NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Assessment 3 Implementing Evidence-Based Practice

Student Name

Capella University

NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Prof. Name

Date

Evidence-Based Practice for Promoting Exercise Among Cancer Survivors

Hey everyone.. I am Gloria. Cancer is one of the most lethal diseases that prevails in our society, with a low mortality and survival rate. Usually, cancer is diagnosed in the late stages, when radiation and chemotherapy become evident for the patient’s survival. The American Cancer Society has just recently announced the updated cancer incidence and death rates in the United States. It revealed a significant decline in the overall cancer mortality trend from 1991 to 2017 by a total of 29% (Siegel et al., 2019). There were an expected 19.3 million new instances of cancer (18.1 million excluding non-melanoma skin cancer) and roughly 10.0 million (9.7–10.2 million) deaths from cancer (9.9 million excluding non-melanoma skin cancer) globally in 2020.The uncertainty interval for this estimate is from 19.0 to 19.6 million (Hanahan, 2022). The term “cancer” refers to a wide variety of diseases, each of which has its own set of symptoms, approach to therapy, and outlook on survival. Cancer has a tremendous effect on the physical, emotional, and social well-being of individuals who are affected by it. It begins at the moment a diagnosis is made and continuing through the road of treatment and survival. The prognoses of a large number of cancer patients have greatly improved as a result of recent developments in research, prevention methods, diagnostic procedures, and treatment modalities.

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

On the other hand, there is still a continuous need for additional research, early detection, effective medications, and extensive support systems in order to further improve cancer prevention and management. The aim of this poster presentation is to fill the gap between evidence-based practice and clinical practice and help the clinician have information that is embedded in the scientific findings and based on background information.

PICOT Question 

Cancer requires a lifestyle change that helps manage a cancer-free life. Dietary habits, exercises, medications, and food choices have to be changed to manage bodily counts and spaces. The PICOT question seeks to investigate the impact of the exercise programs on the quality of life of cancer survivors as compared to standard care or non-exercise programs within 6 months of the intervention. If we open up the PICOT, The population in question is the cancer survivors, while the intervention that is being implemented is an exercise program, which is being compared to standard care or no exercise program, and the outcome is an improvement in the quality of life within the timeline of 6 months.

Action plan 

Exercise has a significant role in bringing about active change in our lives. Similarly, incorporating exercise programs into the regimen of a cancer patient gives the ultimate hands-on assistance in bringing about change in one’s life. This program is based on a course of six months where the recently cancer-free patients were given a regimen of walking and doing low-paced exercises that would help them feel energetic and active. The action plan for this was to ensure that people who have recently survived cancer were encouraged to engage in physical activities such as walking and low-pace exercise to encourage them to develop healthy habits. Studies have highlighted that exercise has a significantly positive impact on cancer survivors and has been characterized as one of the most frequently advised activities to have in the patients’ regimen. Also, a study based on a breast cancer survivor revealed that exercise in the follow-up routine had a significantly positive response among patients. Similarly, a systematic review aggregated information regarding the benefit of exercise through a systematic review of existing systematic reviews in the cancer exercise literature (Stout et al., 2017). The review came to the conclusion that exercise is useful before, during, and after treatment for cancer, for all different forms of cancer, and for a range of impairments that are associated with cancer.

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

When it comes to enhancing physical function and reducing the negative effects of cancer-related impairments, the optimal degree of exercise intensity is moderate to vigorous physical activity (Cormie et al., 2017). An additional systematic review was conducted to provide a thorough summary of the information that is currently available from epidemiologic and randomized controlled trials evaluating the function of exercise in the management of cancer. Patients who exercised following a diagnosis of cancer were found to have a decreased relative risk of cancer mortality and recurrence in comparison to patients who engaged in no exercise or less exercise. Furthermore, patients who exercised following a diagnosis of cancer were reported to have experienced fewer or less severe adverse effects (Ferioli et al., 2019).

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

1. Need assessment: the first and foremost plan of action is to conduct a need assessment to determine the specific exercise needs and preferences of the cancer survivor. Focus groups, surveys, and consultation with professionals are used to gather the information.
2. Review evidence: conducting a thorough literature review to find the best practices would be the second step in the plan to become more aware of the best practices and how the literature supports the use of exercise in the plan.
3. Recommendation for the practice change: based on the need assessment, bring changes to the plan and develop specific person-oriented practice changes such as guidelines, protocols, frequency, intensity, duration, and type of exercise that would suit the patient best.
4. Creating a timeline: Developing an intervention plan and creating an estimated timeline would help them specify the milestones and deadlines for each step.
5. Identify the practice changes: implementation of the practice change recommendations according to the timeline and using the identified tools and resources
6. Identify tools and resources: This could include educational materials for cancer survivors and healthcare providers, exercise equipment, and funding for program development and implementation.
7. Evaluation of the Impact: Evaluate the impact of the practice change on cancer survivors’ health outcomes and quality of life. This could include collecting data on exercise participation, physical function, and other relevant outcomes.

Stakeholders and Potential Barriers 

The following stakeholders would hold an important place in the implementation of the project:

1. The survivors: Cancer patients who have survived the disease will be the project’s key beneficiaries. These individuals will take part in the fitness program and provide feedback on how beneficial it is.
2. The health providers—oncologists, nurses, physical therapists, and other healthcare practitioners—who deal with cancer survivors and are able to provide direction on the formulation and implementation of the exercise program are considered to be healthcare providers.
3. Hospitals: Organizations that provide support and resources to cancer survivors and can help with the dissemination of information about the fitness program are referred to as cancer support organizations.
4. Certified professionals: Certified exercise specialists who are able to assist in the development and implementation of an exercise program for cancer survivors are referred to as “exercise professionals.”
5. Researchers: Researchers who examine the influence that exercise has on cancer survivors and who are able to provide advice on the evidence-based techniques that ought to be implemented into the program.

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Similarly, the following are examples of potential barriers to the implementation of the project:

1. Both cancer survivors and healthcare practitioners lack information and understanding regarding the benefits that exercise can provide for cancer survivors.
2. Cancer patients have a difficult time gaining access to exercise facilities and equipment.
3. Cancer survivors may find it difficult to join a fitness program due to financial constraints.
4. Some cancer survivors struggle to engage in particular forms of physical activity because they struggle to overcome the physical restrictions or comorbidities that prevent them from doing so.

Outcome Assessment: 

The outcome criteria can be evaluated through multiple sources, such as:

1. Participation rate: The percentage of cancer survivors who are part of an exercise program can help identify the outcome.
2. Physical functioning: Changes in physical functioning can be assessed through the walk test or grip strength test. Similarly, mood assessment can also be included to assess the overall mental well-being and see the impact of exercise on cancer survivors’ mental well-being.
3. Quality of life: Changes in quality of life among cancer survivors who participate in the exercise program, as measured by standardized questionnaires such as the Functional Assessment of Cancer Therapy-General or general quality of life questionnaire
4. Cancer-related outcomes: the assessment of recurrence rates, mortality, and treatment-related issues to monitor the change can help in determining the criteria.

Value and relevance 

The evidence that supports the necessity for a practice change to incorporate exercise into the treatment of cancer survivors is compelling and extremely pertinent. Numerous benefits are offer by excercise  for cancer survivors . It includes better physical function, quality of life, and cancer-related outcomes. These benefits have been the subject of a number of systematic reviews and meta-analyses (Czosnek et al., 2021). As such, the findings of one systematic review indicated that exercise is beneficial before, during, and after therapy for cancer, for each and every form of cancer, and for a range of impairments that are associated with cancer (Campbell et al., 2019). Patients who exercised following a diagnosis of cancer were shown to have a decreased relative risk of cancer mortality and recurrence, and they reported fewer or less severe side effects. This was in comparison to patients who engaged in no or less exercise following their cancer diagnosis.

Conclusion 

In conclusion, exercise does help cancer survivors. Exercise improves health, quality of life, and cancer outcomes. An evidence-based practice project to incorporate exercise into cancer survivors’ care may involve assessing population needs, reviewing the evidence, developing practice change recommendations, creating a timeline, identifying tools and resources, implementing the change, and evaluating its impact. Cancer survivors, healthcare practitioners, cancer support organizations, exercise professionals, and researchers may participate. Healthcare professionals and cancer survivors may not comprehend the benefits of exercise, have limited access to exercise facilities or equipment, have budgetary constraints, or have physical limits or comorbidities. Participation rates, changes in physical function and quality of life among cancer survivors who exercise, and cancer-related outcomes, including recurrence and mortality rates, are used to evaluate the initiative.

References 

Cormie, P., Zopf, E. M., Zhang, X., & Schmitz, K. H. (2017). The Impact of Exercise on  Cancer Mortality, Recurrence, and Treatment-Related Adverse Effects. Epidemiologic reviews, 39(1), 71–92. https://doi.org/10.1093/epirev/mxx007 Campbell, K. L., Winters-Stone, K., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S., … & Schmitz, K. H. (2019). Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine and science in sports and exercise, 51(11), 2375. Czosnek, L., Richards, J., Zopf, E., Cormie, P., Rosenbaum, S., & Rankin, N. M. (2021). Exercise interventions for people diagnosed with cancer: a systematic review of implementation outcomes. BMC cancer, 21(1), 1-25.

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Ferioli, M., Zauli, G., Martelli, A. M., Vitale, M., McCubrey, J. A., Ultimo, S., Capitani, S., & Neri, L. M. (2018). Impact of physical exercise in cancer survivors during and after antineoplastic treatments. Oncotarget, 9(17), 14005–14034. https://doi.org/10.18632/oncotarget.24456 Siegel, R. L., Miller, K. D., Fuchs, H. E., & Jemal, A. (2022). Cancer statistics, 2022. CA: a cancer journal for clinicians, 72(1), 7-33. Hanahan, D. (2022). Hallmarks of cancer: new dimensions. Cancer discovery, 12(1), 31-46. Stout, N. L., Baima, J., Swisher, A. K., Winters-Stone, K. M., & Welsh, J. (2017). A Systematic Review of Exercise Systematic Reviews in the Cancer Literature (2005-2017). PM & R : the journal of injury, function, and rehabilitation, 9(9S2), S347–S384. https://doi.org/10.1016/j.pmrj.2017.07.074

ADDITIONAL INSTRUCTIONS FOR THE CLASS – NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

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