The aim of this paper is to formulate a PICOT question and describe how important this research question is to nursing practice. It will include a summary of five research articles related to my PICOT question and identify a nursing practice that is supported by current research. The paper will also explain how a nursing practice that is supported by evidence-based practice can contribute to better outcomes. Lastly, I will share a strategy to share evidence-based practice throughout my organization and explain the importance of the practice.
Alcohol abuse has become one of the principal causes of mortality and morbidity in the United States causing more than 200,000 deaths every year (Hendey, Dery, Barnes, Snowden, & …show more content…
Our organization uses benzodiazepines as the first choice for the treatment of AWS. Formulating a PICOT question can help my organization find if evidence best practice supports the use of benzodiazepines for the treatment of AWS. Therefore, I will introduce you my PICOT question which is: In patients that are withdrawing from alcohol, what is the effect of benzodiazepines, compared to other drugs in the treatment for AWS?
Evidence-Based Practice The study by Amato, Minozzi and Davoli (2011) examined five randomized controlled trials to find an efficient and safe medication to treat AWS. The study which had a total of 7333 patients concluded that benzodiazepines were better for controlling seizures when compared to a placebo and antipsychotics (Amato et al., 2011). When comparing benzodiazepines versus anticonvulsants, researchers concluded that the benzodiazepine chlordiazepoxide had better outcomes. No other studies were found which would compare the effectiveness among benzodiazepines for the treatment of AWS. The study by Askgaard, Hallas, Fink-Jensen, Molander, Madsen, and Pottegard (2016) compared how effective the antipsychotic phenobarbital is when compared to the benzodiazepine chlordiazepoxide. The study involved a total of 2428 patients who had AWS; 1063 patients were treated with chlordiazepoxide, and 1365 patients were treated with phenobarbital (Askgaard et al., 2016). Researchers
Alcohol use has spanned history. In fact, there is speculation that alcohol use actually preceded the formation of societies (Doweiko, 2015, p. 30). Thus, alcohol has long been a part of mankind’s life. The function of alcohol has unarguably changed throughout the course of history, as it was first used for nutritional purposes and then later on for religious purposes (Doweiko, 2015, p. 32). Today, alcohol serves a social purpose. In the United States, the prevalence of use is quite high, with just over 50% of the population partaking monthly (Doweiko, 2015, p. 34). This statistic is somewhat alarming considering alcohol use comes with a number of potential adverse consequences. Case in point, even
“Nearly 88,000 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States” ("Alcohol Facts and Statistics” 1). There need to be stricter federal requirements in detox facilities because someone who has an alcohol issue will deny it, an alcoholic will do anything to be released and get another drink, and repeated intoxication offenders and alcoholics are not capable of making their own decisions.
Discovering new information applicable to the field of nursing begins by asking a focused clinical research question. According to Stone (2002), asking the appropriate question is essential for the research process that follows. Although there are countless nursing problems that are worth investigating, it is imperative to narrow the focus of the problems so they can be empirically tested (Adams, 2012). Personal clinical experience, professional literature, previous research, and current nursing theories are a few examples of sources where research questions can be identified (Adams, 2012). The purpose of this paper is to explain the connection between research and evidence-based practice, discuss how
This paper will discuss how evidence based practice effects nursing practice and how nurses can apply what they learn to their practice. Evidence based practice is a great way to improve the quality of care we provide. “Evidence based practice means using the best available research findings to make clinical decisions that are most effective and beneficial for patients” (Chitty & Black, 2011, p.258). By allowing nurses to participate in research and development, we are able to see firsthand how effective our intervention can be. Nurses run into all kinds of problems on a daily basis and they are able to share their experience and expertise to help develop a better way to solve a problem.
Recent studies show that approximately fifty-three percent of adults in the United States have one or more close relatives that have drinking problems. Alcohol Abuse has cost the United States more than 220 billion dollars in 2005 alone. Problem drinkers are most often found in young adults between the ages of 18 and 29 years old, and the fewest in adults who are 65 years of age or older. Alcohol Abuse is one of the major risk factors for violence, and research shows that fifty percent of all homicides and forty percent of all assaults in the United States are alcohol related. In the United States, more than forty percent of the people who start drinking when they are fourteen years old or younger are more likely to become alcoholics than those who don’t. One in ten Americans, currently have alcohol problems.
According to the Dual Diagnosis website, “In 2012, as many as 87.6 percent of American adults over age 18 were reported in a SAHMSA…study to have consumed alcohol at some point in their lives…The National Institutes of Health…estimated that 17 million adults in the United States in 2012 had an alcohol use disorder” (“Disease…”). Approximately one in every 12 people either are abusing alcohol, or they are becoming, if not are, victims of alcoholism (National…). Alcohol consumption is especially known in our society’s culture. There are numerous people who like to drink every now and again in moderation; however, there are far too many people who abuse the alcohol and may even be completely dependent on it. Several
CBT stresses on the patient learning to view the triggering, or stressful situations from a different, more manageable perspective, and to use learned methods of relief that attempt to change the thoughts and behaviors that involves training the patient to detect internal and external stimuli that trigger anxiety and to apply newly learned coping skills that target the psychic and somatic symptoms of the disorder. The drawbacks to psychological therapy such as CBT stems from not only its limited availability, since few providers are trained in providing this type of mental health treatment, especially in rural areas, as but also from patient participation in the treatment. Psychotherapy is a gradual process which may take weeks to derive benefit. As such, many patients become unmotivated due to lack of immediate relief of symptoms. Pharmacotherapy via medications such as antidepressants or benzodiazepines is much more effective at relieving immediate symptoms with medications that have few adverse effects and a lower potential for abuse, though is not normally adequate at long term management of GAD. Combining psychotherapy and and pharmacotherapy is the ideal for improvement of symptoms and management of patients with GAD.The benzodiazepine antianxiety drugs relieve anxiety but should only be prescribed for 4 to 6 weeks because of the potential for abuse
The John Hopkins Nursing Evidence Based Practice Model (JHNEBP) has three phases that describe the practice question, evidence and translation (PET) for determining the practice problem finding evidence that supports change in current practice and than translating the new information into practice (Newhouse, Dearholt, Poe, Pugh, & White, 2012). The first phase, practice question, is developed used to develop an answerable evidence-based practice question that derived from the PICO mnemonic (Newhouse et al., 2012). The second phase of is conducting the research and finding the evidence to be used in implementation for change of practice. The PET process finds the evidence, makes an appraisal of the findings and provides recommendations for change in practice (Newhouse et al., 2012). The final phase is to determine if the information obtained in research is appropriate for implementing change in the current practice. The PET process within the JHNEBP Model can be used as a means for finding evidence, evaluating and synthesizing the information from the research and evaluating
Alcohol abuse is something that has affected countless lives, both mentally and physically. There are numerous disorders linked to this abuse, from Substance-Induced Anxiety Disorders to Alcohol-Induced Psychotic Disorder. These disorders have varying affects on the body and the person’s lives, and can cause serious injury and/or have serious side effects. A US Department of Justice study found that as many as 40% of violent crimes occur under the influence of alcohol. Of the 3.9 million Americans who received treatment for a substance abuse problem in 2005, 2.5 million of them were treated for alcohol use. Drinking alcohol to the point of dependence poses a severe health
Reducing the harm caused by alcohol is therefore a priority for the Government. Excessive consumption of alcohol is a major preventable cause of premature mortality with alcohol-related deaths accounting 1.2 million hospital admissions and around 15,000 deaths in 2010 to 2011.
The patient presented with persistent symptoms of depression, anxiety, and stress-related medical complaints. Alprazolam was recommended for anxiety. The patient has been taking Alprazolam for an extended period of time however, that exact duration of medication use in unclear. Dr. Curtis appealed a previously denied Alprazolam on 12/30/15. Dr. Curtis indicated that benzodiazepines could be used long-term for the treatment of severe persistent panic anxiety. However, the CA MTUS and ODG guidelines do not support the long-term use of this medication. Per ODG, antidepressants are more appropriate treatment for anxiety disorders. Medical necessity of Alprazolam 0.5 mg # 60 has not been established. Recommend non-certification. Non-certification
Alcohol has been a part of many people’s lives for centuries in America as well as crime. It may seem like a positive aspect of life to many individuals around the United States, but causes a burden on some people and may increase crime rates. Although many other drugs may have a more extreme effect on individuals, alcohol is still an addictive substance that plays a huge role in violent crimes. It is no coincidence that over a third of two million convicted offenders reported that they were drinking at the time of their arrest (NCAAD, 2015). Because alcohol is legal, all those of legal age have access to it almost anywhere at any time unlike other drugs which may be harder to access and be way more costly. Alcohol abuse has many severe consequences
Alcohol dependence is known to be the most severe form of alcohol abuse. A person becomes so dependent on alcohol consumption that he/she loses sight of all the other important things going on around him/her. Family matters and social responsibilities become secondary worries to his/her primary concern for existence, which is drinking (Stephens, 2007). Nearly fourteen million Americans are somewhat dependent on alcohol. Alcohol dependence is more prominent in men, and young adults ages 18-29 (Stephens, 2007). According to a study done by Saitz “85,000 deaths, along with substantial disability from medical and psychiatric consequences, injuries and “secondhand” effects (ex: motor vehicle crashes) are attributed to the use of alcohol” (Saitz, 2005).
Alcohol is one of many dangerous substances that effects our bodies. The effects of this drug can be very harmful. Alcohol is a potent non-prescription drug sold to anyone over the national legal drinking age, 21. Unlike other deadly drugs it is easy to access. This makes it easy to over-consume and create a tragic accident, even death. It can damage a person not only physically but also mentally and emotionally. Many people each year become more and more addicted to alcohol and soon experience all of it?s dangerous effects. Even if alcohol use is discontinued, some of these damages can not be cured, because the scars have been left on those that drink and those that surround them. The only hope
In the United States, 17.6 million people – about one in every 12 adults, abuse alcohol or are alcohol dependent. (NIH: National Institute on Alcohol Abuse and Alcoholism, 2012) The Mayo Clinic defines alcoholism as a chronic disease in which your body becomes dependent on alcohol (Mayo Clinic Staff, 2010), and indicates that more than 100,000 Americans die annually from alcohol related causes (Johnson) . Aside from the physical problems that alcohol addiction can create, there are frequently emotional and social complications. Alcoholism is a disease that harms not only the alcoholic, but also the co-workers and family of the alcoholic.