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Evidence-Based Practice Model To Address a Practice Issue Essay

Evidence-Based Practice Model To Address a Practice Issue Essay

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Competency 3

Apply an evidence-based practice model to address a practice issue.

Criterion

Explain the ways in which you used the specific evidence-based practice model to help develop the care plan, identifying what interventions would be necessary. This requires a particular evidence-based model, such as the Johns Hopkins, Iowa, Stetler, or other. Evidence-Based Practice Model To Address a Practice Issue Essay

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Your Result:NON_PERFORMANCE

Does not explain the ways in which you used the specific evidence-based practice model to help develop the care plan, identifying what interventions would be necessary.

Faculty Comments:I did not see where you discussed a specific EBP model to assist you in developing your own plan of care for this patient. Please review the resources for assessment 2, to help you with this.

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Competency 4

Plan care based on the best available evidence.

Criterion

Propose your evidence-based care plan to improve the safety and outcomes for the patient in the provided case study with a discussion of new content for the care plan. Evidence-Based Practice Model To Address a Practice Issue Essay

Your Result:BASIC

Describes an evidence-based care plan, but the relevance to the patient in the provided case study or how the plan would improve outcomes is absent or unclear.

Faculty Comments:This is a good start. You have summarized the current care plan. Now add to the plan with your own interventions, suggestions etc.. based on your review of the literature. You can also note what evidence or data would have been helpful to your construction of your care plan for this client.

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Competency 5

Apply professional, scholarly communication strategies to lead practice changes based on evidence. Evidence-Based Practice Model To Address a Practice Issue Essay

Criterion

Identify benefits and propose strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.

Your Result:BASIC

Identifies benefits or proposes strategies to mitigate the challenges, but not both, of interdisciplinary collaboration to plan care within the context of a remote team.

Faculty Comments:This is a good start. You discussed benefit and challenge of the client. Take this further and discuss benefits and challenges of the interdisciplinary team . Then add to it by giving your own suggestions to enhance the collaboration for the present and future outcomes. Evidence-Based Practice Model To Address a Practice Issue Essay

Transcript Example:

Hello. My name is “STUDENT”. This recording will focus on Making Evidence-Based Decisions. According to Barret (who published on this topic in 2017), caring for individuals who live in remote areas of the country is a challenging proposition and as a result, policymakers, and health care organizations along with health care professionals are searching for resources, such as telehealth services, to promote health and wellness as well as independent self-care for patients. Issues including primary care and specialist access, availability of ancillary services and transportation to and from each appointment continue to be roadblocks that could affect patient outcomes. In this video, I will discuss one such patient, Patrick Lake, and attempt to provide an evidence-based care plan to outline a safe, realistic outcome. Evidence-Based Practice Model To Address a Practice Issue Essay

Let me share some information with you about Mr. Lake

Mr. Lake is a 64 -year old veteran who has had a left above the knee amputation after a service related injury over 35 years ago. He presented one week ago to the clinic after he had chest pain and trouble breathing. These symptoms began one week prior to his appointment. He stated that he did not have a ride to come to the clinic and had little choices about emergency care due to inability to pay the co-pay. He was admitted and diagnosed with congestive heart failure. He was discharged with a plan of care to improve his safety and wellness outcomes by arranging for home health visits which will include physical therapy and nursing care. Mr. Lake lives at home with his wife Gloria who is concerned with this new diagnosis. He is unable to return for frequent follow up appointments and lives at least 50 miles away from the nearest rehabilitation facility. Gloria relates that this is a concern for her as it is a “long drive” to the hospital if anything should go wrong. Prior to discharge, Mr. Lake asked if there is “any other way that he could complete my follow up appointments other than coming in to the clinic?” He mentioned that he has reliable internet as well as a telephone landline and cell phone. Mr. Lake will be discharged to home with an electronic home blood pressure cuff and also with a Holter monitor. The event monitor will be worn for one week and data can be uploaded to a central cardiology department for analysis. Evidence-Based Practice Model To Address a Practice Issue Essay

Now, I will explain the ways in which an evidence-based practice model was used to help develop the care plan for Mr. Lake

An interesting publication from 2017, written by Barret, describes that telehealth and telemedicine have been an evolving evidence-based practice (EBP) since the 1970’s. This allows primary care providers to contact their patients through a phone call or online and discuss any concerns and monitor progression of recovery and wellness, according to a developed plan of care. The modalities for Mr. Lake may include home blood pressure readings, heart monitors and medication reconciliation. Daily blood pressure readings are extremely important as Mr. Lake was placed on two new blood pressure medications after his recent hospitalization. Without close follow up, the potential for significant blood pressure changes could impact his overall health. For example, measuring hemodynamics allows providers to correctly titrate blood pressure medications in an attempt to maximize cardiac output. This is key in patients diagnosed with CHF and leads to more energy and better quality of life. Cardiac monitors provide caregivers with information about electrical activity of the heart during any given situation. Event monitors allow individuals to mark incidents where they experience palpitations, pain or other symptoms by pressing a button on the device. These devices allow for avoidance of any other cardiac event. Evidence-Based Practice Model To Address a Practice Issue Essay

Next, I will reflect on which evidence was most relevant and useful when making decisions regarding the care plan

The decision to implement a telehealth program for Mr. Lake is based out of necessity. His lack of transportation and long commute to the clinic would most likely cause missed appointments and possibly delay sufficient recovery. The 2017 reference to Barret supports my point that telehealth and telemedicine offer an innovative and exciting method to deliver care and maximize patient outcomes.

Lastly, I would like to identify benefits and strategies to mitigate the challenges of interdisciplinary collaboration to care plan within the context of a remote team. Evidence-Based Practice Model To Address a Practice Issue Essay

Mr. Lake initially suggested alternatives to traditional follow up appointments due to limited transportation and his location. This demonstrated motivation on his part to initiate and maintain health and wellness. The benefits of the interdisciplinary collaboration were that the patient could receive on-going and consistent care by the caregivers, RN’s and physicians without having to travel a great distance. A couple of strategies to mitigate the challenges of interdisciplinary collaboration efforts include the use of an electronic health record system which all health care members can access and accurately monitor the patient findings and frequent communication with one another with the use of technology for the purposes of corresponding with one another such as via telephone, Skype, FaceTime, etc. The overall result with such collaboration of a remote team leads to better patient outcomes.

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In conclusion, evidence-based practice models provide frameworks to apply EBP across a variety of settings. It’s known that EBP models assist the baccalaureate prepared nurse with developing tailored plans of care by incorporating the most current and relevant research when making vital decisions about care. In addition, having the most current evidence along with the collaboration of an interdisciplinary team who communicate effectively leads to positive patient outcomes. Evidence-Based Practice Model To Address a Practice Issue Essay

Stetler Model (Ciliska et al., 2011Stetler, 2001). The Stetler Model enables practitioners to assess how research findings and other pertinent evidence are implemented in clinical practice. The model examines how to use evidence to create change that fosters patient-centered care. Steps in this model are referred to as phases.

Phase I. Preparation: Identify a priority need. Identify the purpose of the EBP project, context in which the project will occur, and relevant sources of evidence.

Phase II. Validation: Assess sources of evidence for level and overall quality. Determine whether source has merit and goodness of fit and whether to accept or reject the evidence in relation to project purpose. Evidence-Based Practice Model To Address a Practice Issue Essay

Phase III. Comparative Evaluation/Decision Making: Evidence findings are logically summarized and similarities and differences among sources of evidence are evaluated. Determine whether it is acceptable and feasible to apply summation of findings to practice.

Phase IV. Translation/Application: Develop the “how to’s” for implementation of summarized findings. Identify practice implications that justify application of findings for change.

Phase V. Evaluation: Identify expected outcomes of the project and determine whether the goals of EBP were successfully achieved. Evidence-Based Practice Model To Address a Practice Issue Essay

  • Designed to encourage critical thinking about the integration of research findings
  • Promotes use of best evidence as an ongoing practice
  • Helps lessen errors in critical decision-making activity
  • Allows for categorization of evidence as external (e.g., research) or internal (e.g., organization outcome data)
  • Emphasizes use by single practitioner but may include groups of practitioners or other stakeholders

Evidence-Based Practice

Good morning everyone and thank you for joining me in discussing the case study of a patient with Chronic Obstructive Pulmonary Disorder (COPD) and the efficacy of remote collaboration in enhancing patient outcomes. As we focus on the intricacies of COPD, there is a need to acknowledge the challenges experienced by patients like the 70-year-old male residing in rural areas and has limited access to specialized care. The symptoms presented by this patient included a chronic cough, shortness of breath, and frequent respiratory infections that required an evidence-based approach in resolving it.

For this patient, I believe that there is a need to discuss an evidence-based care plan for the patient, while using remote collaboration for optimal health outcomes. As the first step, there is a need to ground the care plan in evidence-based practice. For this step, I would propose the Stetler model that guides people through the process of identifying, appraising, and applying evidence to clinical practice. By applying the steps in the model, the decisions made will likely be informed by best available evidence and clinical expertise.  Evidence-Based Practice Model To Address a Practice Issue Essay

From the case of this patient, I propose a multifaceted approach for the management of COPD in the patient. Pharmacological interventions such as bronchodilator therapy with long-acting beta-agonists and inhaled corticosteroids have proved useful in improving lung function in the patient and reduction of symptoms (Nagase et al., 2022).at the same time, non-pharmacological techniques could help the patient as they have proven effective in improving the quality of life for the COPD patient (Kermelly & Bourbeau, 2022). Such sessions encompass tailored exercises, physical activity, and education on how to manage its symptoms. In all these techniques, remote collaboration is needed for improved coordination among health professionals when providing specialized care. Challenges such as technological barriers and limited patient-provider interaction should be addressed (Fu et al., 2022). Mitigation of challenges can be effected through leveraging of telehealth and regular virtual follow-up visits for ongoing monitoring of the patient’s progress and adjustment of the care plan as required.    Evidence-Based Practice Model To Address a Practice Issue Essay

References

Fu, Y., Chapman, E. J., Boland, A. C., & Bennett, M. I. (2022). Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review. Palliative Medicine36(5), 770-782. https://doi.org/10.1177/02692163221079697

Kermelly, S. B., & Bourbeau, J. (2022). EHealth in self-managing at a distance patients with COPD. Life12(6), 773. https://doi.org/10.3390/life12060773

Nagase, F. I., Stafinski, T., Avdagovska, M., Stickland, M. K., Etruw, E. M., & Menon, D. (2022). Effectiveness of remote home monitoring for patients with chronic obstructive pulmonary disease (COPD): Systematic review. BMC Health Services Research22(1). https://doi.org/10.1186/s12913-022-07938- Evidence-Based Practice Model To Address a Practice Issue Essay

 

 

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