RUBRIC
VI. PICO Solution, Relevance to Clinical Practice and Implementation (1-2 pages)
The identified outcome and answer to PICO question is clearly stated and reflects research findings. Implementation of findings to clinical practice is clearly explained in a step-by-step format which is logically and completely stated. Relates and integrates the constructs of the theoretical model by stating how the model guided the EBP process to implementation.
VII. Conclusion Preceptorship II (½-1 page)
Exemplary overview and succinctly written summary of paper includes impact to clinical practice and evidence-based process.
X. APA Format (7th ed.) Evidence of Scholarly Writing. Meets Assignment Criteria All Courses:
Paper is written co
ectly in APA format. All assignment criteria are met including the appropriate body of paper limit to 10 pages excluding appendices and references. Organized, grammar co
ect, and with organized flow of thoughts.
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COVID 19
An Evidenced Based Pape
SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE
DEGREE OF MASTER OF SCIENCE DEGREE IN NURSING
IN THE GRADUATE SCHOOL OF THE
TEXAS WOMAN’S UNIVERSITY
COLLEGE OF NURSING
Byrishia Williams
NURS 5615 K79
Kristin Cove MSN, APRN, FNP-BC
March 26, 2023
COVID 19
The COVID-19 pandemic has had a great influence on the livelihoods of the American people as well as the healthcare providers. At the start of the pandemic, no effective treatment options were available. Instead, preventative measures were implemented, such as social distancing, hand washing, and wearing masks. Two scientists, Weissman and Kariko, later discovered a vaccine to help aid in the prevention of infections. This paper explores the process of treatment of patients against COVID-19. In adults 25 to 50 years old with mild to moderate symptoms of COVID 19 (P), how effective is monoclonal antibody therapy (I) versus antiviral medications (C) at preventing potential mortality (O)?
Significance of the Problem
Daniel XXXXXXXXXXstates that COVID-19 was first reported in Wuhan, China, in December 2019. Over time the condition has progressively led to the infections of more people, and the death rates have progressively risen. Researchers have helped guide The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) on what is supposed to be done to ensure that the condition is managed. One of the proposed interventions during the start of the pandemic was the maintenance of social distancing which led to the closure of companies, schools and restrictions put on health facilities. This was followed by the provisions to have regular instances of wearing masks. The use of masks was mainly intended to help in the elimination of any exposure to the droplets of the virus causing COVID-19.
All the proposed interventions were being implemented, but the pandemic was still leading to deaths and more infections in the population. With research, BioNTech
ought in the vaccination that could help in boosting immunity to ensure that the virus may not strive in the body. Progressively there has been an implementation of other proposed methods that are expected to help improve the capacity of the people to avoid infections.
Monoclonal antibodies are one of several treatment options in helping attack the virus. There are other treatment methods, including the use of antiviral medications, to ensure that the mortality rates due to COVID-19 are reduced. With the use of monoclonal antibody therapy, the goal is to ensure that the cases of hospitalization are reduced, that there will be a reduction in the viral load and that there will be a reduction in the severity of the symptoms of COVID-19 (Su & Lu, XXXXXXXXXXMonoclonal antibody therapy mainly depends on monoclonal antibodies. The monoclonal antibodies are not different from those that are made by the body, and hence they respond naturally to infections. The antibodies help in the detection of the COVID-19 virus and prevent it from attaching. Specifically, the antibody can recognize the spike protein on the outer shell of the COVID-19 virus and ensure that there is an elimination of the capability of the virus to attach and be able to enter the body cells (Bariola et al. 2021).
Theoretical model
Implementing changes in the healthcare practice such as the proposal for changes to ensure that the patients with COVID-19 symptoms are treated with the use of a monoclonal antibody therapy will call for the use of a framework or theory. The framework that has been selected in this case is the ACE Star model. The model has five stages: discovery research, evidence summary, translation to guidelines, practice integration, and process and outcome evaluation (Indra, 2018).
In the first stage of discovery of research, there is an examination of the issue of COVID-19 and the research that has been done on the treatment of patients suffering from the condition. This includes the need for the determination of the success attained and the alternatives as well as the recommendations that are made by the researchers across the literature. The research will help to provide the information regarding the health condition.
The second stage entails the summary of evidence. This will entail the identification of specific areas that are found to be of importance in the research. This includes the areas on the issue of healthcare concerns faced by the patients and the effects of certain treatment methods.
The third stage will focus on the translation of the findings into guidelines. In this case, the findings that include the implementation of monoclonal antibody therapy will be developed as guidelines that are to be followed in the process of delivery of care to patients with COVID-19.
The fourth stage will be practice integration. In this stage, there is an adoption of the use of monoclonal antibody therapy in the treatment of patients suffering from COVID-19. This will also focus on determining the influence that the issue of COVID-19 has had on the patient and the changes
ought in by the implementation of this therapy.
The fifth stage is the evaluation of the outcome that is attained with the implementation of monoclonal antibody therapy. In this case, there will be an examination of the issue of mortality due to COVID-19 and the changes that have been attained due to monoclonal antibody therapy. The outcome will be useful for determining the recommendations on the necessary treatment measures for patients with symptoms of COVID-19.
Search Strategy and Results
In the process of selecting articles that are to be used, there will be a consideration of search terms that are to be used. The search terms that are to be used in this case are prevention of mortality due to COVID-19, use of monoclonal antibody therapy to manage COVID-19, use of antiviral medications to manage COVID-19, and the prefe
ed interventions to manage COVID-19. These search terms are used in the search process for literature in databases such as CINHAL, PubMed, Google Scholar, and Cochrane.
The selection process of articles to be used will be based on various factors. First, it will be required that the articles that are to be selected are recent. This implies that the articles that are supposed to be selected are expected to have been published within the last five years. This would be ideal as the information that will be collected will be relevant. The article as well is expected to be with primary data, and hence there will be avoidance of any use of secondary data.
Level of Evidence
The literature search will as well entail consideration of the level of research. The studies that are to be selected are those of levels one, two, and three only. As such, systematic reviews, randomized controlled trials, cohort studies, and retrospective case-control studies will be considered. This will ensure that the studies are reliable and that they are primary research studies. The consideration of such aspects is fundamental in that it will allow for the determination of the reliability of the shared information.
Literature Review
Ja
ett et al XXXXXXXXXXfocused on examining the impact that could be there on the application of neutralizing monoclonal antibody therapy. The implementation of this therapeutic method is ca
ied out to help in the understanding of the impact of the implementation of a therapeutic practice that could influence the increasing cases of infections and deaths due to COVID-19. The implementation of this intervention intends to allow for cases of mortality to be reduced.
The findings in the study by Lin et al XXXXXXXXXXare that cases of use of mAbs help reduce the cases of deaths due to COVID-19. The intervention is expected to play a critical role in the elimination of cases of death. The findings in this study are in line with the findings in the study by Ja
ett et al XXXXXXXXXXThis investigation allows for determining the practice quality and practices for the basis of decision-making. The articles have therefore concluded that the implementation of neutralizing mAbs plays a critical role in reducing the mortality rates among patients suffering from COVID-19 among outpatients.
The investigation by Liu et al XXXXXXXXXXaims to evaluate the efficacy experienced with the implementation of antiviral medication in managing COVID-19. The use of antiviral medications for managing COVID-19 has been ideal in that it has allowed for the development of interventions that are expressed for the patients to have a reliable means of managing COVID-19. The systematic review has helped in addressing the use of antiviral medication and the impact that it has on the health of patients.
In the research article by Self et al. (2022), there is an evaluation of the impact of the implementation of at least two interventions or measures that are supposed to be used to handle the challenges of COVID-19. The two neutralizing mAbs are supposed to help in the determination of whether the implementation of the therapy is ideal or not. This is an important strategy in that there will be ease in the identification of the factors to be taken into account for the process of delivery of patient care. The intention is to ascertain the influence of the use of sotrovimab and BRII-196 in the elimination of issues of unreliable health practices and activities for better health services and standards. The findings in the investigation show that the issue of COVID-19 may be managed by the use of mAbs if they are complied with effectively.
The authors of the study by Sullivan et al XXXXXXXXXXhelp in the evaluation of the influence of the implementation of polyclonal high titer convalescent plasma in reducing mortality rates. The authors found that in cases of rising mortality rates, the implementation of ideal practice standards may help eliminate any poor control strategies. This implies that one can learn the prefe
ed means of are and that one can apply them in the development of practice quality and standards.
AminJafari and Ghasemi XXXXXXXXXXopine that COVID-19 is a new pathogen that causes extensive severity of respiratory symptoms. The authors in this investigation intend to examine the possibility of having immunotherapy that could help in the management of the issue of COVID-19. This entails understanding the prefe
ed immune therapy that may be ideal for the elimination of issues of COVID-19. The authors have concluded that although there is still a need for further research, the implementation of immunotherapy may help in the reduction of the severity of the COVID-19 pandemic.
The implementation of monoclonal antibody therapy and antiviral medications has been common. It could be ideal for determining which of these interventions is ideal for eliminating the rising mortality rates of COVID-19 patients. From the literature, it is found that monoclonal antibody therapy is preferable for implementation to help in reducing the high mortality rates of COVID-19.
Analysis of Literature
Ja
ett, M., Licht, W., Bock, K., Brown, Z., Hirsch, J., Coppa, K., ... & Nash, I XXXXXXXXXXEarly experience with neutralizing monoclonal antibody therapy for COVID-19: retrospective cohort survival analysis and descriptive study. JMIRx med, 2(3), e29638.
This is a descriptive statistic in which median and IQR was used along with categorical standards and proportions. Fisher exact tests were used to compare categorical data between patients who were and weren't hospitalized, and nonparametric Kruskal-Wallis tests were used to evaluate continuous variables. To reach the differences in hospitalization rates, patients were divided into three groups depending on the timing of mAb therapy relative to the date when symptoms first appeared. The results of two thousand eight hundred and eighteen patients getting mAb treatment were described and was compared to in-hospital fatality with a well-matched control group. No randomized controlled trial was used to evaluate the impact of mAb therapy on reducing hospitalization, and the investigation did not show that mAb therapy is helpful in decreasing in-hospital mortality.
Lin, W. T., Hung, S. H., Lai, C. C., Wang, C. Y., & Chen, C. H XXXXXXXXXXThe impact of neutralizing monoclonal antibodies on the outcomes of COVID‐19 outpatients: A systematic review and meta‐analysis of randomized controlled trials. Journal of medical virology, 94(5), XXXXXXXXXX.
The risk of COVID-19-related hospitalization or emergency department visits was the primary outcome. The chance of mortality and unfavorable effects were the secondary outcomes. Three thousand three hundred and nine individuals got neutralizing mAb and two thousand three hundred and ninety seven patients received a placebo in the five included papers. Patients who received neutralizing mABs saw a substantially reduced risk of hospitalization or ED visits than those who got a placebo, odds ratios confidence interval.
Liu, W., Zhou, P., Chen, K., Ye, Z., Liu, F