NSG 300 topic 1

Evidence-based practice (EBP)

Problem solving approach to clinical practice that combines deliberate and systematic use of best evidence from research in combination with a clinician’s expertise, patient preferences, and values.

(invloves nurses addressing clinical problems by looking for the very best knowledge and scientific and clinical evidence that are available for treating or managing patient problems and implementing changes in practice.)

Steps of evidence-based practice (EBP)

1. Cultivate a spirit of inquiry

2. ask a clinical question in PICOT format

3. Search for the best evidence

4. Critically appraise the evidence

5. Integrate the evidence

6. evaluate the outcomes

7. communicate the outcomes of the EBP decision

Health

complete state of social and mental well being, not merely the absence of disease or infirmity (personality, value, beliefs,)

Illness

How a person reacts to defeat. physical, mental, spiritual.

State in which a person’s Physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired.

Health promotion

Helps individuals maintain or enhance their present health

Illness prevention

activities such as immunization programs and bp screenings protect people from actual or potential risks to health

Health promotion Model

1. individual characteristics and experiencesbeh

avior-specific cognitions and affect

behavioral outcomes, which result in a patient committing to or changing a behavior

Holistic Nursing

Promotes patient’s optimal level of health by considering the dynamic interactions among the emotional, spiritual, social, cultural, and physical aspects of individual’s wellness (patients at center of care)

Transtheoretical Model of change: stages of health Behavior change

Precontemplation

contemplation

preparation

action

maitenance

Precontemplation

No intent to make changes within the next 6 months

Contemplation

Considering a change within the next 6 months

Preparation

Making small changes in preparation for a change in the next month

Action

Actively engaged in strategies to change behavior; lasts up to 6 months

Matenance

Sustained change over time, begins 6 months after action started and continues indefinitely

Health Education

providing information on topics: physical awareness, stress management, self-responsibiity that allows people to develop greater understanding of their health

Illness prevention

activities like immunization programs and blood pressure screenings protect people from actual or potential risks to health

Internal Variables

persons developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors

External variables

person’s health beliefs and practices include family practices, psychosocial and socioeconomic factors, and cultural background

Primary Prevention

Reduces the incidence of disease

Secondary Prevention

Prevents spread of disease, illness, or infection once it occurs (screening)

Tertiary prevention

When a defect or disability is permanent and irreversible

Risk factor

non-modifiable:age, ethnicity, genetics,gender

modifiable: smoking, drinking, activity, diet

Enviornment: location, air, water, soil (condition of living area)

Vital signs (VS)

Provide data to determine a patient’s usual state of health (baseline data)

Body core temperature

norm (96.8-100.4F)

Oral, axillary, rectal, temporal, tympanic, pulonary artery

Pulse (Heart rate)

60-100 bpm

Riadial

Apical

carotoid

brachial

popiteal

posterior tibial

Tachycardia

Elevated HR above 100bpm

Bradycardia

below 60 bpm

Respiration

rate, depth, rhythm, SaO2, Capnography (EtCO2)

Blood pressure

Force exerted on the walls of an artery by the pulsing blood under pressure from the heart

Systolic pressure

Ventricles of the heart contract and force blood under high pressure into aorta

Diastolic pressure

when ventricles relax, heart fills, and pressure of blood in arteries

Hypertention

high bp

Hypotention

low bp

orthostatic hypotension

when client changes position resulting in dizziness

Pain

Subjective data (using faces to rate pain)