Comment 1

Evidence-based practice is the conscientious integration of best research, evidence with clinical expertise and patients’ values and needs in the delivery of high-quality, and cost-effective healthcare (University of Illinois at Chicago, 2015).

Evidence-based practice (EBP) promotes quality, safe, and cost-effective outcomes for patients, families, healthcare providers, and the healthcare system. It evolves from the integration of the best research evidence with clinical expertise and patients’ needs and values (Grove, Gray & Burns, 2015. 6th ed).

The treatment for acute muscle strain has changed over the years.  In the past, nurses learned to ice certain injuries for the first 24 hours and then apply heat to increase blood flow. Presently, evidence-based practice shows that only heat is beneficial (The university of New Mexico, 2016, Nov.30).

Evidence-based practice has been developed to prevent healthcare–associated intravascular device–related bloodstream infections with the use of I-Care and the acronym stands for:

• I—IV device management
• C—Cleaning of hands
• A—Access: Use of alcoholic chlorhexidine to prepare the insertion site, and use of sterile alcohol swabs to clean the injection port before accessing.
• R—Reviewing the need for the IV device on a daily basis and remove when no longer required
• E—Education about I-Care given to: staff, patients, and other care-givers (The Joint Commission, 2013, Nov.20).

I work in prison facility and we had several cases of flu infection during this last episode. Hand washing with soap and water and contact precaution was evidence-based practice used to prevent the spread, also screen and testing others in the same dorm help to control spread of infection.

Comment 2

Evidence-based practice (EBP) is the combination of using research and clinical expertise, and include the patients’ values when making decisions about the care of individualized patients (Rauen, Chulay, Bridges, Vollman, & Arbour, 2008). Research findings are a group of facts and they become evidence when the findings are relevant and useful in particular patient situations. One example of EBP is collecting an accurate measurement of blood pressure, and it starts with picking the correct cuff size according to the circumference of the patient’s arm. Positioning the arm is also important and that should be based on how the patient is positioned. The study also found that using an automatic cuff to measure blood pressure in patients with atrial fibrillation was interchangeable with checking the blood pressure manually (Rauen, Chulay, Bridges, Vollman, & Arbour, 2008).

Another EBP used when assessing pain is to intervene appropriately in patients that are non-verbal or have dementia. Assess for pain and intervene with non-verbal and/or demented patients when they have conditions that typically cause pain (Flynn Makic, n.d.). Assess for facial expression, verbalizations, a change in activity, and rubbing of certain parts of the body. The nurse can also evaluate for restlessness, agitation, and combativeness. Nurses should use a valid, reliable tool for assessing pain and re-evaluate frequently (Flynn Makic, n.d.).

The first EBP on accurately measuring blood pressure is widely used in all settings of health care including home health where I work. We manually check blood pressure and are instructed on choosing the proper cuff size and proper positioning of the patient for the most accurate results. The EBP for pain assessment we use the Numeric Pain Rating Scale as well as the Wong-Baker Faces Rating Scale. The numeric scale can tell us the intensity of pain which can help guide the nurse’s choice for pain medication and for the non-verbal, limited cognitive ability, and/or patient with mild to moderate dementia we use the scale with pictures (Wong-Baker). Patients with advanced dementia will need behavioral observation to determine the presence of pain (Wells, Pasero, & McCaffery, n.d., Chapter 17).

Write 100-word Reflective Journal on how the attached clinical scenario enhanced your understanding of important communication techniques and what would be incorporated into your individual communication style to improve the nurse-patient/family relationship.

Required criteria:

1. 100 word minimum reflection 2. Identifies how this scenario enhanced understanding of communication techniques 3. Addresses how these communication techniques will be incorporated into their own communication style to improve the nurse-patient/family relationship 4. Logical reflective flow which follows standard grammatical rules with minimal (1-2) misspellings

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question 

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Discussion # 2

Why is a philosophy of science important to nursing? Provide examples from your clinical practice that demonstrate how the scientific method influences nursing knowledge, and in turn, practice? (Essentials I, III, VI, VIII and IX)

The initial post will be regarding the topic of the week and will be a minimum of 250 words. Make sure you provide appropriate references and utilize APA style.. Each discussion will be allocated to a specific Master’s Essential.

Discussion Rubric is attached

Master’s Essential is attached

The benchmark assesses the following competency:

Benchmark: 5.1. Understand the human experience across the health-illness continuum.

Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:

1. Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
2. Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
3. Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.