Part -1: Discuss responsibilities of the nurse, related to health promotion, risk factors and disease management.
(a) How does the nurse use nursing process to plan care in promoting health, risk reduction and disease management?
(b) Explain the benefits of using evidence- based practice in planning care.
(c) Discuss strategies for including evidence -based practice in planning care.
Part- 11: Choose a disease and compare the evidence based pathophysiology; diagnosis and treatment applied to two different age groups.
(a) Explain the pathophysiology and etiology of the disease, including impact of age.
(b) Examine the impact of age on risk factors.
(c) Differentiate between the diagnostic processes for the two age groups.
(d) Compare treatment of the disease based on age, using scientific evidence based information.
(e) Explain how the nurse uses evidence-base information to manage care; reduce risk factors and collaborate on diagnostic treatment processes of the disease. Discus how age impacts care.
Evidence based practice has developed into a very important aspect of nursing science today. It is no longer just learning theory of and applying it to patient care, but rather conducting scientific research and transmitting findings to improve nursing care generally. In this document the writer will explore the value of evidence based practice and the role of the nurse in making thei transition a reality as well as examining diabetes mellitus between two age groups from an evidence based perspective.
Nursing: Evidence Based Practice Paper-Pathophysiology
Part -1: Discuss responsibilities of the nurse, related to health promotion, risk factors and disease management.
(a) How does the nurse use nursing process to plan care in promoting health, risk reduction and disease management?
The updated evidence- based perspective regarding nursing process being advanced by the American Nurses Association embraces the paradigm that it is a common thread which binds nurses internationally since implementation of an evidenced- based approach in planning care, promoting health, reducing risks and disease management is its main focus (American Nurses Association, 2012).
As such, integrating each step into planning allows the nurse to demonstrate scientific expertise as a professional. Each stage of the nursing process has its district role in promoting health, reducing risks and enforcing disease management. For example, the initial assessment protocol implies that the ABC technique is always a strategy to adopt. This is instituted by checking airway potency; evaluating breathing capacity and establishing that the client circulation is adequate to sustain life.
Precisely, assessment and diagnosis precede planning which is in itself an element of the nursing process. Therefore, in planning effectively aimed at health promotion; risk reduction and disease management; the nurse must be articulate and develop critical thinking skills to make accurate assessments for arriving at the most appropriate nursing diagnoses.
In Lunney’s (2009) evidence -based approach towards nursing diagnosis actual diagnosis is followed by risk diagnosis. Thirdly, comes health promotion diagnosis. He suggests that the nurse employ critical judgments in making an effective nursing diagnosis (Lunney, 2009).
Importantly, actual diagnoses inform the health team concerning what the patient is experiencing at the time or the evidence of an impending condition. Risk diagnosis determines factors that can either contribute towards the spread of the health issue or allow it to display combined effects with associating ones.
In making a health promotion diagnosis the aim is to create a critical judgment based on the actual and risk diagnoses ways to expedite recovery of the client to full health status. Syndrome diagnoses are a set of symptoms and signs demonstrated by the client that cannot be classified as a single event, but characterized by an association of features.
Explain the benefits of using evidence- based practice in planning care.
Evidence- based practice is planning and rendering care from the standpoint of proof derived through research findings. These results are then used when nurses are make decisions regarding assessment, nursing diagnosis; planning; implementation and evaluation of patients’ care (Duffy et.al, 2008).
The benefits are immense. Primarily, it creates the scientific constituent of nursing practice. There are no guessing or non empirical judgments as it relates to executing the nursing process. Nurses have supporting foundation which informs every step of the process. Before evidence- based practice there was a situation of trial and error. Hence, the great benefits of integrating evidence- based practice in twenty-first century planning model many errors can be detected and remedied before hand. Duffy et.al, 2008).
(d) Discuss strategies for including evidence -based practice in planning care.
Strategies that can be employed when planning care utilizing evidence-based practice according to Marita Titler (2008) embody ‘several translation science principles.’ These include considering the context into which the research evidence could be applied to the particular planning model. Further, it would necessitate inclusion of health care personnel who operate at the point of care to directly select and prioritize relevant client safety initiatives while circulating this evidence within the healthcare network (Titler, 2008).
Next it would require illustrating the evidence for staff to understand and grasp the importance for its application in planning patient interventions. Another important aspect involved in the translation science principle is having health care organizations invest resources to inculcate an evidence based planning care culture. Evaluating benefits to the patient’s safety must always be addressed in assessing response to this new intervention (Titler, 2008)
Part- 11: Choose a disease and compare the evidence based pathophysiology; diagnosis and treatment applied to two different age groups.
(a) Explain the pathophysiology and etiology of the disease, including impact of age.
The disease condition chosen in this comparative evidence- based pathophysiology discussion is diabetes mellitus. Consistent research has shown where this disease is mainly nutritional and considered an endocrine disorder affecting the beta cells in the islets of langerhans located in the pancreas. Evidence- based research has advanced two assumptions for diabetes mellitus. It is ether that insulin which is produced by the pancreas is insufficient or does not store glucose due to some defect in its chemical composition (Wild et.al, 2007).
Hence, further assumptions derived from studies posit, that there are three major types of diabetes occurring in humans. They are classified as Type 1; Type 11 and gestational diabetes.
The pathophysiology pertaining to these three are similar except for gestational diabetes where pregnancy hormones could produce alterations in pancreatic functions resulting in diminished insulin production (Wild et.al, 2007).
In explaining types 1 and 11 diabetes the inference between age related diabetic is drawn. Type 1 diabetes is usually referred to as juvenile diabetes since this affects the younger age group below 40 -45 years of age. Evidence-based research has revealed the pathophysiology of type 1 diabetes indicates that the insulin produced by the body is not capable of storing glucose and is usually referred to immune mediated or idiopathic diabetes; whereas in type 11 the pancreas is not producing insulin in enough qualities for adequate storage of glucose. (Wild et.al, 2007).
The etiology of diabetes mellitus varies with age group and gender. The type 11 affecting older adults is directly related to diet and obesity; whereas Type 1 or juvenile diabetes arises from pancreatic diseases or just pancreatic dysfunction. Gestational diabetes occurs due to a pregnancy (Wild et.al, 2007).
(b)Examine the impact of age on risk factors.
The risk factors for diabetes can be classified from evidence- based research as the complications of diabetes. Recent studies in Germany conducted by Pediatrics Diabetes revealed that there is a low incidence of children between the ages of 0-20 affected by type 11diabetes (Nue et.al., 2009). While this is a rare occurrence globally, it is relevant evidence -based knowledge for twentieth century intervention regarding risk factors and the impact of age in disease.
Further, studies have shown where younger people affected by the disease are at higher risk of complications at an earlier age as well as dying than those with a type 11. Reasons tendered from evidence are that they are often insulin dependent; especially, children have always to be monitored by parents since they may not remember to take their shots (Nue et.al., 2009).
(c)Differentiate between the diagnostic processes for the two age groups.
Diagnostic procedures for diabetes classified as juvenile –Type 1 and type 11 predominant, are similar and different in some sense. Evidence based research has discovered that adolescence are now developing type11. Therefore, diagnostic processes vary with age and more importantly, the type for which a provisional diagnosis was made.
In adults the diagnostic procedures include evaluating for signs and symptoms of the condition which are characterized by thirst, frequency in urination, hunger, and unexplained weight loss in adults. Studies have revealed that children when evaluating symptoms they may not even recognize how their bodies are depreciating and there are many other factors which ought to be ruled out before a clinical judgment is arrived at. Adolescents, especially, might be on drugs and involved in activities which affect their metabolism. As such, screening would go beyond fasting glucose plasma, glucose plasma and glycated hemoglobin towards a thorough pancreatic and metabolic rate evaluations. Importantly, the C- peptide assay is an evaluation conducted for differentiating type 1 diabetes from type 11(Wild et.al, 2007).
(d)Compare treatment of the disease based on age, using scientific evidence based information.
Treatment for diabetes has evolved over the years into a dynamic scientific inquiry. Evidence- based research has proven where various interventions such as predictable cures through eating raw beside numerous insulin administrations have become the mode of treatment. Insulin pumps usage have gained momentum as a sure device to instill continuous insulin for patients whose Type 1 diabetes requires this method of replacing the hormone (Bluestone et.al, 2010)
According to Bluestone ‘s studies (2010) since most young people are affected with type 1 diabetes they are the ones who use pumps and insulin as the primary treatment. While it is true that all treatment for diabetes must continue indefinitely children have no choice since the pancreas does not produce insulin that can be used by the body. Studies have shown where adults on the other hand once they can control their diet and weight it is possible for them to be taken off of insulin therapy and oral diabetic agents as well (Bluestone et.al, 2010)
(e) Explain how the nurse uses evidence-based information to manage care; reduce risk factors and collaborate on diagnostic treatment processes of the disease. Discuss how age impacts care.
Evidence based information as espoused in this document can be disseminated using scientific transmission principles. Once a culture of evidence based practice has been established whereby new discoveries in the management of diabetes in adults are acknowledged then, contemporary assessment, diagnosis, planning, implementation and evaluation techniques are adopted.
Managing care is an organizational responsibility regarding evidence based intervention. This cannot be undertaken by single nurse in isolation, but from the level of administration. Hence, once systems embodying evidence based practices have been implemented then the nurse simply complies and a new conception of managed care; risk reduction and collaborative diagnostic treatment will be practiced
Certainly; the age impact will have to be considered since children and young people require a different approach towards care and the risk factors for diabetic complications in youths and adolescents are more severe from research investigations. As such, separate intervention will have to be designed based on the age factor.
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