Student Name

Daniela Fernandez

MSN Program

Family Nurse Practitioner

Project Title

Stepwise Management of Asthma.

Week 1

State Your Clinical Question

[100 to 150 words]

· State your clinical question or topic for your capstone project proposal.

· What issue is the question/topic addressing?

· What are the reasons you selected this question/topic?

Week 2

Background Information

[200 to 250 words]

Address the following questions/bullets in completing this section:

· Start at the starting point – What, Where, When, Why, and How?

· What is known about this topic or what is the evidence on this topic (Scoping Search)?

· What is the outcome of interest?

· What are the gaps in our understanding or knowing related to this topic?

Asthma is a serious illness that has affected 25 million people across the globe. The disease is more vulnerable to women than male adults (Cloutier et al., 2018). Stepwise management of asthma needs serious interventions and cooperation between the healthcare professionals and the general public. The starting point to manage asthma is the requirement to provide a framework through emerging technologies to track the signs and symptoms and how effective the lungs are working. The second starting point is to treat asthma based on evidence-based practice while prioritizing children and the elderly.

There are various evidences about asthma based on scientific research. The first one is the leading and the most serious chronic illness among children. The chronic disease is triggered by allergies, including cockroach waste, mold spores, dust mites, and pollens. The asthma triggers differ from person to person. Asthma is closely associated with fungal substances through the allergic bronchopulmonary aspergillosis test (Prasad et al. 2020). Therefore, the authors found that antifungal therapy provides treatment benefits of sixty percent to patients.

The most interesting outcome is that this proposal will use evidence-based information from research and developments to mitigate the risk of asthma in causing death and other health complications. There are many gaps in achieving mitigation and eradication of asthma which are contributed by false misconceptions. For instance, many people believe that asthmatic people should not exercise. However, healthcare workers advocate for body exercise through evidence-practice since it strengthens lungs and control asthma. The second most interesting outcome is to advise the patients and the healthcare personnel to use emerging technologies to track and monitor asthma. For instance, electronic health records enable nurses to track how effective previous medicines promote quality health to a patient.

Week 3

Literature Search Strategies

[150 to 200 words]

Provide details of your exhaustive search process. Be certain to list:

· Databases searched.

· All the keywords or search phrases used.

· How many articles in total that were found?

· List the inclusion/exclusion criteria.

· Provide the number of articles that were retained and a description on why those articles were retained.

· Consider using a flowchart to outline the search process.

ProQuest Digital Theses, Dissertations, NLM, New York Academy of Medicine Grey Literature Reviews, SCOPUS, Web of Science, EMBASE, CINAHL, Cochrane Library, and PubMed databases from peer-reviewed and grey-literature were used during the research. The databases were credible since experts reviewed them before storing them in the database. The keywords used in the research include asthma, multimorbidity, chronic, person-centered, and psychological. The researcher searched for the articles using the framework using preferred reporting items for systematic reviews and meta-analyze (PRISMA) (Saberi et al., 2018).

Initially, there were forty-eight topics that had been selected for the study. However, only thirty-four articles met the study’s criterion. Some of the articles did not provide information based on the medical framework, and therefore, some were very general. Some of the articles were published many decades ago and seemed not to address asthma disease based on the current challenges and the emerging technologies. Additionally, some of the articles were not English-related. Based on the criteria outlined for the studies, the fourteen articles never fulfilled the set rules and regulations.

The article's authors only used thirty-four articles to develop the recommendations and the conclusion. The authors noted no standard assessment method to identify asthma (Sheehan et al., 2019). The authors recommended providing the most effective assessment method in the future to enhance diagnosis, prevention, and healing of asthma.

Week 4

Literature Review

[500 to 1000 words]

Conduct a review of the literature. Include at least five (5) research articles and/or evidence-based guidelines. Address the following questions/bullets in completing this section:

· Conduct a review of the literature.

· Provide the highlights from the research.

· Synthesize the literature on the topic.

· Summarize how the project will contribute to knowledge by filling in gaps, validating, or testing knowledge.

· Cite references in this section per APA and list the reference in the References section at the end of the form.

Based on Montalbano et al. (2020), the first literature review compare determined the quality of life with behaviors problems among asthmatic people. The article uses the MIMIC model to provide comprehensive, evidence-based information based on a quality assessment. The article indicates some behaviors such as somatic symptoms, depression, and anxiety reduce the quality of life among asthmatic children. The article based on Gupta et al. (2020) provided challenges, asthmatic children faced during the COVID-19 pandemic. The COVID-19 pandemic was less vulnerable to children than adults, and thus children were less likely to be admitted to intensive care. Various measures such as maintaining hygiene to reduce the spread of COVID-19 also work to the advantage of asthmatic people since there was a reduction in the number of asthmatic cases across the globe.

Landeo-Gutierrez and Celedón (2020) provided evidence on stress and psychological stress among asthmatic adults. The article indicates that exposure to chronic and acute stressors in the community, family, and individuals leads to severe complications among asthmatic people. Hufnagl et al. (2020) indicated that the lung microbiome and dysbiosis of the gut have a huge role in asthma. The article indicated genus haemophilus and phylum proteobacteria are more common among asthmatic patients. The study has shown that many asthmatic adults are associated with haemophilus parainfluenzae. Changes in asthma's severity, particularly due to weather changes, relate to dysbiosis and the growth of Proteobacteria. Ahmed and Turner (2019) provided various risks and treatment among asthmatic children. The article indicated that anti-IgE biologic omalizumab is effective among children between 6 and 11. Additionally, the mepolizumab medication has been approved in European countries. The project will create more awareness on the importance of maintaining hygiene to reduce factors such as dusts that increases the complications of asthmatic people. Also, the project has provided evidenced information on the most effective medication to asthmatic children.

Week 5

PICOt Question

State your PICOt question here. Use the elements of the PICOt in separate sections below to describe each component.

· Population – Provide the description of the targeted population.

· Intervention – Describe your evidence-based intervention.

· Comparison – What is currently happening?

· Outcomes – List at least two (2) measurable outcomes.

· time – What duration of the study for the project? (e.g., usually 6 months or 3 months)

Population (P): Asthmatic children below ten years. Many children cannot achieve their highest academic goal due to many side effects of asthma, such as depression and anxiety.

Intervention (I): The intervention is conducting qualitative and quantitative research to provide evidence for asthmatic management among children below ten years. The most common intervention for asthma management is bronchodilators (quick-relief inhalers) (Benka-Cokerc et al., 2020). Since most asthmatic children are allergic to dust and animal waste, allergic management is also critical.

Comparison (C): There are various factors to compare the advanced effects of asthma among children. The first comparison measure is housing density and income, which measures the outcome by monitoring the hospital readmission. There is a relationship between housing density and income. For instance, there are few cases of asthma in areas where people are less populated. High-income rates enable a family to access mediations and early intervention from good hospitals, thus reducing the effects of asthma among children.

Outcomes (O): Effective asthma management can be measured through various outcomes. The first one has reduced school absenteeism. Proper asthma management will make students increase their quality of life, thus improving self-esteem and reducing school absenteeism. Additionally, the other outcome is a reduced rate of hospital readmission and visits to emergencies departments (Lovinsky-Desir et al., 2020). Therefore, proper asthmatic management will enable children to improve their academic performance, enhance self-efficacy and improve their quality of life. Through various healthcare insurance policy coverages, all people, including low-income families, have the same platform to access quality care with reduced cost.

Time (t): 90 days.

Week 6

P (Target Population)

[75 to 100 words]

Address the following questions/bullets in completing this section:

· Who is your target population?

· Describe your population, i.e., age, ethnicity, gender, condition/diagnosis, etc.?

· Describe the setting where this project be implemented?

The target population for study is twenty students living with autism in the United States (Lewis, 2020). Ten children will be picked from Land Park Academy, California, United States. The rest of the participants would be students from Jericho National School which is in Florida (Yu et al., 2020). The population will involve the equal number of males and females, white and Hispanic. Children between the age of three to ten will be considered for the project. The setting of the project will be at Land Pack Academy. The project will be implemented through the help of medical personnel.

Week 7

I (Intervention)

[100 to 200 words]

Address the following questions/bullets in completing this section:

· What are you planning to investigate or implement as a policy/process or program?

· What are you doing that is different than what is currently happening?

· List 2-3 potential actions that will be applied in this practice change.

NOTE: Be very specific in your description.

The implementation of the project is to ascertain the best medical intervention for the asthmatic children. The project will involve asthmatic children from Land Park Academy. The project will develop education programs and treatment plans that will enhance individualized education and management of asthma (Paula et al., 2020). Asthmatic children face a lot of challenges in school particularly when they are exposed to periods of exacerbation.

The project will provide evidence-based information that will lead to the collaboration of educators and healthcare workers in monitoring and promoting the wellbeing of asthmatic children. The project is different from what is implemented in the United States. Currently, in the United States the autistic children are managed differently by healthcare personnel and the educators. However, the implementation of this project will evaluate the effectiveness of incorporating various type of therapist in the education curriculum.

Potential intervention includes:

Provide special education programs for asthmatic children with high cases of hospital admission to cover the days they are absent from school.

Introduction of therapeutic nursing intervention in schools for asthmatic children (Ainsworth, et al., 2020).

Government should set aside resource to support asthmatic children from humble background since the disease require regularly healthcare monitoring.

*For purposes of this Proposal Project Form the assumption will be that the C (Comparison Group) is ‘traditional care or current care’

Week 8

O (Outcomes to be measured)

[100 to 150 words]

Every project is required to have an evaluation plan. Address the following questions/bullets in completing this section:

· Which 2-3 outcomes are expected for your project?

· What outcomes will be measured?

· How do you plan to do this?

· What tool will you be using to measure your outcome(s)?

· What data will be used to validate success of the project?

Be sure your outcomes link to the identified problem.

· How will you know if your intervention resulted in change?

The research and development will consider asthmatic children and the healthcare personnel who are specialist in service delivery to asthmatic children. The evidence-based information will be used in the nursing and education field to support the asthmatic children (Federman, et al., 2019). The following are expected outcomes.

1. The education sectors will be able to implement school-based asthmatic management programs to support learning to the asthmatic children.

2. The healthcare workers will reduce the number of children visiting the healthcare facilities due to asthmatic complication.

3. Establishment of nursing therapeutic in schools thus promoting guidance and counseling to asthmatic children thus enabling students to cope with asthma and achieve their academic goals.

I would achieve the two outcomes by involving the educators and the healthcare workers in the planning and implementation of the project. The first tool I will use to measure the outcome is the Electronic Health Record (EHR) to determine the rate of asthmatic children readmission (Dhopeshwarkar, et al., 2019). The school assessment data will provide critical information whether the asthmatic children are improving or not.

Week 9 & References

9.1 Conclusion

[200 to 250 words]

· Provide a summary for your MSN Capstone Project.

· Select and provide the rationale for three (3) competencies or specialty standards that you would expect to use in implementing this project [List of your specialty competencies are listed in the Week 9 Reflection Post]

9. 2 References

[Minimal of 5 research articles and references are paged on the last page.]

· Add your references in APA formats on the last page.

Families with asthmatic children have many challenges to manage the healthcare condition. Some of the humble families are not able to adhere to the clinic guidelines due to high out-of-pocket charges. Sometimes some families are not able to afford the inhalers to their children. The project will enable the educators to initiate an education program that incorporates the nursing therapies in schools to handle challenges that need immediate intervention from the nursing perspective (Hoch, et al., 2019). Also, this project will enable educators to create more time for the asthmatic children to boast their self-esteem and cover education topics, for example where to go to seek medications.

The implementation of this will consider three main competencies which will include leadership, quality, and technology and information literacy.

Competency 2 – Leadership Competencies – It is very important to incorporate doctors, teachers, and parents in this project to collaborate and promote teamwork to enhance the well-being of asthmatic children in school. This project will require collaboration of all interdisciplinary teams to improve the management of asthma in schools.

Competency 3 – Quality Competencies – This project will be based on the best resources available and evidence-based practice that involve the views and opinions for both educators and healthcare workers since they interact with asthmatic children daily.

Competency 8 – Ethics Competencies – It is fundamental to incorporate the principle of justice on this project because of this I think asthmatic children in schools should have the same opportunities as other children.