Using personal experiences or based on talking with others in the profession, discuss an accreditation experience that you had. What was your involvement? Were you and the facility prepared? How did the visit turn out – did you gain/keep the accreditation? What could management have done differently to make the process go more smoothly?

Discussion- Presentation of Epidemiological Problem A

This week you will share your findings from your problem paper. You will write up an abstract summarizing your findings. Your abstract should consist of 100 to 500 words. Keep in mind that an abstract should summarize your research, including its key themes and problems and providing your major conclusions.

Sample

The global epidemic of obesity is a significant concern in the United States. Obesity is a preventable chronic medical disease that is increasing in prevalence worldwide. It is defined as the “weight that is higher than what is considered as a health weight for a given height” (CDC, 2016). In the U.S., more than one third of adults are obese. Globally in 2016, more than 1.9 billion adults were overweight and over 650 million were obese. In the state of Florida, 36% of adults are overweight and 26.2% of adults are obese (CDC, 2016).

     Obesity is a multi-factorial condition. There are many causes that contribute to obesity, which are also often associated with many other significant diseases. Some causes include behavioral, genetic, hormonal, environmental, and social factors. Other diseases associated with obesity include diabetes, hypertension, high cholesterol, stroke, depression, and coronary heart disease (Mayo Clinic, 2018). To determine obesity, Body Mass Index (BMI) is used as a measuring tool to calculate ones body fat. A BMI of 25.0 or above is considered overweight and 30.0 or greater is considered obese.

     Due to the high medical costs in the U.S., health care providers should screen all adults for obesity and assess risk factors such as family history, diet, and physical activity specific for every individual. As a future Family Nurse Practitioner (FNP), screening and prevention of obesity should be considered a priority. Evidence based strategies should be implemented to treat and prevent obesity by providing patients with community resources, developing a plan based on daily caloric intake, increasing physical activity, and utilizing a daily diary to reach certain goals.

     Obesity is a complex public health issue. With the right policies, strategies, and collaborative efforts involving governments, media, health care providers, and individuals, the growing obesity epidemic can change.

Reference

Centers for Disease Control and Prevention (2016). Overweight and obesity. Retrieved from http://www.cdc.gov/obesity.adult/defining.html (Links to an external site.)Links to an external site.

Mayo Clinic. (2018). Obesity. Retrieved from http://www.mayoclinic.org/disease-conditions/obesity/symptoms-causes/syc-20375742 (Links to an external site.)Links to an external site.

  

Please READ the COMPETENCES at the end.

Create a one-page patient education tool that explains usage of a medication and factors that can affect outcomes. 

Then, write 2–3 pages in which you explain how the tool promotes patient safety and quality outcomes, and adheres to the principles and practices of cultural competence.

Assessment Instructions 

Imagine your supervisor has asked you to develop a patient education tool for new medication starts in your current area of practice. This tool needs to provide important information to the patient, yet be concise enough to require no more than one page.

Preparation

Review the suggested list of possible topics in Part 1 of the Requirements and then search the Internet for supporting resources. You will need to provide support for the information you choose to include in the patient education tool.

Requirements

Complete both Part 1 and Part 2 of this assessment. You may submit both parts in one document or submit them as separate documents. Be sure you complete both parts!

Submit a total of 4–5 pages. Write no more than one page for Part 1. Write 2–3 pages, plus a separate reference page, for Part 2.

Part 1: Patient Education Tool

Complete the following:

1. Choose one of the following topics as the basis for your patient education tool: 

o Antibiotics (Amoxil/Amoxicillin) for pediatric ear infections.

o Statin therapy (Zocor/Simvastatin) for a newly diagnosed patient with hypercholesterolemia.

o Antihypertensive (ACE inhibitors/Lisinopril/Zestril) for a patient who was discovered to have hypertension at a health screening at work.

o Drugs for treating gastric acidity (Proton pump inhibitors/antacids/H2 blockers) for a patient complaining of chronic indigestion and heartburn.

o Ear drops or eye drops (or both) for an elderly patient.

o Any newly released medication for a patient in your area of practice. This might be a new drug for diabetes, hypertension, or arthritis or a new antibiotic.

2. Include the following in your patient education tool: 

o Explain appropriate use of the medication.

o Identify specific factors (age, access, culture, and so on) that may affect the efficacy of the medication.

o Describe possible chemical interactions, side effects, or other negative reactions patients need to be aware of.

o Explain correct handling, storage, and disposal of the medication.

o Include any other information you feel would be beneficial and promote patient safety and quality outcomes.

You may format Part 1, the patient education tool, any way you wish, but be sure it is logical and understandable by the typical patient who would use it. Feel free to include pictures or diagrams to reinforce the information.

Part 2: Evidence-Based Practice

Provide evidence for the information you included in the patient education tool:

· Explain how the information in the patient education tool promotes patient safety and quality outcomes.

· Explain how the patient education tool adheres to the principles and practices of cultural competence. In other words, is the tool appropriate for all cultures, genders, ages, et cetera; or could it be easily adapted for specific needs?

Format Part 2 according to APA guidelines. This is not a document you would provide to a patient but, for this assessment, it will provide faculty with the academic and professional principles necessary to evaluate your work.

Additional Requirements

· At least 2 current scholarly or professional resources.

· For Part 2 only: 

o Use Times New Roman font, 12 point, double-spaced font.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

· Competency 1: Apply practice guidelines and standards of evidence-based practice related to pharmacology for safe and effective nursing practice. 

o Explain the appropriate use of a medication.

o Explain how a patient education tool promotes patient safety related to pharmacology.

· Competency 2: Explain the relationship between quality patient outcomes, patient safety, and the appropriate use of pharmacology and psychopharmacology. 

o Identify specific factors that may affect the efficacy of a medication.

o Describe possible chemical reactions, side effects, or other negative reactions a patient may experience from a medication.

o Explain correct handling, storage, and disposal of a medication.

· Competency 3: Apply the principles and practices of cultural competence with regard to pharmacological interventions. 

o Explain how a patient education tool adheres to the principles and practices of cultural competence.

· Competency 4: Communicate in a manner that is scholarly, professional, and consistent with the expectations of a nursing professional. 

o Write content clearly and logically with correct use of grammar, punctuation, and mechanics.

o Correctly format paper, citations, and references using current APA style.   

nces using current APA style. 

  

4-Evidence Based Practice (EBP) is a problem-solving approach to clinical decision-making within a health care organization. It integrates the best available scientific evidence with the best available experiential (patient and practitioner) evidence. EBP considers internal and external influences on practice and encourages critical thinking in the judicious application of such evidence to the care of individual patients, a patient population, or a system. The level of evidence are as follows:

Level I
 Experimental study, randomized controlled trial (RCT)
Systematic review of RCTs, with or without meta-analysis

Level II
 Quasi-experimental Study
Systematic review of a combination of RCTs and quasi-experimental, or quasi-experimental studies only, with or without meta-analysis.

Level III
 Non-experimental study
Systematic review of a combination of RCTs, quasi-experimental and non-experimental, or non-experimental studies only, with or without meta-analysis.
Qualitative study or systematic review, with or without meta-analysis

Level IV
Opinion of respected authorities and/or nationally recognized expert committees/consensus panels based on scientific evidence.
    Includes:
         – Clinical practice guidelines
         – Consensus panels

Level V
 Based on experiential and non-research evidence.
    Includes:
      – Literature reviews
      – Quality improvement, program or financial evaluation
      – Case reports
      – Opinion of nationally recognized expert(s) based on experiential evidence.

According to U.S Department of Health and Human services, Evidence Classification Scheme for a Diagnostic Measure include:

Class I: A prospective study in a broad spectrum of persons with the suspected condition, using a ‘gold standard’ for case definition, where the test is applied in a blinded evaluation, and enabling the assessment of appropriate tests of diagnostic accuracy

Class II: A prospective study of a narrow spectrum of persons with the suspected condition, or a well-designed retrospective study of a broad spectrum of persons with an established condition (by ‘gold standard’) compared to a broad spectrum of controls, where test is applied in a blinded evaluation, and enabling the assessment of appropriate tests of diagnostic accuracy

Class III: Evidence provided by a retrospective study where either person with the established condition or controls are of a narrow spectrum, and where test is applied in a blinded evaluation

Class IV: Any design where test is not applied in blinded evaluation OR evidence provided by expert opinion alone or in descriptive case series (without controls).

References

Agency for Healthcare Research and Quality. (n.d.). Agency for healthcare research and quality: a profile. Retrieved December 3, 2018, from https://www.ahrq.gov/cpi/about/profile/index.html

Winona State University. (2018). Evidence based practice toolkit. Retrieved December 3, 2018, from https://libguides.winona.edu/ebptoolkit

 

 
 

5-Evidence based medicine uses evidence to make clinical decisions. There is a hierarchal system for classification of evidence. This hierarchy is known as the levels of evidence. Physicians are encouraged to find the highest level of evidence to answer clinical questions (Barnes, Rohrich, & Chung, 2012, p. 305). The higher the level the more strength the evidence has. Randomized controlled trials (RCT’s) are the strongest research designs for treatment or intervention studies because they exert the most control over the methods and the results are considered more trustworthy (Thomas, 2017). It is important to note that a high level of evidence for a treatment study may not be the highest level of evidence for a study for prognosis. The strongest levels of evidence are at the top of the hierarchy. Some examples put concepts into  practice from the different levels of evidence that may include practice alerts for revising current policies and instituting new practices.

• Meta-Analysis  A      systematic review that uses quantitative methods to summarize the results.
• Systematic      Review         An article in which the authors have systematically searched for,      appraised, and summarized all the medical literature for a specific topic.
• Critically      Appraised Topic          Authors of critically-appraised topics evaluate and synthesize multiple      research studies.
• Critically      Appraised Articles  Authors of      critically-appraised individual articles evaluate and synopsize individual      research studies.
• Randomized      Controlled Trials  RCT’s include a randomized      group of patients in an experimental group and a control group. These      groups are followed up for the variables/outcomes of interest.
• Cohort      Study       Identifies two groups (cohorts) of patients, one which did receive the      exposure of interest, and one which did not, and following these cohorts      forward for the outcome of interest.
• Case-Control      Study       Involves identifying patients who have the outcome of interest (cases) and      control patients without the same outcome and looking to see if they had the      exposure of interest.
• Background      Information / Expert Opinion   Handbooks,      encyclopedias, and textbooks often provide a good foundation or      introduction and often include generalized information about a      condition.  While background information presents a convenient      summary, often it takes about three years for this type of literature to      be published.
• Animal      Research / Lab Studies  Information begins at the      bottom of the pyramid: this is where ideas and laboratory
       research takes place. Ideas turn into therapies and diagnostic tools,      which then are tested with lab models and

References

Barnes, P. B., Rohrich, R. J., & Chung, K. C. (2012, July 1). The Levels of Evidence and their role in Evidence-Based Medicine. Plastic Reconstructive Surgery, 128(1), 305-310. https://doi.org/doi:  [10.1097/PRS.0b013e318219c171]

Thomas, C. J. (2017, May 23). What Does “Levels of Evidence” Mean in Evidence-Based Practice? Nursing Education Expert. Retrieved from https://nursingeducationexpert.com/levels-of-evidence/

 

6-In attempting to prove the accuracy of a case study or other
investigation, various levels of evidence are utilized in associating well
reputed and accurate sources and data collection methods (Petrisor & Bhandari,
2007). These evaluations grade the overall validity of the study, and help to
show whether or not the evidence is accurate in its findings (Petrisor &
Bhandari, 2007). These levels of evidence are generally seen on seven levels,
with the first being the most valid and the seventh being the least valid. The
first level is gathered through a systematic review of randomized control
trials (RCT), and due to the wide range of its data is the most accurate and
can be used as a basis for broad changes in practice methods (Burns, Rohlich
& Chung, 2011). The second level is gathered through a single RCT that
could be applied to a wide range of practice changes, such as determining intervention
method effectiveness (Darrell W. Krueger Library, 2018). The third level of
evidence is similar to the second, but the participants to groups are not
assigned randomly. This form of evidence can be used in detecting extraneous
variables in a study by examining a particular factor (DWKL, 2018).

           The fourth
level of evidence consists of cohort and case-control studies which compare two
different outcomes between similar studies retrospectively, such as those with
and without a disease to determine outcomes. The fifth and sixth levels relate
to descriptive and non-quantitative studies, with the fifth level examining
numerous studies, and the sixth only examines one (DWKL, 2018). These studies
can be used to describe personal experiences. The final level of evidence is
based off of expert opinions, which are worth exploring for new ideas, but not
scientifically valid (DWKL, 2018).

References

Burns, P. B., Rohrich, R. J., &
Chung, K. C. (2011). The levels of evidence and their role in
evidence-based medicine. Evidence-based Medicine Toolkit, 128(1),
94-96. doi:10.1002/9780470750605.ch15

Darrell W. Krueger Library. (2018, September 18). Evidence based
practice toolkit. Retrieved from
https://libguides.winona.edu/c.php?g=11614&p=61584

Petrisor, B. A., & Bhandari, M. (2007). The
hierarchy of evidence: Levels and grades of recommendation. Retrieved from
www.unm.edu/~unmvclib/cascade/handouts/PICOTpyramidofevidence.pdf