NURS FPX 4025 Assessment 02: Role of Evidence-Based Practice on Appendicitis
Student name
Capella University
NURS- FPX4025
Professor Name
Submission Date
Introduction
Acute appendicitis is an inflammation of the appendix with sudden onset and is often due to an obstruction of the appendix, leading to infection of the appendix, which becomes more severe, either as a perforated appendix or an abscess forms. Laparoscopic appendectomy remains the treatment of choice; antibiotics may be an alternative to surgery if the disease is localised in select cases. Risks have to be carefully evaluated in such patients. Laparoscopic appendectomy is still the standard treatment of appendicitis, but recent evidence shows that antibiotics may be a suitable treatment of choice for some patients. Evidence-based practice (EBP) is utilised as part of the decision-making processes regarding the best way of managing appendicitis in practice. This paper examines the diagnosis of acute appendicitis and uses an EBP model to identify and consider the best available evidence to find the treatment options for acute appendicitis. This assessment is systematic in terms of the use of research findings to enhance the understanding of the best way of managing acute appendicitis with minimal risk/complications.
The Role of Evidence-Based Practice in the Choice of Treatment
The most important problem in connection with the diagnosis of acute appendicitis is the choice of the best method of treatment, namely, the treatment in a nonoperative way using antibiotics and classical surgical intervention. Laparoscopic appendectomy is still the actual treatment; however, studies have shown that some patients may be suitable candidates for surgery without undergoing it (Moris et al., 2021). Nonetheless, appendicular dilation, appendicoliths, and mass effect are contrary to the success of nonoperative management.
An EBP approach can help to address this problem by systematically analysing current research to inform clinical decision-making. This allows professionals providing healthcare services to make better-informed decisions throughout the integration of the current best accessible evidence with clinical expertise and patient desire for a reduction of complications and positive patient results (Bogza et al., 2020). An applied EBP model means that the recommendations for treatment of acute appendicitis are based on the quality of research, such that patients are treated more effectively and individually (Kamarajah et al., 2024).
Application of Evidence-Based Practice Model
The Johns Hopkins Nursing Evidence-based Practice (JHNEBP) Model is a structured approach to assessment and application of evidence for clinical decision-making and is therefore very suitable for the issue of selecting treatment in acute appendicitis (Brunt & Morris, 2023). The first step (Practice Question) is the decision on whether antibiotics are a good treatment for a certain clinical problem, such as whether to use antibiotics as an alternative to surgery. The second point (Evidence) is the investigation and appraisal of the existing relevant drug research studies, clinical guidelines, and the opinion of experts to ascertain the strength and applicability of the evidence (Schoberer et al., 2022). The last step, Translation, is concerned with the integration of findings into practice through the creation of recommendations, implementation of changes, and evaluation of results.
The model is valid with respect to the situation covered since the decision-making about treatment of appendicitis is best made based on high-quality evidence, taking into consideration the impacts on patient outcomes, safety, and feasibility. In following this systematic approach, healthcare providers can make informed and well-thought-out decisions that are best suited to the care and treatment effectiveness of the patient, ensuring that clinical guidelines are followed and there is a lower risk of complications. The combination of evidence-based practices will enable the healthcare teams will be able to balance the importance of surgical vs. non-surgical management vs. the recovery times as well as the satisfaction of the patient as a whole.
Use of the Evidence-Based Practice Model in Acute Appendicitis
Using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model, a systematic search was performed to obtain high-quality evidence on the diagnosis, management, and post-surgical management of acute appendicitis. For the Practice Question phase, a research study was found that included the surgical and nursing interventions in appendicitis. During the Evidence phase, studies related to nursing practices and outcomes of appendectomy treatment after surgery were searched from the peer-reviewed databases. The article by Moris et al. (2021) was a comprehensive review report on the diagnosis and management of acute appendicitis that gave insight into how to assess a patient, imaging, and treatment modalities (Moris et al., 2021). Chisum et al. (2020) viewed the role of nurses in pediatric appendicitis patients with the discharge protocol, which portrays the role of the nurses in relation to patient outcomes and postoperative recovery (Chisum et al., 2020). One of the challenges of this phase was to ensure that the selected studies applied to different patient populations and covered both clinical and nursing perspectives.
A further refinement of the search resulted in the identification of meta-analyses studies on post-surgical care and infection prevention. Liu et al. (2024) discussed the benefits of structured nursing care for a more rapid recovery from evidence-based nursing interventions for surgical site wound infections for patients with appendicitis (Liu et al., 2024). Zhang et al. (2023) also concluded that the clinical nursing pathways were one way of improving infection control, and thus the standardization of the post-operative protocols is important (Zhang et al., 2023). In the Translation phase, the results from these studies were synthesized to derive their relevance in clinical practice, especially in the optimization of recovery for patients while minimizing complications. One of the most important challenges was how to balance the effectiveness of surgery with the post-operative nursing care to achieve complete, evidence-based management of acute appendicitis. By undertaking a search using the JHNEBP model, it was ensured that all evidence selected was high quality, clinically relevant, and could be directly applied to the improvement of patient care.
Using the JHNEBP Model to Drive Evidence Search
Applying the JHNEBP Model to search for evidence on acute appendicitis presented a number of problems. In the practice question phase, the challenge primarily was to come up with a clinical inquiry that would be unique to acute appendicitis and that would consider both the surgical and nursing perspectives. During the Evidence phase, determinations had to be made on methods, sample sizes, and applicability to different patient populations in order to weed out the quality studies from the lesser research. A particular difficulty was balancing both the research on adult and pediatric cases, as some of the research, such as Chisum and colleagues (2020), addressed pediatric cases of appendicitis, while the study by Moris and colleagues (2021) was a more general study that looked at the adult cases.
In addition, Liu et al. (2024) and Zhang et al. (2023) also provided valuable meta-analyses on post-surgical infection control, and due to the heterogeneity of different study designs and patient outcomes, it was hard to reach a definitive conclusion. The challenge in the Payload Synthesis phase was to bring together disparate findings to develop safe and feasible treatments that can satisfy the agendas of the contributors, but also take into account what is advisable (where ‘advisable’ means acceptable from a long-term point of view, but not if it is at the potential risk to patient safety). Although there were such obstacles, the systematic nature of the JHNEBP model ensured the outcomes of an evidence-based evaluation of management strategies for acute appendicitis.
Credibility and Relevance of Evidence
Each of the selected resources was critically analyzed for the criteria of credibility and relevance in addressing the diagnosis and management of acute appendicitis. Much like any other medical journal, JAMA is a list of peer-reviewed articles written on the subject terms of diagnostic criteria, imaging techniques, and treatment options. The article by Moris et al. (2021) is a good source to help understand. The paper by Chisum et. al. (2020) published in The American Journal of Surgery adds a nursing perspective to surgical research, as the focus is on the nursing interventions akin to postoperative practice that are often missing. Their credibility comes due to the fact that both Liu et al. (2024) with their meta-analyses in the International Wound Journal and Zhang et al. (2023) with their meta-analyses in the International Wound Journal both are publishing on the topic of infection prevention in appendicitis patients. Compared to single case studies or anecdotal information, these articles show a much more thorough, evidence-based approach to treatment and nursing care. Furthermore, all the sources were published in credible and peer-reviewed journals and are recent, so that the findings do not overlap with present-day medical and nursing practices. Where sources examine only part of care are sources that address only one of these areas, the sources that are concerned with both the surgical and the nursing interventions are more acceptable for a comprehensive evidence-based analysis of the acute appendicitis.
Conclusion
The importance of using the evidence-based practice model is that it can be applied as the treatment decision when the outcome of acute appendicitis is made. An organized process of evaluating antibiotics vs surgery is ensured by the Johns Hopkins Nursing Evidence-based Practice Model, and results are based on credible research to enhance patient outcomes. Despite difficulties, including varying study outcomes, integration of evidence and clinical experience supports safe and effective care. This approach gives attention to the use of evidence-based practice in expanding on treatment strategies and the development of patient-centered care.
References
Bogza, L.-M., Lebeau, P. C., Farmanova, E., Witteman, H. O., Elliott, J., Stolee, P., Hudon, C., & Giguere, A. M. C. (2020). User-centered design and evaluation of a web-based decision aid for older adults living with mild cognitive impairment and their health care providers: Mixed methods study. Journal of Medical Internet Research, 22(8). https://doi.org/10.2196/17406
Chisum, M., May, A., Wang, M., Hagen, E., & Weinsheimer, R. (2020). Postoperative pediatric appendicitis nurse-driven discharge: Patient outcomes and nursing perspectives. The American Journal of Surgery, 221(4). https://doi.org/10.1016/j.amjsurg.2020.02.063
Kamarajah, S., Boghdady, M. E., Anyomih, T. Wohlgemut, J., & Bhangu, A. (2024). State of the art review: Evidence-based management of acute appendicitis. Deleted Journal, 1(2). https://doi.org/10.62463/surgery.45
Liu, F., Zhou, J., & Wu, X. (2024). Effects of evidence‐based nursing on surgical site wound infection in patients undergoing acute appendicitis surgery: A meta‐analysis. International Wound Journal, 21(3). https://doi.org/10.1111/iwj.14539
Moris, D., Paulson, E. K., & Pappas, T. N. (2021). Diagnosis and management of acute appendicitis in adults: A review. Journal of the American Medical Association, 326(22), 2299–2311. https://doi.org/10.1001/jama.2021.20502
Schoberer, D., Breimaier, H. E., Zuschnegg, J., Findling, T., Schaffer, S., & Archan, T. (2022). Fall prevention in hospitals and nursing homes: Clinical practice guideline. Worldviews on Evidence-Based Nursing, 19(2), 86–93. https://doi.org/10.1111/wvn.12571
Zhang, Q., Zhang, L., Wu, J., & Yang, F. (2023). Effects of clinical nursing pathway on surgical site wound infection in patients undergoing acute appendicitis surgery: A meta‐analysis. International Wound Journal, 21(4). https://doi.org/10.1111/iwj.14600
FAQs
1. What is NURS FPX 4025 Assessment 2?
NURS FPX 4025 Assessment 2 will focus on application of evidence-based practice for appendicitis treatment.
2. Why is the evidence-based practice approach important when dealing with appendicitis?
The evidence-based practice approach is crucial since it makes sure that current information from researches is employed by health practitioners.
3. What are the typical themes discussed in NURS FPX 4025 Assessment 2?
Signs and symptoms of appendicitis, surgery, antibiotics, recovery, pain management, and nursing interventions are some of the topics covered in this task.
4. How can research be helpful to patients with appendicitis?
Researches would give the most appropriate clinical practices for effective management of such medical cases and would help nurses provide excellent care.