NCH Case Study

NICE (2014) defines its clinical guidelines as recommendations, which are systematically-developed, on how healthcare professionals should care for a condition or conditions of patient. On the best available evidence, these recommendations are based (NICE 2014). Grol (2010) emphasizes the fact that to improve patient care, efforts are being made on evidence-based guidance, which is one way to do this. NICE guidelines are developed with methodological rigour using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument (Rapu & Matthews 2014). This instrument was designed as to assess, across the spectrum of health, the quality of practice guidelines (Brouwers et al. 2010). Furthermore, it provides guideline development directions and gives information that should be contained in guidelines (Brouwers et al. 2010). Established above, it provides a structure

Once an area of evidence-based practice has been chosen for investigation, the reviewer must locate current evidence sources and, using a structured approach, assess each for applicability to the issue being investigated. The aim of this paper is to use a Rapid Critical Appraisal Checklist (Melnyk and Fineout-Overholt, 2011) to support these sources of evidence into a review that discusses the importance of daily, high-level, multidisciplinary communication and patient safety. The summaries of these evaluations will be provided as an appraisal of each study.

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

Slutsky, J. (2005). Using evidence-based guidelines: Tools for improving practice. In B. F.-O. Melnyk, Evidence-based practice in nursing & healthcare. A guide to best practice (pp. 221-236). Philadelphia, PA: Lippincott, Williams & Wilkins.

The purpose of a systematic review is to attempt to find, evaluate and synthesize high quality research relevant to the research question. A systematic review uses carefully developed data collection and sampling procedures that are put in place in advance as a protocol. (Polit, 2012). A systematic review must contain the following: a clear inclusion and exclusion criteria, an explicit search strategy, systematic coding and analysis of included studies, and a meta-analysis if possible. (Hemingway & Brereton, 2009). Systematic reviews are conducted by nurse researchers to avoid reaching incorrect or misleading conclusions that

Experience with EBP: Evidence-based practice plays a crucial role in the quality of patient care. When care is performed based upon evidence opposed to outdated textbooks, instinct, tradition, or colleagues influence (Beyea & Slattery, 2006). The average nurse is currently more than forty years of age, without the frequent education upon new topics, many nurses’ knowledge has become outdated. As new textbooks are not published yearly or often times not kept up to date within facilities, they do not serve as reliable sources of

Evidence base practice is essential in nursing practice. It incorporates 3 key components which are clinical expertise, patient values, and best research evidence in order to provide the most effective and safe decision making for patient care. Neglecting a key component can affect the accuracy and efficiency of a research. Clinical expertise is based on a clinician’s experience, skill, education level and understanding in a certain area of nursing practice. Patient values can impact evidence base practice depending on their needs, preferences, expectations, values, understanding, and concerns. Best research evidence can be obtained from clinical research with supporting evidence base literature and sound methodologies. Each component will be discussed in further detail and how it links to clinical decision making by registered nurses in order to achieve the best evidence-based practice available.

The principle of treatment therapy is to helping the patients to reduce problematic drinking, deterring relapse back to heavy drinking and achieving and maintaining abstinence from alcohol (Edmunds, 2014). An oral naltrexone (ReVia) or injectable Vivitrol, Acamprosate and Disulfiram are used for the treatment of alcohol abuse (Edmunds, 2014). Disulfiram are used more often if unpleasant physical symptoms when alcohol is ingested but is reported to be more expensive and have reported to have adverse reaction to the patients (Edmunds, 2014). Benzodiazepines such as Lorazepam and Diazepam are also widely used for treatment of alcohol withdrawal. With the side effects and overdosing of benzodiazepines remains controversial in treating alcohol withdrawal and is always in need to monitor the patient for abuse (SAMHSA, 2013). Additionally, social detoxification and lifestyle management would benefit the whole treatment process such as referring the patient to social support groups and encouraging the family to support the patient during the treatment

The National Guideline Clearinghouse provides information on clinical practice guidelines and the US Preventive Task Force provides recommendations for screenings and counseling based on the patient’s gender, age, race, etc. Both supply information for disease prevention and evidence based clinical practices that providers can use daily while caring for their patient. The recommendations and guidelines that are provided on the AHRQ website are ever evolving as new information becomes available thus allowing providers to keep up with current practice. The days of providing care based on “this is how it has always been done” are gone. The AHRQ guidelines and recommendations is the go-to website for medical providers looking to provide best care for their patients by following evidence based

Evidence Based Practice is crucial to support care provided to patient. It is imperative to get evidence base on proven clinical practice that provides valuable insights about human health and illness as per Polit and Beck (2017). The researcher must pick a topic to be research on and A PICOT question formulated. These questions help as a guidance on the research. The researcher then check to see what can be retrieve that are of importances to topic. In most case narrowing of the questions may help. The levels of evidence are important because it help with identifying hierarchy of evidence. The higher the Hierarchy of evidence the better evidence base information.

For the literature review an electronic search was undertaken of articles published in English using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed and Cochrane databases from 2009 to 2013 were searched for medical subject heading terms, both individual terms and combination of the following

2. The previous NCOER NCOIC departed unexpectedly two months ago due to a compassionate reassignement, and he was out the majority of the previous sixty days prior to his departure due to medical and personal issues. As such, the corrections the battalion CSM required on the NCOERs were not done and the NCOERs were not processed in a timely fashion.

Is the information accurate and referenced to a scholarly nursing or medical resource? If not referenced, compare the information to a current journal or book on the topic.

Clinical practice guidelines (CPG) are designed to improve the quality of healthcare services, decrease unwanted, ineffective and harmful interventions for patients. CPG are used to facilitate treatments for each individual patient’s by maximizing the benefits, minimizing the risk of harm and obtain treatment with an acceptable cost. Researchers had proven that CPG is a bridge for change and improving health outcomes. The effectiveness of CPG is perceived to be helpful in clinical decision making. CPG are developed to assist healthcare providers such as doctors and nurses in decision making for specific clinical outcomes (Vlayen, et. al. 2005)

Evidence-based practice (EBP) in nursing means making decisions about patient care on the basis of best, current, standardized practice and guidelines. According to an article, written by Dr. Kathleen Stevens, the development of evidence-based practice (EBP) is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care (Stevens, 2013). The author also mentioned in her article that the intended effect of EBP is to standardize healthcare practices to science and best evidence and to reduce illogical variation in care,