1 hour ago
RE: Discussion - Week 11
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Evidence based Practice is using information and practices obtained from prior research and preferences (Polit & Beck, 2017). When I think of evidenced based practice, I think of current practice utilizing certain practices and procedures because they have been tested and proven in the past. Evidenced based practice can be derived from literature, healthcare workers and patient experiences (Polit & Beck, 2017). There are many practices that we utilize around the hospital today that come from evidenced based practice. We use them so lightly daily and many times not understanding the meaning behind them and that others have tested them making it safe for us to use them. The one thing that came to mind was the use of off label drugs to treat various mental health issues. In Behavioral health it requires various combinations of drugs to gain the warranted effect (Narsa, 2018). When treating bipolar disorder and other mood instabilities there are the well-known medication like lithium, but evidence as presented itself showing that various seizure medicines can elicit the intended result (Narsa, 2018). In Psychiatry they utilize antiepileptic medications such as Depakote, Tegretol and Topamax to stabilize a patient with mood disorders (Demland, 2017). This is many times used in combination with the popular medications such as Lithium. Patients are many times very stunned to find out that they will be placed on such a medication. Many times, these medications will be introduced if the patient has a difficult time adjusting to the medication dosage changes or the intended effect is not seen (Demland, 2017). Many patients have testified to the benefit of these medicines. I think about how evidence-based practice comes in to play here because prior to this medication healthcare providers were only using antiepileptics for seizures only.
Another medicine being used as an off-label drug is Lorazepam. Many in healthcare know this drug as an anxiolytic and never think about its other uses. In Behavioral health this drug is actually used for the opposite effect in patients who are catatonic. When one first thinks of prescribing a drug that is meant to calm a person down and many times sedate them to a patient that is not talking, moving or interacting is seems somewhat bizarre. How will this work? Will it make the patient even more disengaged and possibly sedated? These are all questions myself and many of my coworkers had. In this case, the physicians relied on evidenced based practice to assist them in making such a decision. They utilized such an unpopular treatment but it gained the intended effect. The catatonic patients respond well to this treatment. They can be seen becoming more engaged with peers and staff and taking part in their care.
Demland, J. (2017). Use pattern and off-label use of atypical antipsychotics in bipolar disorder,
1998-2002. American Health & Drug Benefits, 2(4), 184–191.
Nasra, K. (2018). An analysis of the high psychotropic off-label use in psychiatric disorders:
The majority of psychiatric diagnoses have no approved drug. Asian
Journal of Psychiatry, 2(1), 29–36.
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for
nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
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