Evidence Based Nursing Research on Home-Based Health Care Involvement in COPD

Running head: EVIDENCE BASED NURSING RESEARCH
Evidence based nursing research
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1EVIDENCE BASED NURSING RESEARCH
Introduction
Chronic Obstructive Pulmonary Disease (COPD) accounts for large hospital admissions
and various interventions are being attempted to reduce the exacerbations that requires
hospitalizations. The disease is progressive in nature and requires correct treatment to manage
the condition. Intermediate care bridges the gap between the hospital and home based care in
COPD. Hospital-at-home acts as active treatment given at home for COPD condition for better
health outcomes and reduce vulnerability to adverse events. Considering this situation, a PICOT
research was carried out to investigate home-based health care involvement in COPD affecting
re-admissions within 3 to 6 months after discharge. Therefore, the following assignment involves
the review of PICOT research and comparison of research question, sample populations and
study limitations.
Research question
An article published by Adib-Hajbaghery, Maghaminejad & Abbasi, (2013) was aimed at
investigating the reduction in readmission rates through continuous care post heart failure.
Patient education along with follow-ups significantly improved the quality of care. This finding
is supported by another study conducted by Brewster et al., (2016) where they highlighted the
fact that patient education and effective follow-up after discharge has reduced hospital re-
admissions ensuring continuity of care by improving medical performance. This finding is not
consistent with another study conducted by Delbridge et al., (2016) as it was aimed at studying
BCL-2 protein family and its role in cancer therapy and development. However, another study
conducted by Kripalani et al., (2014) supported the capstone project that multiple interventions
like patient education; outpatient follow-ups after discharge have successfully reduced

2EVIDENCE BASED NURSING RESEARCH
readmissions for patients who are discharged to home. Another study conducted by Li et al.,
(2015) was aimed at exploring the transition care needs before discharge to reduce mortality risk
and readmissions after surgery. Whereas, Martínez-Jiménez et al., (2017) studied a framework
that enabled detection of cancer specific mutations like single point mutations and its resistance
impact involved in targeted cancer therapy. On a contrary, Morrison, (2016) studied the
outcomes of transitional care programs in regards to self-management after discharge from
hospital with significant reduction in hospital re-admissions. Nelson & Pulley, (2015) also
studied effectiveness of transitional care in avoiding hospital re-admissions as key factor in
quality care and patent safety.
Sample population
Adib-Hajbaghery, Maghaminejad & Abbasi, (2013) adopted qualitative study design
(random sampling) and identified 16 out of 21 clinical trial studies focused on post-discharge
care for heart failure patients. Databases like Pubmed, Google Scholar and Science Direct were
used including keywords readmissions, heart failure, home monitoring and follow-ups. Brewster
et al., (2016) also used similar qualitative study of 10 hospitals and 82 participants who
participated in quality improvement initiative in the State Action on Avoidable Readmissions
through stratified sampling method. On a contrary, Delbridge et al., (2016) adopted judgmental
sampling in qualitative approach to study the BCL-2 protein family role in cancer treatment.
Kripalani et al., (2014) conducted a qualitative study through random sampling to explore the
approaches for reducing readmissions for discharged patients to home or post-acute care
facilities with high-risk readmission patient identification. On a contrary, Li et al., (2015)
conducted retrospective cohort study of a large sample comprising of 486 colorectal patients who
had curative surgery at tertiary cancer referral centre where home-based care and outcome