Sample Paper on Air Pollution Leading to Asthma, and COPD

Air Pollution Leading to Asthma, and Chronic Obstructive Pulmonary Disease (COPD)

Domain I: Score and Purpose

The overall objective of the CPG is to systematically develop a statement assisting health care practitioners in tending to patients affected by air pollution resulting to asthma and Chronic Obstructive Pulmonary Disease (COPD).  This will ensure intended concise instructions on how to provide health care services to treat the conditions attributed to air pollution are offered and applied effectively and efficiently. As a result, both quality and process of health care and patient outcomes will be achieved and enhanced. This will however have to involve clinical managers and clinicians choosing numerous and differing guidelines that can also be contradicting to ensure patients suffering from asthma and Chronic Obstructive Pulmonary Disease are treated effectively and efficiently. The CPG will therefore ensure valid and effective interventions utilize resources efficiently to ensure persons adversely affected by air pollution are treated and the rest of the community members provided with information to prevent them suffering from asthma and Chronic Obstructive Pulmonary Disease among other health care complications associated with air pollution (Ian & Margaret, 2005)

The scope and purpose of this CPG is therefore to define the diseases and conditions arising from air pollution to determine viable response measures to prevent and treat them. It will determine quality products to be adopted for local use in ensuring air pollution does not attribute to more cases of asthma, bronchitis, and Chronic Obstructive Pulmonary Disease. Thus, it will identify a clinical area to promote quality practices based on the prevalence of conditions and associated concerns and burdens allied to air pollution. Consequently, it will develop an interdisciplinary guideline evaluation group and appraisal process comprising of key stakeholders including patients and family members affected by air pollution (TGC, 2013).

The following health questions are covered by the CPG.

  1. What is outdoor and indoor air pollution?
  2. How does air pollution adversely affect health care conditions among human beings?
  3. What are the respiratory effects attributed to air pollution?
  4. Does air pollution cause asthma, Chronic Obstructive Pulmonary Disease, and bronchitis?
  5. What other allergies are associated with air pollution?

The answers to these questions will provide recommendations to local practitioners, stakeholders, and policy makers across various health care organizations ensuring diseases and chronic conditions arising from air pollution are treated and prevented. The target population to whom the guideline is meant to apply therefore includes patients suffering from chronic conditions attributed to air pollutions. The patients consist of members of the community including students, teachers, industrialists, and corporate societies. Health care practitioners will include nurses, clinicians, and clinical managers. Thus, the recipients of the services outlined in the document will be applied by health care practitioners in order to ensure patients suffering from chronic conditions associated with air pollution are treated (Patrick, 2006).

Domain 2: Stakeholder Involvement

The professions represented in the guideline development group include persons from all relevant professional groups addressing health care issues attributed by air pollution. As a result, views and preferences will be sought from patients grouped as target users of the guidelines provided through the clinical practice to treat chronic conditions they have acquired from air pollution. The views and preferences will be evaluated by professional healthcare providers with sufficient information and resources to address chronic conditions arising from air pollution. To ensure the target populations’ visions and likings are properly considered and sought, the recommendations provided will have to be precise, detailed, and unequivocal. They will be based on thorough discussions ensuring issues such as cost implications and the monitoring and audit processes are addressed to eliminate conflicts of interests and challenges during implementation procedures (Richard & Richard, 2010).

Domain 3: Rigor of Development

The systematic methods used to search for substantiation to develop the CPG involve assessing clinical contexts and contents resulting from the commendations. Appraisal instruments provide little detailed information on the actual recommendations to reduce and prevent air pollution. As a result, a content analysis method has to be applied to evaluate each recommendation to determine its use in ensuring air pollution does not attribute to more chronic conditions. Two clinicians and clinical managers with expertise levels on how air pollution causes chronic conditions are presented to provide a level of evidence for each recommendation. The criteria applied in selecting the evidence is based on the decision of ensuring each recommendation is helpful in caring for patients suffering from chronic conditions attribute to air pollution. The criteria has to ensure each recommendation is appropriate and practicable before being implemented in a specific practice setting with sufficient resources and reliable equipment to reduce air pollution and treat chronic conditions such as asthma and COPD (Richard & Richard, 2010).

There are various strengths of the body of verification used to develop the CPG. The main strength involves availability of information utilized in strategically developing recommendations assisting physicians and health care practitioners to treat patients suffering from chronic conditions due to air pollution. Consequently, the CPG are produced under auspices of medical specialty associations comprising of public and private organizations, professional societies, and government agencies keen in ensuring chronic conditions attributed to air pollution on local, State, and federal levels are addressed. More so, collaborative documents have to be produced to verify the systematic literature reviews and scientific evidence from peer reviewed journals were performed under the guideline development of the practice. Conversely, the main limitation of the body of evidence used to develop the CPG is based on the fact that, the overly simplified instrument cannot be applied internationally. This is because the instrument addresses chronic conditions attributed to air pollution across United States rather on a global platform (Richard & Richard, 2010).

The healthiness, benefits, side effects, and perilx in developing the CPG are considered as follows. Foremost, the guidelines are designed to provide a link between clinical practice and the available evidence. Thus, they do not provide standards of care in typical conditions but rather, they provide measures to ensure patients access the best possible care based on current research and peer reviewed standards of health care with regards to how air pollution attributes to chronic conditions. Thus, the explicit link present between the recommendations and the supporting evidence is based on the validity, feasibility, and reliability or reproducibility attributes of the guidelines (Richard & Richard, 2010).

The CPG is externally reviewed by experts prior to its publication by tasking nurses taking care of patients suffering from chronic conditions attributed to air pollution apply clinical priority nursing care and development consistently. The health care practitioners have to affirm the patients are suffering from shortness of breathing, skin breakdown, and swallowing challenges due to asthma and Chronic Obstructive Pulmonary Disease chronic conditions. This will prompt the experts to affirm that, the adverse effects of air pollution have to be addressed based on acute and long term care through rehabilitation settings. As a result, the procedure identifying population needs, intervention measures and the outcomes with regards to the effects of air pollution has to be put in place to update the CPG (Richard & Richard, 2010).

Domain 4: Clarity and presentation

The following precise, unambiguous and exclusive key recommendations ought to be presented (Fanny & David, 2011).

  1. The effects of outdoor and indoor pollutants affect the respiratory epithelium. For example, they increase biochemical and cellular inflammations in the lungs. They also affect the airways of the patients adversely.
  2. Asthma is chronic disease affecting more than twenty million United States citizens and sox million children. The patients have to gasp for breath as asthma affects lungs causing inflammations and narrowed airways due to a sensation of tightness in the chest. As a result, the patients suffer from shortness of breath coupled with coughing and wheezing. Asthma can be attributed to dust, pollen, volatile organic compounds, and smoke as well as pollutant triggers such as carbon monoxide, ozone, nitrogen oxides, and sulfur dioxide among others.
  3. Chronic Obstructive Pulmonary Disease is also a condition characterized by narrow airways. The consequences are however permanent hence, irreversible. It is experienced by people exposed to pollutants producing inflammations resulting to immunological reactions. When inflammations occur in larger airways, the responses are referred to as chronic bronchitis. The tiny cells at the end of the lungs’ smallest passageways therefore lead to destructions of tissues or emphysema. Although Chronic Obstructive Pulmonary Disease also affects current and former smokers, it is mainly experienced by people with acute exacerbations.
  4. In order to ensure air pollution does not cause such chronic diseases, improved ventilations should be undertaken to ensure people breathe quality air. This will reduce respiratory, chronic, and cardiac deaths.

Domain 5: Applicability

The main facilitator to the application of the CPG includes use of clear communication skills to define air pollution and chronic conditions. This ensures educational research results are applied in reducing air pollution and treating the disease. Conversely, the main barrier is attributed to the restricted time resource challenging the process of formulating, implementing and evaluating if the recommendations are viable on short and long term basis. As a result, the CPG has to provide advice on the application of the recommendations. It has to task clinicians, clinical managers, and nurses in establishing improved practices utilized in treating chronic conditions. Consequently, environmentalists ought to identify measures of reducing and preventing indoor and outdoor air pollution. The possible resource inferences of applying the recommendations that have been mulled over include the healthiness, benefits and side effects likely to be faced by the patients. As a result, the following key monitoring and auditing criterion has to present. The patients ought to be screened using simple valid bedside testing protocol until their airways have cleared to improve how they breathe and swallow (Richard & Richard, 2010).


Domain 6: Editorial independence

The views of the funding body kept should not influence the content of the guideline. As a result, a draft of the recommendations have been reviewed by health care practitioners, stakeholders, policy and decision makers and the patients to ensure identified issues and challenges are addressed and resolved before the implementation proves. This enhances clarity, reliability, and credibility of the recommendations. Possible conflicts of interest such as organizations providing seals of approval that are either unnecessary or illegal are likely to occur. As a result, the finalized guideline has to be sent to regional stroke team and heads of program to provide an official statement endorsing the draft of recommendations (WHO, 2014).


The CPG has to respond o the key clinical questions presented to allow advanced practice nurses to apply the guidelines. Consequently, recommendations and guidelines ought to develop and enhance the process of care and patient outcomes. The clinical settings ought to move towards explicit use of evidence in adopting guidelines under considerable considerations of availability of resources to inform clinical practitioners and program controllers on level decisions and recommendations suitable in ensuring air pollution does not cause chronic diseases.  Lastly, a rigorous and transparent process identifying and adopting appraisal guidelines will be essential across multiple health care and environmental interventions implemented to protect patients and quality care providers.



Fanny, W. S., & David, S. C. (2011). Air Pollution and Chronic Obstructive Pulmonary Disease. Asian Pacific Society of Respirology. Retrieved from:

Ian, D. G., & Margaret, B. H. (2005). Evaluation and Adaption of CPG. Evidence Based Nursing, 8(1), 68-72. Retrieved from:

Patrick, J. M. (2006). The Contribution of Air Pollution to the Burden of Cardiovascular Disease. A Journal of Environmental and Sustainability Issues 13(1), 1-30.

Richard, R., & Richard, S. (2010). Clinical Practice Guideline Development Manual: A Quality Driven Approach for Translating Evidence into Action. Yale University, School of Medicine. Retrieved from:

The Government of Canada (TGC). (2013). Respiratory Effects of Air Pollution: Environmental and Workplace Health. Health Canada. Retrieved from:

World Health Organization (WHO). (2014). Frequently Asked Questions Ambient and Household Air Pollution and Health. World Health Organization Report. Retrieved from: