Case Study

Select a patient population ( pediatric, young adult, adult or geriatric) and briefly analyses a common /acute EENT condition (Sinuses, Pharyngitis, Epiglottitis, Infectious Mono, Epistaxis, Allergy rhinitis, hearing loss, common eye conditions etc…. there are several to choose from) that may affects this population. Briefly tell how it impacts the patient s quality of life and analyze the current research evidence on this topic and gold standard of care if any for your chosen population. ( You may use any clinical example) Describe how you the Family Nurse practitioner can or have made a difference In the care of patients with this specific disease and tell of one specific patient care teaching That he/she may do to help minimize disease symptoms.

 Could you provide me with a specific example of a time when you used the DIKW process and the outcome? Thanks. 

Comment1

My EBP project is on type 2 diabetes management through lifestyle changes. I have chosen my place of employment as a research facility being that huge percentage of the population is diabetic. Potential barriers that may prevent my EBP change proposal is the lack of knowledge and unpreparedness of the rest of the team. The company in which I work for has a total of 13 facilities. Each facility has at least one RN and various providers. In order for my EBP change proposal to be successful, the company will have to invest money in training the RNs. Budget is something that has to be meticulously analyzed before approving any type of training. However, the company believes in providing quality patient care and managing our patient’s diabetes will not only reflect in their blood glucose, but also their overall health. According to the article Budget Management Tips for New Managers, it is cost effective to invest time to learn right initially (McCarthy, 2018). At this time, the company is investing time and money to train all medical assistants into working universally throughout the 13 facilities. Being that diabetes is on the rise, and I have conducted evidence-based practice research, I have a good feeling that the company may want to invest time and money into training not only RNs in providing education to patients living with diabetes, but also mental health providers to support these patients.

comment2

Maintaining safe staffing is key.  Keeping staff engaged in the hourly rounding process and not accepting anything less as practice on our CLC is paramount to keeping the residents safe and continue to keep falls at a minimum.  Maintaining an alarm free environment, no matter what the staffing ratios are, will be important. If management is serious about the alarm free environment, then they will need to actively enforce the rounding and not allow it to slide. Lastly, to maintain staff compliance, on-going education needs to be reinforced regarding proper rounding and alarm/restraint statistics on alarm free environments.

Submit Part One Portfolio due 02/02/19

3 .Using the American nurses association position statement, recommendations for improvement in end of life management focuses on practice, education, research and administration. Listed below are steps that nurses can take to overcome barriers in healthcare practice.

Practice 

1. Strive to attain a standard of primary palliative care so that all health care providers have basic knowledge of palliative nursing to improve the care of patients and families. 

2. All nurses will have basic skills in recognizing and managing symptoms, including pain, dyspnea, nausea, constipation, and others. 

3. Nurses will be comfortable having discussions about death, and will collaborate with the care teams to ensure that patients and families have current and accurate information about the possibility or probability of a patient’s impending death. 

4. Encourage patient and family participation in health care decision-making, including the use of advance directives in which both patient preferences and surrogates are identified. 

Education 

1. Those who practice in secondary or tertiary palliative care will have specialist education and certification. 

2. Institutions and schools of nursing will integrate precepts of primary palliative care into curricula. 

3. Basic and specialist End-of-Life Nursing Education Consortium (ELNEC) resources will be available. 

4. Advocate for additional education in academic programs and work settings related to palliative care, including symptom management, supported decision-making, and end-of-life care, focusing on patients and families. 

Research 

1. Increase the integration of evidence-based care across the dimensions of end-of-life care. 

2. Develop best practices for quality care across the dimensions of end-of-life care, including the physical, psychological, spiritual, and interpersonal. 

3. Support the use of evidence-based and ethical care, and support decision-making for care at the end of life. 

4. Develop best practices to measure the quality and effectiveness of the counseling and interdisciplinary care patients and families receive regarding end-of-life decision-making and treatments. 

5. Support research that examines the relationship of patient and family satisfaction and their utilization of health care resources in end-of-life care choices. 

Administration 

1. Promote work environments in which the standards for excellent care extend through the patient’s death and into post-death care for families. 

2. Encourage facilities and institutions to support the clinical competence and professional development that will help nurses provide excellent, dignified, and compassionate end-of-life care. 

3. Work toward a standard of palliative care available to patients and families from the time of diagnosis of a serious illness or an injury. 

4. Support the development and integration of palliative care services for all in- and outpatients and their families. 

Discussion Board Question 2: End of Life Care.

Choose 1 focal point from each subcategory of practice, education, research and administration and describe how the APRN can provide effective care in end of life management.