Unit 6 evidence-based practice. 800w. due 12-5-23. 4 refence

unit_6_evidence_based_practice.docx.pdf

Unit 6 Discussion: Evidence-based practices

According to Hamilton et al., (2021), Evidence-based clinical practice guidelines bridge the gap between clinical practice and research, improve patient outcomes, promote consistency of care, and enhance quality of care; they are built on the findings of systematic reviews of available data regarding a specific topic.

Plan (P):

1. Insomnia:

Diagnostics: N/A

Therapeutic: start melatonin 5 mg at bedtime today and increased to 5 mg in 3 days for a maximum of 10 mg at bedtime.

Insomnia in patients with alcohol dependence has increasingly become a target of treatment due to its prevalence, persistence, and associations with relapse and suicidal thoughts, as well as randomized controlled studies demonstrating efficacy with behavior therapies and non-addictive medications such as melatonin. (Brooks,, & Wallen 20140

Educational :

1 Sleep hygiene

According to Majd et al., (2020), Any level of drinking has the potential to negatively impact sleep so introducing good sleep hygiene practices is often one of the first steps in treating insomnia. Sleep Hygiene refers to a variety of behaviors that promote sleep quality. (Majd et al., 2020) Sleep promoting behaviors include avoiding going to bed hungry or thirsty, avoiding stress and anxiety, avoiding physical activity before going to bed, preparing a bedroom that provides a relaxed environment, and limiting activities in the bedroom to sleep and sexual activities. (Majd et al., 2020)

2. Lifestyle modification: diet and exercise,

According to Hensley, R. (2018), the AACE/ACE guidelines recommend lifestyle therapy for patients who are overweight or obese. The lifestyle recommendations include a low-calorie meal plan, increased physical activity, and behavioral interventions which include self-monitoring of weight, food intake, and physical activity; clear and attainable goal setting; educational interventions on diet, nutrition, and exercise, aerobic exercise on a progressive course,

Collaborative: refer to dietitian if not losing 1-2 pounds a week for 3 months and

Follow up in 1 week for med adjustment if needed and to monitor for meds adherence,

2. Alcohol Use Disorder

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Diagnostics: Liver Function panel, CBC, CMP, urinalysis today, CBC, CMP weekly, urinalysis, lipid panel, liver function panel every 3 months.

According to Thoma,, (2021), WBC, RBC, Hgb, HCT are correlated negatively with alcohol misuse. As a result of these changes, anemia is a common finding in alcoholics. (Thoma,. 2020), Laboratory testing can assist in diagnosis, classify the severity of disease, and predict outcomes.

Therapeutic: start naltrexone 25 po today, and 50 mg po tomorrow as tolerated, increased to 50mg/day for a total of 100 mg po daily.

Educational: takes meds as prescribed and do not stop med abruptly.

Collaborative: refer to cognitive behavioral therapy for alcohol dependence, Refer to AA meeting.

Follow up in 1 week

References:

Brooks, A. T. & Wallen, G. R. (2014). Sleep disturbances in individuals with alcohol-related disorder: A review of cognitive behavior therapy for insomnia (CBT-I), and associated non- pharmacological therapies.

Hamilton et al., (2019). Factors affecting nurse practitioners’ integration of evidence into practice. JAANP. https://prx- herzing.lirn.net/MuseProxyID=mp01/MuseSessionID=6o324ds72/MuseProtocol.

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Unit6Evidence-BasedPractice.800w.due12-5-23.4refence.docx

Unit 6 Evidence-Based Practice. 800w. due 12-5-23. 4 refence

Initial Response

Instructions:

Consider the following questions in your initial discussion post:

· Review the partial SOAP note accessed through this link.

· EBP SOAP Note Download EBP SOAP Note Download EBP SOAP Note[Word Doc]

Initial Post

Post a discussion constructed as the ‘P’ (treatment plan) that completes the partial SOAP note accessed through the link above.

Include in the discussion:

1.

1. Your treatment "Plan" for the first two diagnoses (see note below on how to structure the ‘P’)

2. Citations for each of the evidence-based practice (EBP) interventions included in your Plan

3. For each article you cited in support of an element of the Plan, provide your thoughts about the strength of the evidence presented in the article(s)

Plan (P):

These are the interventions that relate to each individual, numbered diagnosis.

Document individual plans directly after each corresponding assessment (Ex. Assessment Plan). Address the following aspects (they should be separated out as listed below):

Diagnostics: labs, diagnostics testing - tests that you planned for/ordered during the encounter that you plan to review/evaluate relative to your workup for the patient's chief complaint

Therapeutic: changes in meds, skincare, counseling, include full prescribing information for any pharmacologic interventions including quantity and number of refills for any new or refilled medications.

Educational: information clients need in order to address their health problems. Include follow up care. Anticipatory guidance and counseling.

Consultation/Collaboration: referrals or consult while in clinic with another provider. If no referral made was there a possible referral you could make and why? Advance care planning.

NOTE: please input N/A where appropriate for the above 4 categories, do not assume that your clinical faculty person will know it was not applicable.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Peer Response

Instructions:

Please respond to at least 2 of your peer’s posts with substantive comments using the following steps:

· Construct a response – ideally one who utilized the same EBP interventions that you did and one who did not.

· Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.

· References and citations should conform to APA standards.

· Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.

· Plagiarism is never acceptable – give credit when credit is due - cite your sources.

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

Please review the rubric to ensure that your response meets the criteria. Collaboration points will be forfeited if you fail to meet the response post guidelines.

Please be sure to validate your opinions and ideas with citations and references in APA format where appropriate.