Jeffrey Bourguignon Best Evidence Paper EM 6305 Fall 2011 PICO Question In COPD patients, does breathing rehabilitation or anxiolytics produce a greater reduction in anxiety and subsequent dyspnea? Search Strategy The search terms I initially used to find material suitable for this assignment were: COPD, anxiety, pulmonary, rehabilitation, treatment, dyspnea, quality of life. Search Outcome My search returned 80 papers, of which 22 were free full texts. 21 of the papers were relevant to my query and supported pulmonary rehabilitation programs for patients with COPD to reduce anxiety and thus, dyspnea. Relevant Articles Table Article | Patient Group | Study Type | Outcomes | Key Results | Study Weaknesses | 1 | 45 patients - 13 male, 32 female, mean age 67.4 years | Observational Study | Pts who completed pulmonary program showed improvement on all four scales.
Structure is measured by the staff: amount, skill-level, and education or certification. Process indicators measure the facets of nursing care, such as assessment and intervention. Outcome indicators refer to patient outcomes that are affected by nursing care and are considered nursing-sensitive if directly affected by the quantity or quality of the nursing care (ANA, 2013). Through understanding of nursing-sensitive indicators and integration into daily practice, the staff caring for Mr. J could have been more aware of potential issues that interfere with patient care. Knowledge of the increased risk for pressure ulcers and the need for frequent turning and off-loading of pressure points could have allowed the staff to prevent the one forming along Mr. J’s spine.
Nursing Sensitive Indicators Nurse sensitive indicators included in this case are Mr. J’s use of restraints, complications of pressure ulcers, and patient satisfaction. Had the nurse who was caring for Mr. J been aware about the risks of pressure ulcer development with the use of restraints, the beginning stage of a pressure ulcer could have been prevented. Better RN assessment of Mr. J’s restraints, repositioning Mr. J every two hours and a thorough skin assessment should be done at every shift. The NA should be instructed to notify RN if they see anything out of the ordinary with patients, such as the redness to the lower spine of Mr. J. The nursing staff assigned to Mr. J will need additional training about restraints as far as appropriate use of restraints and how to care for a patient who is restrained.
Through review of recent literature into the assessment and management of individuals affected by paranoid schizophrenia, this paper will discuss in detail how the nurse goes about assessing the patient, why assessment is vital, common outcomes of the assessment and finally go into detail on how the nurse manages a patient with paranoid schizophrenia. Stein-Parbury (2009) discuss the importance of providing an environment without distractions for an assessment to occur in, as this enhances the ability of both the patient and
His initial medical diagnosis is heart failure (HF). Bert is immediately admitted to the acute care facility for further evaluation and treatment. Heart failure is called cardiac failure, pump failure, or congestive heart failure (CHF). It is defined as the inability of the heart to pump enough blood to meet the tissue's oxygen demands. Risk Factors Heart failure occurs most commonly in clients over the age of 60, and occurs more commonly in males than females.
Understanding this weakness through the perception of the nurses can improve patient outcomes; this is the research problem in the study. The study highlights the attitudes and values of the selected nurses and also ways to increase knowledge and preserve their dedication to pressure ulcer prevention. The authors established the significance of the study by highlighting the role of the nurse in the prevention of the pressure ulcers and how the break in care contributes to the development and progression of pressure ulcers. Purpose and Research Questions “The study aimed at describing contributing factors for the progression or regression of pressure ulcers in the care trajectory as they were understood by nurses working in hospitals or community care” (Athlin et al., 2010, p. 2252). The authors did not specifically develop research questions, however some appropriate
Hobson believes that because problems in our life are usually through interpersonal relationships, we should resolve these problems through a therapeutic relationship. The quality of the relationship is crucial for the effectiveness of the therapy. PIT consists of several interlinking components, of which include ‘explanatory rationale’ and ‘staying with feelings’. A potential strength of PIT is that it is just as effective if not more so than current treatments at improving depressive symptoms. Research support comes from Elkin, who found that when compared to CBT, PIT is just as effective at treating depression.
The faces scale should be used last due to its frequency of misinterpretation (Herr, 2010). The alert patient will be able to vocalize their pain level, the location, duration, frequency, intensity and type of pain. The nurse will also be able to see differences in facial expression while speaking with the alert patient. The unconscious or not alert patient will be assessed differently. The nurse must be very observant and watch for signs of pain.
It is important to be positioned correctly as a therapist so you prevent yourself from pain or injury if you consistently and positioned correctly this can result in repetitive strain injury. • It is important to use the correct products, tools, equipment and technique because so the client can feel the best benefit from their treatment and it will not harm the client. • It is important to complete treatment records correctly so that you have on record if the client has any contra-indications which may prevent or restrict a treatment. You will also have on record anything the client may be allergic to. • It is important to complete the treatment to the satisfaction of the client so they go away feeling happy and return to you again in the future.
Construct Development: Exercise and Depressive Behavior The intricate values of calculation offer essential understanding of statistics. Developing means and standard deviations within the analysis of experiential research will help mental health professionals better understand the significance and efficiency of the intervention or procedure they may use on a patient. Studies conducted by Balkin, Tetjen-Smith, Caldwell, and Shen (2007) discovered that mental health professionals can recommend that a patient with depressive symptoms participate in exercise programs established on measurements attained by employing the Beck Depression Inventory-II on individuals who partook in the study. Demonstrating Gain Balkin, Tietjen-Smith, Caldwell & Shen (2007) provide a straightforward statistics Table that shows how the aerobic exercise group presented the most prevalent gain of 29 percent reduction in their symptoms of depression. The anaerobic group presented a 24 percent reduction whereas the control group presented a 20 percent reduction in their symptoms of depression.