Thursday, March 6, 2014

HGT1 Community Health Nursing

My Practicum can be viewed in my other blog Vickie Views

I choose Disaster Preparedness. Living in Florida and working at a coastal hospital for over 20 years as both a LPN and a RN, I volunteered on our team. We had mock disasters from train derailments, chemical spills, hurricanes, and plane crashes. I had fun practicing setting up decontamination tents and putting on the "zoot suit". Thankfully I never had to use what I learned in real life.
I hope this helps demonstrate the format required in the paper.

EBT1 Task 2 Research Integration

EBT1 Task 2 Research Integration
Victoria Hart
Western Governors University

A. Review of the Sources of Evidence
Name of Source Author
A1. Types of Sources of Evidence
A2. Appropriateness of Sources of Evidence

A3. Classification of Sources of Evidence

In text citation
Classify the type of each source of evidence as either a general information resource, a filtered resource, or an unfiltered resource.
Discuss whether each source of evidence is appropriate for this nursing practice situation.
Classify each source of evidence as primary research, evidence summary, evidence-based guideline, or none of these.
("Diagnosis and management," 2004)
This source is a filtered resource as it identifies a question of whether to wait to treat acute otitis media or to initiate antibiotic therapy immediately.
This source is appropriate for this nursing practice situation. It is peer reviewed and received formal approval by partnering organizations. This study is data 2004 therefore a more current source may be of value to support of dispute the recommendations and opinions of this guideline.
This source is an evidenced based guideline.
(Block, 1997)
This is a filtered resource as the author identifies the problem of resistance to antibiotic therapy and provides a summary of the most effective course to therapy.
This source is inappropriate for this nursing practice. It is dated 1997, the research is not current however the results support the trend of the resistance to antibiotics in causative organisms. There is no research on waiting to initiate treatment
This source includes primary research and an evidence summary
(Kelly, Friedman & Johnson, 2007)
This source is general information as it is from a textbook.
This is an appropriate source for the practice as it provides the background information to explain the practice guideline.
This source is an evidence-based guideline
(McCracken, 1998)
This source is a filtered resource as it contains information that can help decide a course of action in response to a problem.
This is an appropriate source for the practice as it provides research data and information to explain the potential evidence practice guideline.
This source is a primary source.
Interviews are general information.
Interviews are appropriate as they provide the current beliefs of the parents of the children being treated in the clinic. It is important to evaluate this source to determine how implementation will be achieved.
This source is a primary. It is research conducted by the clinic staff.

B1. Watchful Waiting
Watchful waiting is an appropriate approach for treating children under certain conditions base on the article “Clinical Practice Guideline”. This article gives the evidence-based statement that allowing 48-72 hours before prescribing antibiotics is an option to be considered by clinicians. Included in this study are children up to age 12. The observation option applies to the children greater than age 2, without other chronic illnesses or anatomic abnormalities. The recommendation was based on placebo controlled trails that spanned 30 years. This article includes results the AHRQ evidence-report, the Dutch College of General Practitioners guidelines, and a randomized trial in the United Kingdom as part of the evidence in making the recommending. In conclusion it is imperative to ascertain the history of acute onset, to identify signs of middle ear effusion or inflammation, the child must be within the appropriate age, the severity of the illness must be considered and an assurance of follow-up obtained ("Diagnosis and management," 2004).
C. Application of Findings
The process of applying the findings in “Diagnosis and management of acute otitis media” into practice would include education of the clinical staff. A team to implement the change should be created, a team leader should be appointed to help educate and gain acceptance of the evidenced-based guideline. This includes education of the entire staff and cliental. The physicians must agree to the change. A pilot group should be formed to implement the new guidelines; this will allow for adjustments or added education to be put into place. Collect benchmarks of current success rates and re-occurrences of acute otitis media (AOM) to compare with the EBG once implemented. Rolling out new treatment recommendations in increments will make it easier for the staff and clients to adjust and accept the change; it will also provide the opportunity to make any necessary adjustments. Communicating the change and the rationale to the parents of the children affected by the practice will gain their support and understanding providing compliancy with follow-up evaluation. A policy outlining criteria to be implemented will solidify the change as a standard of practice within the organization. (Titler, M.G., 2008)
D. Ethical Issues
The three main ethical concerns of research studies are autonomy, beneficence, and justice. Autonomy recognizes the participant is capable of giving informed consent. This includes a thorough explanation of the benefits and risks. Beneficence includes protecting the participant’s privacy and confidentiality, providing information that may arise during the course of the study to protect or prevent harm and maintaining the safety of the participant. Justice provides compensation for the participation in the study in the event they were in a group that did not receive the best treatment or in the event that their condition worsened as a result of the study. (Callahan & Hobbs, October)
D1. Issues
Vulnerable populations include various ethnic groups, the elderly, prisoners, handicapped individuals, mentally ill or handicapped, prisoners, women, poverty stricken and children. It is required that information is presented in a language that is understandable to them. Confidentiality must be guaranteed, they have the right to refuse or withdraw from the study at anytime. Any questions that are asked by them must be answered in a manner that they understand. Under no circumstances may they be harmed or exploited. (Gaines, 2006)