1 Evidence-Based Practices to Guide Clinica

1 Evidence-Based Practices to Guide Clinica

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  1 Evidence-Based Practices toGuide Clinical Practices Marilaura Mieres Miami Regional University Dr.Mercedes 03/28/2021 Evidence-Based Practices to Guide Clinical Practices
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  2 Introduction Evidence best practicesis an approach that translates excellent scientific research evidence to enhanced practical decisions aiming at improving health. EBP involves using research findings obtained from systematic data collection that is achieved through observations and analyzed experiments. The connection of research, theory, and EBP are interlinked in that the delivery of one results in another aspect's discovery. Through research findings, a theory is discovered, and through various experiments and observations, evidence-based practices are identified. Interrelationship Between the Theory, Research, and EBP. According to Cannon & Boswell (2016), health professionals require standards to analyze behavioral treatments in the behavioral sciences. Through complete incorporation and implementation processes, health professionals must value EBP
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  processes, health theories,and research. Through experience, health practitioners must learn to integrate research results to determine the best treatment plans suitable for patients. Through this research results, experiments, and evidence, health practitioners with academicians ally to discover a theory. The treatments are offered according to patients' values, interests, and preferences (Cannon & Boswell 2016). The values increase practitioners' skills and knowledge to analyze research outcomes effectively. Nurses are expected to think critically after being taught and encouraged, which corresponds with evidence-based practices. Nurses' critical thinking skills require a foundation on which proven research and tested data can be based. The proven research, evidence-based practices, and a good foundation all connect to form a theory that research can rely on and nurses can use to prove their practices. 3
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  Additionally, health professionalsat all levels must identify challenges and arising questions to address patients' needs and offer quality practices to discover appropriate interventions suitable for every challenge. Health professionals are directly involved in research projects that allow them to understand the best methods to publish for evidence-based practices. Through different researches and publications, health professionals like advanced practice nurses use research to solve health dilemmas. Nurses find platforms centered on tested clarifications through nursing practices and methodical examinations from research to build a base for procedures and care. Moreover, research is a scientific procedure that anticipates outcomes through the use of fundamental expertise. Research processes enhance the capacity of discipline through clarity and visualized aspects. The discipline's ability to put into practice required evidence relates to anticipation, transparency, and guidance that controls and governs the findings. The discipline's capacity ensures the quality of research is achieved. Once the
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  analysis is completed,the evidence-based practices can be realized. The realization of the EBP results in discovering a theory based on practices, evidence, foundation, and research. Furthermore, research leads to the discovery of theories that have become a growing expectation in healthcare provision. The research results are used to determine and distinguish appropriate quality care to offer patients, which translates to forming a constant feature that can be used to base patient's characters like behavioral theory. Research Questions, Sampling and Sampling Size, Research Designs, Hypothesis, Data Collection Methods, And Research Findings from Each Study From Cannon & Boswell (2016) journal, it is evident that qualitative and quantitative research designs are used in scenarios where nurses use observation and personal experience 4 with patients to determine the best treatment to use on a patient. Whereas quantitative research
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  designs are usedby health professionals when researching a health product or treatments. The statistical data collected is evaluated through experiments to weigh information with the highest loads. The collected data with high loads are then taken for further piloting and analysis to determine the information's authenticity. The data is used to advocate for a clinical method. On the other hand, research questions from Cannon & Boswell (2016) evaluate patients' health literacy and how evidence-based practices help clinical practices and patients. Research questions focus on identifying and analyzing the effectiveness and clarity of theories, research, and evidence-based practices with their relationship to improving healthcare delivery services to patients. According to mick (2017), health professionals must identify questions and analyze challenges facing patients to help recognize appropriate interventions to use for quality practices. Additionally, health professionals engaging in the invention of theories and advanced knowledge for health policy changes use data collection methods like surveys, observations,
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  planned interviews, andfocus groups. The data collection methods and research findings from Cannon & Boswell (2016) determine health professionals' critical thinking processes to provide the right settings for primary care. Through research findings, nurses' knowledge and skills are improved and enhanced through positive attitudes towards providing value on evidence-based practices to improve quality care and increase patient outcomes. Research methods use techniques and methodical examinations to provide a platform to base clinical practice. The research findings from the study of Cannon & Boswell (2016) indicate that conclusions from research studies are used to solve clinical dilemmas that form the basis of quality research. The anticipation, clarity, and guidance required in scientific processes are put into practice through sound evidence from research findings. 5 Moreover, health professionals' satisfactory evidence while conducting their research
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  adds up tohypothesis testing. Mick (2017) indicates that the evidence achieved by health professionals is fueled into practice after tests and experiments have been designed. The evidence is tested to understand the variability and the deepness of the data collected. Through different observations and conclusions, a research finding is invented. Furthermore, the steps in the clinical study involve having an appropriate setting for research. The study to be conducted requires the health professional and researchers to sample several patients or individuals to ask research questions related to the sample size. Once the sampling process is achieved, the data collection methods are used to accomplish the research findings. The findings are then evaluated to determine the effectiveness of the samples. According to Mick (2017), the research aims to generalize research goals from a sample and relate it to larger populations. The sampling process is accomplished through statistical methods centered on the perspectives of a theory. A sample is a small proportion of a population
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  that is representativeof a larger population. Therefore, researchers use sampling methods free from errors to determine the study and purpose of the research. Goals, Health Outcomes, And Implementation Strategies in The Healthcare Setting (EBP) Training and support strategies, according to Mathieson et al. (2019), results in successful adoption. Engaging nurses in training before implementing an innovation boost nurse's confidence to use the innovation skills acquired through training. Offering practical training on how to use a particular treatment or how to handle a scenario suggests that training plays a significant role in successful adoption. Support strategies involve receiving support from 6 staff members, having enough and safe space for nurses to share their experiences, physical contact with researchers, and management support through resource allocation.
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  According to Mathiesonet al. (2019), Roles' allocation enhances nurses' ability to monitor implementation processes. The roles allocation process involves appointing nurses into leadership positions, giving them the chance and time to follow practice guidelines and develop quality-required solutions. By allocating roles, health professionals enhance their knowledge, skills, and courage to handle health problems effectively without fear. They are also able to think critically in times of urgency and make prompt decisions. The allocation of roles improves the delivery of healthcare services and increases patient satisfaction. Allocation of roles aims to create responsible and accountable health professionals who can collaborate to foresee positive implementation. Through evidence-based practices, patients' trust is enhanced since the interactions between them are created. The research incorporated with evidence-based practices increases patients' satisfaction since assisting patients on their recovery process motivates nurses to implore more quality techniques to reduce costs of healthcare
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  services to accommodativelevels. Conclusions Evidence-based practices promote overall professional development as it also provides elements and data that guide nurses to recognize interventions and strategies to use to improve daily practices. Evidence-based practices incorporated with theories and quality research promote nations' healthy well-being since a healthy country is the first realization of economic development. Healthcare teams should, therefore, encourage nurses' roles through evidence- based practices and research to allow efficient management of cost-effective resources 7 References Cannon, S., & Boswell, C. (2016). Evidence-based teaching in nursing: A foundation for
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  educators. Jones &Bartlett Publishers. Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed- studies review and qualitative synthesis. Primary health care research & development, 20. Mick, J. (2017). Funneling evidence into practice. Nursing management, 48(7), 27-34. SOAP NOTE Name: V.N Date: 8/23/2020 Time: 0800 Age: 53 years Sex: Male SUBJECTIVE CC: “I am having pain in my right leg” HPI: The patient states that the pain started four days ago and it is in the right lower leg. The patient states that his right leg feels tight and he rates the pain as 7/10 Medications: None PMH
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  No past medicationhistory indicated by the patient Allergies: NKDA Medication Intolerances: Denies any intolerance to the medication Chronic Illnesses/Major traumas Denies having any chronic diseases Hospitalizations/Surgeries: Denies any surgical procedure or hospitalization Family History Father is having cardiac heart failure related disease while the mother is having high blood pressure Social History The patient is a university graduate and he is married with two children. He denies taking alcohol or smoking. ROS General The patient denies weight change, fatigue, fever, chills, and the night sweats. Cardiovascular The patient denies pain in the chest, no orthopnea, no palpitations. Skin Denies any delayed process of healing, bruises, rashes, bleeding or discoloration of the skin, and any moles or lesions Respiratory
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  No coughing, nopneumonia, no wheezes, no dyspnea, no hemoptysis Eyes Denies corrective lenses, no blurring, no changes in her vision. Gastrointestinal Denies abdominal pain, no constipation, no history or present hepatitis, no ulcers, denies black tarry stools Ears Denies pain of the ear, hearing problem, ringing of the ears, or any ear discharge Genitourinary/Gynecological Patient denies the presence of the urge or frequency burning, denies change in the urine color and any menstrual issue. Admits to be sexually active. Denies having been diagnosed with STDs Nose/Mouth/Throat Denies sinus issues, dysphagia, nose bleeding, discharges, dental illness, hoarseness, pain. Musculoskeletal Admits swell near his right leg which is painful and tight. Denies history of fracture or osteoporosis. Breast Denies any changes or bumps Neurological The patient denies syncope, seizures, short-lived paralysis, weakness, paresthesias, or black-out spells. Heme/Lymph/Endo The patient is HIV negative. He denies bruises, has undergone blood transfusion, no night sweats, has swollen glands, increased hanger, denies thirst, cold and heat intolerance. Psychiatric Denies sleeping problems, anxious, and suicidal thoughts or attempts.
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  OBJECTIVE Wt 68kg BMI18.7 Temprature 97 Blood Pressure 122/62 Ht 6’3’’ Pulse 68 beats/min Respiration 16 General Appearance The patient looks well in no acute distress. He is alert and oriented and is responding to the questions in appropriate manner. Skin The patient is brown, warmer, clean, and intact. Absence of the lesions or rash HEENT Normocephalic, atraumatic and with no lesions of the head. The hair of the patient is evenly distributed. Eye is having intact EOMs with no injection of the conjunctival or scleral. Ear is having patent canals, easily visualized landmarks, and the bilateral TMs Nose pink mucosa with normal turbinates Neck is supple without palpable lymphadenopathy, there is no occipital nodes, nodules, nor thyromegaly. There is moist and pink oral mucosa. The pharynx is non- erythematous with no exudate. The teeth is in good shape with normal dental arrangement Cardiovascular Normal S1 and S2 with regular rate and rhythm. No splitting in the heart sounds heard. No murmur. No friction rub, no edema. Respiratory There is stable, regular, and easy respiration. The auscultation of the bilateral lungs is clear. Gastrointestinal No obese, active BS in all the four quadrants, soft and non- tender abdomen, and no hepatosplenomegaly.
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  Breast No masses ortenderness of the breast. Absence of the discharge and dimpling, wrinkle, and skin color is the same Genitourinary Both testes are palpable, no masses or lesions, no hernia, no urethral discharge. prostrate is smooth, non-tender and free from nodules, is of normal size, sphincter tone is firm Musculoskeletal There is no full ROM in the patient’s extremities. The movement is limited Neurological The patient is having clear speech, good tone with no erect posture. There is unstable balance and abnormal gait. Psychiatric He is alert and oriented, clean, able to maintain eye contact, soft speech, and appropriately responding to the questions asked. Lab Tests Urinalysis – pending Urine culture – pending Wet prep - pending Special Tests Complete blood count: to help in the knowing the number of leukocytes MRI: to detect the presence of thrombus D-dimer: to help in excluding thromboembolic illness Diagnosis Differential Diagnoses Deep Venous Thrombosis: it is characterized by pain and the swelling of the limb that is non-specific. The patient have warm, swollen, and tender leg. Cellulitis: this is a non-necrotizing inflammation of the skin and the subcutaneous tissues. It has symptoms such as swelling,
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  warmth, pain, anderythema Pulmonary Embolism: occurs as a result of the blood clot clogging in an artery in the lung and blocking the flow to the lung. Diagnosis o Deep Venous Thrombosis Plan/Therapeutics o Plan: · Further testing: ultrasound to see clear picture of the arteries and the veins to monitor how the blood flows. Venogram can also be ordered to be followed by the x-ray to determine the location of the DVT · Medication: Painkillers such as acetaminophen; heparin, lovenox, arixtra, and warfarin to help in the thinning of the blood. Thrombolytic drugs are also prescribed to help in the breaking of the clots. · Education: The patient is advised not to sit for long to reduce the development of the blood clots. The patient is advised to adopt exercise such as knee pulls that involves the bending of the leg and raising of the knee towards the chest. The patient is also taught on the importance of ankle circles exercise where the feet are lifted off the floor while the patient tries to draw the circle with the toes in one direction for a few seconds · Non-medication treatments: Keeping of the arm elevated through the use of the stool or chair. Wearing compression stockings to help in the prevention of pooling and swelling. It also helps in increasing the blood flow. Evaluation of patient encounter: The patient is evaluated based on the reduction of the pain and the ability to make movement with a lot of ease after discharge from the facility References Murrell, D. (2019, November 13). Everything You Want to
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  Know About DeepVein Thrombosis (DVT). healthline: https://www.healthline.com/health/deep-venous-thrombosis Ouellette, D. R. (2019, October 16). Pulmonary Embolism (PE). Medscape: https://emedicine.medscape.com/article/300901- overview