Evidence-Based Practices & NursingIntroduction Normally,.docx
- 1. Evidence-Based Practices & Nursing Introduction Normally, PICOT format is helpful in formulation of questions in an evidenced based clinical practice. PICOT generated questions generally fall under for main categories of clinical practices. These include; therapy, prevention, diagnosis, etiology as well as Prognosis. The essential elements in PICOT questions. The PICOT format is valuable in addressing research questions comprehensively. Five elements are normally addressed including; population, intervention, comparison, outcome and time as well (Riva, Malik, Burnie, Endicott, & Busse, 2012). Summary of Case Study The ever increasingly high incidence of breast cancer conditions has posed serious challenges in the nursing profession. Provision of appropriate healthcare to the cancer patients has been lacking leading to adverse effects of the proliferation of cancerous cells which further worsen the conditions of the patients. As primary care, clinicians have the responsibility to stressing providing healthcare services within healthcare facilities as well as monitoring treatment in home based facilities to help manage cancer condition. Most cancer patient need clinicians who practice evidence-based clinical practices (Riva, Malik, Burnie, Endicott, & Busse, 2012). Research Question In cancer patients receiving chemotherapy, will they have better white blood cell count monitoring with a follow-up at home versus follow-up at a health care facility during their treatment? PICOT Format 1) P-Population: Patients aged 18-60 years-old, breast cancer who have not received chemotherapy in the past six months are subjected to the treatment. Patients with other serious health conditions such as heart diseases were excluded in the study. 30
- 2. patients, with 15patients stationed at the healthcare facility while the other 15 patients receiving home-based care, are expected to take part in the study. 2) I -Intervention: The patients will receive dosage based on the age, sex and health general body health as well as the stage of cancer cells proliferation in the body. The patients are required take the prescribed drugs at regular intervals. The subjects will be subjected to treatment under the same during the research study. 3) C-Comparison: All the subject regardless of variations in their level of dose requirement will be subjected to the same treatment for the same duration, 3months. Standardized treatment will be given to subjects with no extreme variations in their level of dose requirement and would be used as an active control group. Using this strategy, it will be possible to minimize the non-specific effects due to a group of the patient receiving treatment within the healthcare. 4) O-Outcome: The response in chemotherapy treatments will be check by examining the numbers of defective cancerous cells in the body tissues. The patients will report to the theatre in order to be examined by an oncologist. The results will be recorded in terms of improved seen in each patient and in the two categories, that those that received home-based care as well as those who received chemotherapy treatment within the healthcare facility (Stevens, 2001). 5) T-Time: The outcome would be measured after 2 weeks for 3months. The results will be recorded at an interval of two weeks from the onset of the study throughout the 3months In evidenced-based clinical practice, it is imperative to standardize treatments in order to avoid skewing expected treatment outcomes. Teaching the subjects, the importance of chemotherapy treatment should be part and parcel of the planning process of the patient recruitment into the research study. More importantly, standardizing instruction to study subjects is also important in ensuring no additional interventions are inadvertently introduced during the study
- 3. period. Additional intervention can be by way of extra pieces of advice to the study subjects (Stevens, 2001). Evidence-based clinical practices, clinicians are encouraged to not only provide available cancer care choices but also undertake to provide information on quality care. In addressing challenges and complication associated with breast cancer, clinicians should provide timely, accurate information (Morley, 2009). Keywords in Literature Review The keywords to look for in literature review include; breast net weight, breast biopsies related history, hyperplasia prior to biopsy, radiation of the chest, breastfeeding, obesity, excessive use of alcohol, sedentary lifestyles, and chemotherapy as well as exogenous hormones. These items show the mode of progression of cancerous cells and influence the type of healthcare to be provided to patients in evidence-based clinical practices (Stevens, 2001). Reference Morley, P. T. (2009). Evidence evaluation worksheets: the systematic reviews for the evidence evaluation process for the 2010 International Consensus on Resuscitation Science. Resuscitation, 80(7), 719-721. Riva, J. J., Malik, K. M., Burnie, S. J., Endicott, A. R., & Busse, J. W. (2012). What is your research question? An introduction to the PICOT format for clinicians. The Journal of the Canadian Chiropractic Association, 56(3), 167. Stevens, K. R. (2001). Systematic reviews: The heart of evidence-based practice. AACN Clinical Issues, 12(4), 529–538. Title ABC/123 Version X 1
- 4. Assessing the Crisis BSHS/445 Version 4 1Assessing the CrisisPart 1 Complete the table below to show a compare and contrast between the hybrid model and psychological first aid model. Be sure to use complete sentences and explain the tasks/steps in your own words. (Do not use only quotations from the text). The first step is completed for you. Task # HYBRID MODEL PSYCHOLOGICAL FIRST AID Task 1 The first task of “predispositioning” involves the worker preparing for the first interaction with the client in crisis by demonstrating empathy, introducing themselves, and identifying their intention to the client. The first step is “contact and engagement” in which the interventionist aims to initially engage the client in a compassionate manner. Task 2 Task 3 Task 4 Task 5 Task 6 Task 7
- 5. Task 8 Part 2 Create a progress note* that captures the ABCs of assessment— affective, behavioral, and cognitive—from the client in Scenario 5 in this week’s readings. See the following example before completing the table that follows. The ABC information should be between 260 words combined. Affective Client is a 20-year-old single Caucasian female. She reported feeling upset for the last two months since her boyfriend broke up with her. Client appeared to be depressed, as evidenced by tearfulness during the session. Client denied any suicidal or homicidal ideation (SI/HI) and reported no past history of danger to self or others (DTS/DTO). Behavioral Client was asked if there have been times in the past that she felt this way. She stated the last time she felt like this was a year ago when she failed her math final. This writer explored strategies with the client that helped the last time she felt this way. The client reported that she has been able to get a lot of assistance from talking with her friends and running. She stated her friends are very supportive and that running helps her feel better about herself. Client agreed that if she continued feeling this way over the next 24 hours, she would call her best friend and go for a run. Cognitive Client appeared to be clear and logical in her thinking. Client denied any auditory or visual hallucinations (AH/VH) or delusions. She was future-oriented and has a plan in place if she does not start feeling better. *A progress note is a note used to document interaction with a client. A good example of a common process note is a SOAP note. Many agencies use the SOAP note to document contact
- 6. with clients. SOAP notes refer to the following type of assessment: subjective, objective, assessment, and plan. Affective Behavioral Cognitive Copyright © XXXX by University of Phoenix. All rights reserved.