NURS FPX 4025 Assessment 2 Role of Evidence-Based Practice in Recurrent Urinary Tract Infections 

Role of Evidence-Based Practice in Recurrent Urinary Tract Infections 

Student Name

Capella University

NURS-FPX4025

Professor’s Name

Submission Date

• In NURS FPX 4025 Assessment 2 student apply an evidence-based practice model to a specific health condition based on current research evidence.

Introduction

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that has multiple systemic manifestations. These can be problems with the nervous system. Some of the most worrisome and problematic manifestations of SLE are the neuropsychiatric symptoms. These are things like headaches, seizures, and different types of psychosis, mood, and cognitive problems.

Many of the symptoms of SLE are similar to several neurologic/psychiatric diseases, and it may be difficult to make a clinical association of the symptoms with SLE. According to Jayasinghe et al. (2025), many times, it is difficult to prove the neurological involvement, and if not identified, it will bring a lot of morbidity to the patient.

The Role of Evidence-Based Practice in Treatment Selection

One of the problems in neuropsychiatric lupus is determining the time to unravel the inclusions of the central nervous system or the peripheral nervous system. The diagnosis of neuropsychiatric lupus is very complex, as many of the symptoms often combine or mimic other psychiatric disorders, nervous system disorders, or the side effects of medication used. Furthermore, the diagnosis of neuropsychiatric lupus is more difficult, as the disease is not widely understood, making treatment more difficult and longer, which could lead to potential problems being avoided (Mitchell, 2024).

Although neuropsychiatric lupus is becoming more widely recognized in most clinics, there are no consistent or systematic assessments, evaluations, or frameworks, and opportunities to make early diagnosis and intervention are frequently missed. Because of these reasons, it is important to identify what assessment tools exist that will likely be evidence-based and can be easily and routinely part of clinical practice.

Combining evidence-based practices with clinical judgment enables health-care workers to analyze the evidence and pinpoint relevant interventions for particular populations. In combination with patient preferences, the recognition of neuropsychiatric symptoms and the facilitation of the referral process to specialist services can be promoted by nurses. While neuropsychiatric assessment practices in SLE are still maturing, Bam (2025) believed that they facilitate and promote the use of a variety of specialty practices and improve the overall level of care. Death certificates, written documents, lists, etc., seem to be possible ways to get the relevant specialties/subspecialties engaged and involved, to identify frameworks that would foster the recognition of neuropsychiatric symptoms, and to develop and expand care for the patient.

Application of the Evidence-Based Practice Model

The Johns Hopkins Nursing Evidence-Based Practice Model can be used as a framework to address the underrecognition of neuropsychiatric symptoms in SLE patients by starting with the first step: Practice Question. The emphasis here is on the possibility of screening for the neuropsychiatric symptoms on a regular basis so that neuropsychiatric symptoms can be recognised early in patients with SLE. This is followed by the step Evidence.

This involves a full review of the literature. In this step, literature is reviewed to consider the best evidence related to neuro-psychiatric symptoms of lupus, screening and diagnosis, and evaluative methods and tools. In the proposed change in practice context, Mohamed et al. (2024) pointed out that the systematic gathering of evidence constitutes the basis for the application of scientifically grounded practices, as opposed to practices based on custom and tradition.

The Translation phase takes place following the evidence review and aims to implement evidence into practice. A finding that supports and reinforces the need to recognise and assess the symptoms of the patient more often may be evidence. This may result in an organized method of patient meetings. However, in practice, it is essential to consider the evidence that is available. In conducting this review, it should be determined that the guidance is relevant to the target group and health care context. When deciding on changing practice, Singh et al. (2021) note that the quality of the evidence and barriers should be considered.

Based on the evidence synthesis, health care workers are free to develop a practice framework consisting of continuous inter/intra-disciplinary neuro-psychiatric evaluations of health care workers, as well as continuous patient evaluations. The aim of the ‘framework’ is to reduce total time to diagnosis, to have more control over symptoms, to lessen the impact of the progressive nature of the disease, and to improve the quality of life for SLE patients.

Delayed Recognition of SLE and the Neuropsychiatric Evidence-Based Practice Model

Adaptation of Johns Hopkins Nursing Evidence-Based Practice (EBP) Model is needed for the diagnostic delay and recognition of neuropsychiatric symptoms with systemic lupus erythematosus (SLE). From the presence of overlapping psychiatric or neurological symptoms, doubts were raised about the clinical nature of the condition. Neuropsychiatric symptoms can be unknown in the case of SLE, and SLE symptoms can be masked partially or completely by psychiatric disorders. In addition, headaches, seizures, and psychosis, all of which contribute to the burden of SLE, are often undiagnosed because of the delay in diagnosis, according to Maristany et al. (2024).

This problem focused on literature pertaining to the neuropsychiatric symptoms of lupus, as well as literature related to screening, recognition, and diagnostic delay of neuropsychiatric symptoms in lupus and the neurological symptoms of lupus. The main literature included the neuropsychiatric symptoms of lupus and screening, recognition, and diagnosis delay of neuropsychiatric and neurological symptoms of lupus. Other studies offered evidence of a timely diagnosis and improved outcomes personalized for patient care by embracing discipline with full assessment (Galoppini et al., 2023). This body of work gave a foundation for the recognition of neuropsychiatric symptoms and also the diagnostic delay of neuropsychiatric symptoms in SLE.

To apply evidence to nursing practice, the most recently published studies that had better design quality, were reviewed if related to the topic of neuropsychiatric lupus, and if they were peer reviewed. Evidence was presented by Trapp et al. (2022) to show that healthcare workers need to develop more complicated neuropsychiatric symptoms. This can involve developing assessment and monitoring systems.

Schlencker et al. (2022) called for an implementation of a structure to support the ongoing evaluation of symptoms and self-care support so that timely referrals and interventions can be made. Analysing the studies for quality, credibility and relevance in relation to the practice issue was the first of the activities required to review the literature. Synthesized evidence was used to adoption and use the Johns Hopkins model approaches to evaluating neuropsychiatric symptoms, and practice teams to use communication and assessment frameworks. The goal of the framework was to offer safe, effective, and patient-centred care.

Using the Evidence-Based Practice Model to Guide Evidence Search

The Johns Hopkins model, its evidence search, and appraisal process called for a very specific, structured evaluation process. As I sat down to develop the Practice Question from my general clinical question, I was faced with certain tasks, such as how to go from such a broad clinical question to creating a Practice Question about the problem of the delayed recognition of neuropsychiatric symptoms in SLE patients. During Evidence, I had to come up with criticisms on the methods of the study, populations of the studies I was reviewing, clinical outcomes; etc.

There was a diversity of literature on neuropsychiatric symptoms and SLE. In his review, Patel (2024) explained why the diverse symptoms of neuropsychiatric lupus can be difficult to diagnose and study. Emerson et al. (2022), on the other hand, talked about the different ways of classification and various healthcare systems and thus different frameworks. Therefore, a thorough classification was warranted that covered evidence that catered to adult patients with SLE as well as cases of clinical neuropsychiatric symptoms.

During evidence synthesis, challenges come up because of studies’ varying assessments of neuropsychiatric disorders. Flores et al. (2025) explored the different aspects associated with a late diagnosis and the evolution of the disorder. In between, Yusof and Vital (2021) spoke about how clinical outcomes may be improved by implementing a system for screening and early intervention. Even so, the Johns Hopkins model enabled a systematic and organized presentation of the results and a method for recognizing and dissecting the recurring themes in the literature.

Further, the model can be used to assess the strength and relevance of the evidence before deciding upon the evidence for application in clinical practice. As a result, integrating the suggestions provided an improvement in SLE patients, which was evidence-based and considered the nurses’ views and preferences regarding the assessments and interventions for SLE patients.

Credibility and Relevance of Evidence

Quality and practicality of evidence were analysed to discuss the delayed recognition of neuropsychiatric symptoms in people with SLE. The majority of the studies cited were peer-reviewed journals and were the works of others who had backgrounds in the fields of rheumatology, neurology, etc. Patel (2024) was cited the most and was the first and only researcher to give a foundation about the early recognition of neurologic-psychiatric symptoms of SLE. For the nursing profession, Emerson et al. (2023) offered evidence of the need to better and more specifically assess patients and about how members of the health team were cooperating and collaborating with patients at high risk for developing neurological complications.

The articles of Flores et al. (2025) were of even better quality and explained how informative and beneficial the periodic checks and the post checks were. Finally, Yusof and Vital (2021) evidence showed that the neuropsychiatric symptoms of SLE can be controlled through early recognition and more effective treatment, which subsequently can lead to a reduction of the risks associated with the condition. The current evidence suggests that there is a need for a shift in practice to identify, assess, and manage neuropsychiatric symptoms in SLE.

Conclusion

The use of an evidence-based practice model will help to address the issue of late diagnosis and identification of the neuropsychiatric manifestations of Systemic Lupus Erythematosus (SLE). The Johns Hopkins Nursing Evidence-Based Practice Model offers one approach to EBP that can be used to identify a clinical issue, appraise the evidence, and implement appropriate clinical practice. It is crucial for health providers to critically examine relevant written material on Neuropsychiatric Lupus in order to discover new books and innovative screening tools for early application of treatment where needed. The involvement of EBP is likely to achieve better clinical outcomes and improve the lives and SLE management effectiveness.

Next Assessment: NURS FPX 4025 Assessment 3