthmatic patients. However, the first article highlighted a treatment method, telemedicine, to control asthma in adults. All the four articles researched monitoring of symptoms and the control of asthma. The articles propose the use of home-based interventions to facilitate early intervention and treatment of asthma. The first article by Chongmelaxme et al. (2019) suggests an increased access to information on asthma through telemedicine to control the disease. The intervention is home-based and can enable patients to detect asthma early enough to facilitate treatment. The second article proposes that individuals should have heightened perception to allow for easy management of asthma at home. The third article by Adams et al. (2018) supports home-based intervention by emphasizing that there is no huge differences when the peak expiratory flow is measured while the patient is standing or sitting. Finally, the last article proposes the use of hand-held electrochemical devices in measuring FeNO. Home-based interventions should be modified through early detection, proper testing of the disease, increased communication with physicians, and appropriate medication in the treatment of asthma.

Improving Clinical Practices

Policies

The organizational change process will involve equipping nurses to increase access to information on treatment. They should make medical information readily available to patients through information technology. Besides, the nurses should allow patients to seek clarifications on areas they don’t understand. The policy will allow nurses to share their medical therapies through the internet and facilitate early detection and treatment of asthma.

In the current, patients have visit health practitioners, which causes a delay in the detection since some patients may not be willing to visit a hospital. However, the policy change addresses this concern by making medical information, and nurses readily available online. Registered nurses will be required to monitor the progress of patients online and only arrange for a visit when necessary.

Education

The first educational initiative of the policy should focus on training both patients and nurses. The nurses should be taught through workshops and other in-services programs organized by the hospitals. They should be enlightened on the procedural guideline to help them manage asthmatic patients at home.

Secondly, patients should be educated on how to detect, test, and obtain medication for asthma while at home. Education will enlighten the patients and reduce cases of negative perception of airway obstruction. They will be able to ask informed questions that will improve their medication and result in positive outcomes. Registered nurses should email the patients and use other online platforms to educate the patients.

Evidence-Based Practice Process

Nurses, physicians, and other medical practitioners will have the confidence to adopt and apply the proposed changes since they are evidence-based. Receiving treatment at home is convenient for patients and reduces the cost of readmission. On the other hand, physicians prefer home-based interventions since it increases the patient’s response to treatment, thus leading to positive outcomes. The proposed will significantly improve care delivery in asthmatic patients. Telemedicine will increase access to medical and treatment information to both the patient and the physicians. Home-based intervention will reduce cases on poor perception of airway obstructions among patients and enable them to detect asthma symptoms early enough. The intervention will also enlighten nurses on the best procedure to measure peak expiratory flow in patients. Besides, the nurses will use the recommended equipment to measure FeNO and get accurate results for efficient treatment.

The practice change will have a positive patient outcome by improving healthcare, reducing the cost of treatment, and creating convenience for both the patient and the nurses. Home-based interventions are generally cheaper than receiving treatment in hospitals since there are no extra charges. The proposed policy change will significantly reduce admission rates among patients, thus reducing the cost of treatment. The practice change offers evidenced-based interventions that, when implemented, will improve the delivery of healthcare. For instance, handheld electrochemical devices are not only convenient but also accurate in measuring peak experatoty flow in patients. Furthermore, the home-based intervention will allow patients to receive medical information regarding their treatment using telemedicine, thus creating convenience.

Conclusion

Analysis of the four articles reveal that they have adequately answered the clinical question. The study proposes a home-based intervention to help patients to detect, test, and receive information regarding the treatment of asthma. Changes can be made through the education of both nurses and patients and improved communication between them. The proposed changes will help improve healthcare, reduce the cost of treatment, and create convenience for both the patients and health practitioners.