Watch the following videos, then complete the required assignment. Review the document in Course Resources for instructions on accessing the videos.

Lab 1

OSCE Clinical Skills

Chest Pain 14:53  

Upon completion of watching the video write up the scenario into a SOAP format. Is there anything you would do differently on your plan?  

Lab 2

OSCE Clinical Skills

Shortness of Breath 26:53

Upon completion of watching the video write up the scenario into a SOAP format. Is there anything you would do differently in your plan?

Evidence Translation and Change

Week 7

What are the common barriers to evidence translation in addressing this problem?

           There are many barriers when it comes to translating evidence into practice. In regards to obesity, the most common barrier to translate evidence-based changes locally, nationally, and globally are the stakeholders. According to Chamberlain College of Nursing, (2020, translating research into practice relies on the clinician knowing who the stakeholders are and getting them involved in the planning stage and in every aspect of the practice change. Some stakeholders may not be conducive to change. In order to adopt and launch a practice change, the change leader has to be able to sell the project to key stakeholders. For a project leader to get others to go along with a practice change, the leader has to be knowledgeable, motivated, and believe in the research he or she is presenting to the stakeholders.

           Additional barriers in translating research evidence into this practice problem would cost, available resources, and timing.  For instance, it is less likely for individuals living in a low socioeconomic community to prioritize a 30 minutes time slot five days a week for exercising activities. Barriers like work schedules, family commitment, and financial obligations may impede these practices. The lack of motivation may also be a factor. Most individuals may not have a membership to the local gym, and rain and cold weather may prevent walking in the local park. The lack of appropriate lighting in the parks may fend off participation in outdoor activities in the fall and winter months. According to Tucker, the individuals, the location, and the practice itself and have a huge role in influencing evidence-based practice (2017). For an evidence-based practice to be adapted effectively it must be realistic in all public health settings.

What strategies might you adopt to be aware of new evidence?

           I would create an interprofessional group to include clinical and research practitioners to discuss new and upcoming research evidence appropriate to the practice problem. Focus groups both locally and nationally as well as globally are great outlets to discover what is working in different areas of healthcare. Small focus group outlets in which to gather people with the same interest to discuss and present new research (Chamberlain College of Nursing 2020). I would sign up for alerts on new research, evidence-based practice interventions, and quality improvement publications on obesity throughout the country and globally. Tucker indicated that research experts are great resources to look into and introduce the latest pieces of evidence (2017). I also believe an expert Ph.D. colleague would be a great mentor to help guide me in this practice problem intervention. Dang and Dearholt indicated that a team approach between DNP and Ph.D. scholars influenced the best clinical outcome.  

How will you determine which evidence to implement?

           First, I would focus on finding evidence to support my practice intervention, base not only on research but evidence that supports the participants’ cultural values and beliefs. I would look at the available evidence and ask myself, whether this is appropriate for my particular demographic. There are many quality improvements in evidence-based research practice in healthcare that can be pilot to other practice problems.  I would look at the data for similarities and tailor it to this particular focus practice problem on a local level. The team would appraise the appropriate data and determine whether it is pertinent to obesity. Most importantly, I would communicate the evidence to all key stakeholders.

How will you ensure the continuation or sustainability of the change?

           To ensure continuity and sustainability of the practice change, I would look at the impact the change has had on individual participants, both locally and nationally. Since the intervention is patient-centered, I think it is appropriate to be familiar with the participant’s values and preferences. Without the support and commitment of the participants, the practice problem intervention will be ineffective. Taylor et al. wrote evidence-based practice is a combination of best evidence, patients choice, and the skillfulness of the practitioner (2016). I believed that persons who have had positive outcomes tend to continue to participate in activities more so than those who have had negative experiences. I would continue to involve participants and families in the planning and implementing phase of the intervention. I would also mandate ongoing training to all interprofessional team members. I would reinforce the ongoing review of the evidence to maintain current research. Clear and respectful communication and teamwork are also important in sustaining and continuing change. Evidence-based intervention is being carried out throughout the globe, I believe by working alongside interdisciplinary teams and familiarizing myself with the evidenced available will give me a global sustainability outlook.

Reference

Chamberlain College of Nursing. (2020). NR-701 Week 7: Translation of Evidence: Overcoming Barriers [Online lesson]. Downers Grove, IL: Adtalem.

Dang, D., & Dearholt, S. (2018) John Hopkins nursing evidence-based practice model and guidelines (3rded.). Sigma Tetu Tau Intentional.

Taylor M.V., Priefer, B.A. & Alt-White, A.C. (2016). Evidence-based practice: Embracing integration. Nursing Outlook 64(6) 575-582. doi.org/10.1016/j.outlook.2016.04.004

Tucker, S. (2017) People, practice, and places: Realities that influence evidence-based practice uptake. Worldviews on Evidence-based Nursing 14 (2) 87-89. Doi10.111/wvn.12216

I NEED A COMMENT FOR THIS POST WITH AT LEAST TWO-THREE  PARAGRAPH AND TWO SOURCES NO LATER THAN FIVE YEARS

Why is there increasing emphasis on nutrition and exercise for middle  aged and aging families? Why is it more significant than 30 years ago?

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. 

The practice problem that I discussed in weeks 1 and 2 was alcohol abuse. Alcohol abuse is a major problem globally and locally for my home state as well. Common barriers in addressing this problem are lack of treatment facilities, patient’s reluctance to seek help, treatment compliance, high potential for relapses, perceived treatment efficacy, and perceived treatment need (Pinedo, Zemore, & Rogers, 2018). Alcohol use has continued to increase over the past decades and is predicted to continue increasing as well worldwide (Shield, Manthey, Rylett, Probst, Wettlaufer, Parry, & Rehm, 2020). This expected increase is even a bigger problem than the barriers for treatment. The real question in battling this practice problem should be why is this practice problem expected to increase and what can we to do prevent this? Yes, that sounds simple in theory, however alcohol abuse has been a problem for many decades and we still yet don’t have an answer to this or a solution.

                Strategies to adopt awareness of new evidence for this practice problem would be educating the public on the dangers of alcohol and how it can lead to alcohol abuse. I think this is the first step for primary prevention of the problem. Regarding patient’s that this is already a problem in, strategies that might help to overcome some of the issues that we face as barriers might include opening more treatment facilities and doing our best to remove the stigma that is associated with addiction. I think as primary care providers it is also useful to implement questionnaires that could lead to the identification of alcohol abuse such as the cage questionnaire. By being able to identify alcohol abuse in our patient’s we are able to talk to them about alcohol abuse, options for treatment, and potential complications for the future (Taylor Jr, El-Sabawi, & Cangin, 2016).

                I think the regarding alcohol use it is important to be implement all of these strategies. Alcohol abuse is a problem that affects people both physically and mentally. It also affects not only the patient themselves but the family members and friends of this patient. It is important to implement all of this evidence because this practice problem needs to include prevention and treatment. Prevention is necessary to hopefully decrease this problem or prevent it from getting worse. Treatment is needed for the already high numbers of patient’s that are suffering from this problem. As far as the continuation or sustainability of these changes that can be difficult to ensure. By providing more treatment facilities, this does ensure that we have more places for people to be seen for this practice problem. By implementing the cage questionnaires, this also helps to identify problems early on or problems in people that don’t see their alcohol use as a problem. However, alcohol abuse is a problem that requires the patient to be ready as well for this to be successful. We can aid the patient in success by encouraging them, being positive, and not ever putting blame or guilt on them. Relapses are common in this population and is necessary that we are able to identify this as part of the disease process and not noncompliance or failure.

Angelina

Pinedo, M., Zemore, S., & Rogers, S. (2018). Understanding barriers to specialty substance abuse treatment among Latinos. Journal of substance abuse treatment, 94, 1-8.

Shield, K., Manthey, J., Rylett, M., Probst, C., Wettlaufer, A., Parry, C. D., & Rehm, J. (2020). National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: a comparative risk assessment study. The Lancet Public Health, 5(1), e51-e61.

Taylor Jr, P., El-Sabawi, T., & Cangin, C. (2016). Improving alcohol screening for college students: screening for alcohol misuse amongst college students with a simple modification to the CAGE questionnaire. Journal of American college health, 64(5), 397-403.

Allied health professionals are confronted with different death and dying practices. An effective allied health professional recognizes the importance of understanding different cultural practices, and learns how to evaluate the death, dying, and spiritual beliefs and practices across the cultures.

Read the two specified case histories and choose one for this assignment.

Chapter 4, “Stories of Abby: An Ojibwa Journey” and Chapter 14, “Stories of Shanti: Culture and Karma,” by Gelfland, Raspa, and Sherylyn, from End-of-Life Stories: Crossing Disciplinary Boundaries (2005), from the GCU Library.

Identify your role as a health care professional in supporting Abby’s or Shanti’s dying rituals, and in creating strategies for displaying respect while still providing quality care. Identify communication strategies necessary in caring for your select person. Integrate your strategies as you develop a care plan describing how you would approach the situation and care for the patient. Review the “Care Plan” template prior to beginning.

Include the following in your care plan:

1. Communication: family and patient
2. Treatment options that align with the specific culture
3. Education: family and patient
4. Family roles in the process
5. Spiritual beliefs
6. Barriers
7. Cultural responses
8. Any additional components that you feel would need to be addressed (from your perspective as a health care professional)

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