Summary
One of the essential principles of modern medicine is evidence-based practice (EBP), which is also true in nursing. The Johns Hopkins Nursing Evidence-Based Practice Model is used to address a quality or safety issue. The model attempts to enhance clinical practice through evidence-based practice (EBP), including collecting, analyzing, and applying problem-solving research to serve patients better. The usage of oxygen in patients having the chronic obstructive pulmonary disease (COPD) is the subject of the quality or safety issue (COPD). Nurses must adhere to evidence-based practice (EBP) in nursing guidelines (Branson, 2018). According to some debates, distributing oxygen to such individuals increases the likelihood of developing major conditions such as acidosis, hypercarbia, and mortality. Long-term oxygen therapy (LTOT) at home has been demonstrated to improve survival in patients with COPD and severe resting hypoxemia. The EBP procedure, however, eases the administration of oxygen to COPD patients.
Criteria Considered when Determining the Credibility of Resources
It is recommended that a person uses reputable sources of information when completing adequate research. Several elements would be considered in the selection of credible sources. First and foremost, the authority and credibility of the materials are important considerations to consider. Whether they are a person or an entity, the author would be one of the characteristics taken into account (Kopsaftis et al., 2020). The qualifications of the author in a particular subject area and the qualifications of the publisher are equally crucial factors. After then, it is necessary to check the resource’s accuracy and dependability.
It is critical to evaluate the current date and the timeliness of the information. The requirements included the period during which the paper was published and whether or not the data was verifiable. Aside from the publishing date, it is critical to determine whether it contains up-to-date information, which may need more recent sources of information. According to Kopsaftis et al. (2020), “when it comes to evaluating sources, the importance of objectivity or bias is paramount.” Consider whether the source reflects facts or opinions, and hence if the resources are subjective or objective in their presentation.
Relevance and Credibility of Resources and Evidence
In 1971, two investigations were carried out in the United States and the United Kingdom to determine whether treating hypoxia in COPD could have a role in reducing the risk of mortality. The two trials were conducted under normal medical experimentation procedures (Branson, 2018). Following this, various findings were made that may be useful to nurses in their daily work. First and foremost, multiple elements in the ambulatory oxygen setting may be beneficial in managing a COPD patient. Ambulatory oxygen treatment can be utilized as a component of the progressing interaction of giving oxygen to patients before they are transported to a healthcare institution. In every instance, oxygen usage is intended to increase the number of hours per day that a patient with COPD can benefit from oxygen (Branson, 2018). Aside from that, the experiment would be critical in retaining good physical activity, such as participation in pulmonary rehabilitation programs.
Secondly, there is the issue of oxygen in mild hypoxemia. The experimental results in the study revealed that treatment given to people with extreme hypoxia and COPD who had gone through long-haul treatment brought about a decrease in mortality. Patients with less severe degrees of hypoxia, on the other hand, do not reap any significant benefits from regular oxygen treatment, according to the research. Third, the hazards connected with the administration of oxygen during acute exacerbations of COPD are discussed in detail. According to the findings of previous studies, those who were experiencing acute exacerbations of COPD and were subjected to high amounts of supplementary oxygen were more likely to develop difficulties associated with hypercapnia. (Hatipolu & Stroller, 2018). The rationale underlying the occurrence has to do with hypoventilation combined with other factors, “The use of noninvasive ventilation (NIV) in chronic respiratory disease combined with oxygen therapy at home was reported) (Branson, 2018). These Haldane effects include the displacement of Carbon monoxide retained by hemoglobin in high amounts of oxygen and the aggravation of the ventilation-perfusion mismatch.
Other concerns about patient safety include titrated oxygen therapy in patients with chronic obstructive pulmonary disease (COPD). The evidence suggests that acute prodromal symptoms of COPD should be managed with titrated oxygen therapy to achieve an oxygen saturation of roughly 88-92 percent (Hatipoğlu & Stroller, 2018). As a result, movement may be critical in reducing the dangers of hypoxia and hypoxia-induced hypoxia. Compared to patients who are given titrated oxygen, the risk of death increases by 2.4 times in the event of an acute exacerbation of the disease (Kopsaftis et al., 2020). The rise in mortality rates is attributed to increased atmospheric carbon dioxide partial pressure. Additionally, blood flow in the coronary or myocardial reperfusion injury can also be reduced by hypoxia, which can lead to rebound hypoxia if the supply of oxygen is interrupted.
Benefits of Incorporating Credible Evidence into EBP
Boosting the survival of patients who use oxygen is dependent on maintaining patient safety. Nurses play a crucial role in administering oxygen to patients who require it. On the other hand, COPD sufferers require the appropriate concentration of oxygen that will not endanger their lives (Hatipoğlu & Stroller, 2018). We hope to investigate studies and experiment with dependable facts that may be used in EBP nursing practice with the evidence. If evidence-based nursing practice is incorporated into care delivery, it will play a crucial role in minimizing organ damage or hypoxia while simultaneously supplying patients with additional oxygen. It is essential to consider the patient’s condition and use the highest effective oxygen concentration available.
References
Branson, R. D. (2018). Oxygen therapy in COPD. Respiratory care, 63(6), 734-748.
Hatipoğlu, U., & Stroller, J. (2018). Supplemental oxygen in patients with stable chronic obstructive pulmonary disease: Evidence from Nocturnal Oxygen Treatment Trial to Long-term Oxygen Treatment Trial. 24(2), 179-186.
Kopsaftis, Z., Carson‐Chahhoud, K. V., Austin, M. A., & Wood‐Baker, R. (2020). Oxygen therapy in the pre‐hospital setting for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews.