Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in

Two qualitative, peer-reviewed research articles that were identified in the Topic 1 assignment to complete Topic 1 assignment. Nursing practice problem will be Chronic obstructive pulmonary disease (COPD) in adults.

Literature Evaluation Table

Chronic obstructive pulmonary disease (COPD) can be identified as a very common disease in adults. The chain smokers are prone to this disease more than non-smokers. This disease can get worse as a person age. Although COPD has traditionally been considered a disease that affects men, in some countries, the prevalence and associated mortality rate are higher among women than among men. The COPD can be defined as a chronic inflammatory lung disease characterized by airway obstruction. This is a progressive disease that continues to damage the lungs over time, making the affected individual have difficulties breathing. This condition is caused by long-term exposure to irritants such as cigarette smoke and irritating gases that can damage a person's lungs. This condition has several symptoms that are associated with it. These symptoms include difficulty breathing, coughing, wheezing, tightness in the chest, and excess sputum production. People suffering from this condition are at risk of developing different conditions such as lung cancer, high blood pressure, heart problems, and depression. Two clinical conditions are normally associated with a chronic obstructive disorder; these are emphysema and chronic bronchitis (Celli, 2019). Individuals who have been diagnosed with COPD have both conditions. Emphysema slowly destroys the wall sacs of the lungs and is one reason people with COPD experience breathing difficulties. Chronic bronchitis results in narrowing and inflammation of the bronchial tubes, resulting in mucus build up in the lungs. The risk factors for COPD are exposure to tobacco smoke, asthma, exposure to dust, fumes from burning fuel and chemicals, and genetics. It is estimated that in the United States, approximately 30 million people are suffering from this condition. Although this condition is progressive, it is treatable.

PICOT Question:

In adults who have been diagnosed with COPD exacerbations, does the use of pharmaceutical drugs such as antibiotics and bronchodilators improve the rate of recovery compared to the use of nutrition and oxygen therapy?

Population (P): Adults > 18 years of age with COPD

Intervention (I): Antibiotic Therapy and use of Bronchodilators

Comparison (C): Use of nutrition and oxygen therapy

Outcome (O): Quality of life (SGRQ), exacerbations (hospitalization rate and duration, and complications)

Time (T): Short- to medium-term.

Criteria	Article 2	Article 3
APA-Formatted Article Citation with Permalink	Moore, D. (2019). Home oxygen therapy in patients with COPD: safety issues for nurse prescribers. British Journal of Nursing (Mark Allen Publishing), 28(14), 912–917. https://doi-org.lopes.idm.oclc.org/10.12968/bjon.2019.28.14.912 Permalink: https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=31348713&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1	Alton, S., & Farndon, L. (2018). The impact of community pharmacy-led medicines management support for people with COPD. British Journal of Community Nursing, 23(6), 214–219. https://doi-org.lopes.idm.oclc.org/10.12968/bjcn.2018.23.6.214 Permalink: https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=129785121&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1
How Does the Article Relate to the PICOT Question?	The article is relevant to the picot question since it discusses the effectiveness of oxygen therapy and the safety of prescribing it to patients who have the COPD condition	It relates to the PICOT question since it discusses the proper use of bronchodilators that are best administered with the use of handheld inhalers
Quantitative, Qualitative (How do you know?)	It uses qualitative research. This is because the article there is a questionnaire that has to be filled by the attending nurse that assesses the risk of using patients using oxygen therapy at their homes.	The qualitative research method was used in research. They handed out questionnaires and used observation where pharmacy personnel was sent to assess how they were using their inhalers.
Purpose Statement	The aim of this article is, therefore, to evaluate an issue critically that poses a challenge to the RNS as an independent prescriber.	The aim was to assess the impact of pharmacy-led medicines management support (in addition to the routine annual nurse-led reviews for long-term conditions) in patients with COPD in one community nursing team in Sheffield.
Research Question	What are the issues that are the issues that affect home oxygen prescription?	Are patients using inhalers correctly in the administration of bronchodilators?
Outcome	The author found doubts on the use of home oxygen therapy since the identified risks were so many.	Most of the patients did not know how to use the inhalers correctly.
Setting (Where did the study take place?)	Personal residence for Mrs.Sue White	COPD patients living around Sheffield
Sample	One participant	Fifty-four patients were included in the study; however, nine were excluded from the study due to different reasons
Method	Questionnaire and observation	Observation and use of questionnaires
Key Findings of the Study	Many risks are associated with the use of oxygen therapy at home. The risks include fire hazards that can either result in the death of the patient and skin burns	Most patients don't know how to use inhalers properly, and those who have dementia, also referred to as cognitive impairment, had limited options for the proper administration of the medicine
Recommendations of the Researcher	Giving medical guidance and counseling to COPD individuals to stop smoking. Installation of safety equipment such as fire breaks and flow stop devices to reduce fire incidents.	The author's recommendations were to use alternative therapies for patients with dementia as they did not use their inhalers properly.