Integration of Evidence-Based Practice in Nursing - Free Essay Example

Sample details Pages: 3 Words: 1036 Downloads: 6 Date added: 2017/09/24 Category Advertising Essay Type Narrative essay Did you like this example? | Introduction On a daily basis health care professionals are confronted with difficult questions and situations while caring for patients. They want to know how to interpret diagnostic test accurately, how to predict the prognosis of a patient, and how to compare the effectiveness of therapeutic intervention. As health care professional we are challenged to stay familiar with any new information regarding health. This allows us to give our patients the highest quality health care available. This is where Evidence-Based Practice is important. It is defined as the integration of the best systematic research evidence with clinical expertise and patient values. The intent of this presentation is to look at the pros and cons of Evidenced-Based Practice, how nursing schools need to teach it to their students, how nursing management can incorporate it to their employees and how it can work for patients with pressure ulcers. PROS AND CONS OF EVIDENCE-BASED PRACTICE Evidence-Ba sed Practice is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of patients, (1) It involves integrating the individual clinical expertise of the physician or nurse with the best available external clinical evidence for systematic research and individual patient preferences, (2) Research shows that patients’ outcomes are at least 28% better when clinical care is based on evidence rather than the tradition common sense (Bryan-Brown, 2006). Opponents of Evidence-Based practice argue that the use of it can potentially nurses to be less autonomous and it is â€Å"responsible for the suppression of the innovation and creativity† (Walsh, 2010 p. 27) There have been barriers to Evidence-Based Practice implementation identified as the time it takes to research evidence, limited team cooperation, and staffing levels. Also, for nurses in rural areas, they are less likely to hear about new research for evidence based p ractice. Often it is the nurses in the larger medical centers that participate in the research or have the information easily obtainable. Fortunately, the research on the benefits of Evidence-Based Practice are abound. Data is collected over a period of time targeting a particular audience. Quantitative and qualitative research is gathered by research groups. There are two mnemonics to remember when conduction quantitative and qualitative research: For quantitative research, PICO stands for: 1. Patient population, 2. Intervention, 3. Comparison group and 4. Outcome. Alternatively, the mnemonic SPICE stands for: 1. Setting, 2. Perspective, 3. Intervention. 4. Comparison group and 5. Evaluation. Ideally, once qualitative and quantitative integration occurs, qualitative metasynthesis takes place and more definitive interpretations of the study can be incorporated (Broeder Donze, 2010 p. 199). TEACHING EVIDENCE-BASED PRACTICE Ferguson and Day (2005) emphasized that nursing facult y are incorporating Evidence-Based Practice by helping students increase their skills in accessing and analyzing the most relevant evidence to support their beginning nursing practice. Nursing faculty can help students recognize the importance of current research evidence. Erikson-Owes and Kennedy (2001) emphasized that an evidence based nursing approach is a learned skill for both the student and the clinical educators that requires intellectual curiosity to explore beyond â€Å"the way it has always been done† (p. 137). Students need to be able to enhance their evidence-based knowledge through guided research questions, systematic searches, reading and critiquing the strength of the evidence, synthesizing the evidence and preparing the evidence based on recommendations. Leadership Responsibilities The phrase, â€Å"Knowledge of Power† applies to the responsibility nursing leaders have to empower their staff. Leaders need to have their staff, â€Å"think outsid e the box†. When this is done effectively, nursed begin to question whether there is a better way to deliver patient care and a â€Å"culture of inquiring is born† (Halm, 2010 p. 377). Nursing leaders need to be a role model and collaborate with their staff regarding implementation of Evidence-Based Practice. If we remain â€Å"inside (the box) looking in†, evolution of the nursing profession will be hindered and patient outcomes will be jeopardized (Halm, 2010 p. 77). Evidence-Based Care for Pressure Ulcers Prevention and treatment of pressure ulcers are major nursing priorities. There is evidence that a program of prevention guided by risk assessment can simultaneously reduce the institutional incidence of pressure ulcers by as much as 60%, and bring down the cost of prevention at the same time (Potter and Perry 2004) Evidence-Based Practice shows that lack of documentation of patients at risk demonstrates the need for hospitals to increase the strategies for p redictability and prevention. Therefore implementation of a risk scale can provide triggers to plan care to decrease risk factors. Evidence-Based Practice also shows that extended stays over 7 days increase the risk of pressure ulcer development. Therefore, nurses need to be vigilant in the prevention of pressure ulcers in patients with longer hospital stays. Evidence-Based practice also shows the use of daily skin assessments, use of pressure-relief surfaces and objective risk assessment measure such as the Braden scale have reduced evidence of pressure ulcer development (Lyder, et al, 2001). Nursing intervention based on Evidence-Based Practice will help with the care of, reduction of, and prevention of pressure ulcers. Conclusion Because the nation is encountering a healthcare shift, we must alter the way in which we practice nursing to meet the needs of society and health care delivery. Teaching methods and responsibilities of our nursing leaders to implement Evidence-Base d Practice were explored. The Pros and Cons of Evidence-Based Practice were discussed as well. Finally how Evidence-Based Practice can help predict, prevent and resolve pressure ulcers were reviewed. References: Broeder J. L. , Donze A. , Smith J. R. , Sonze A (2010. The Role of the Qualitative Research in Evidence-Based Practice. Neonatal Network, 2010 May-Jun: 29 (3): Suppl: 197-202 Walsh N. (2010). Dissemination of Evidence into Practice: Opportunities and Threats. Primary Health care, 2010 Apr: 20:20 (3): 26-3 Halm M. A. (2010). â€Å"Inside Looking In† or â€Å"Inside Looking Out? † How Leaders Shape Cultures Equipped for Evidence-Based. American journal of Critical Care, 2010 Jul: 19:49 (7): 387-92) Bryan-Brown, C. W. , 2006, Evidence-Based Practice is Wonderful Sort Of, American Journal of Critical Care Kozier, B. nd Erb, G. 2004 Fundamentals of Nursing: Concepts Process and Practice 7th Edition Pearson Education Inc. Lyder, C. H. , J. Pererson, et al 2001. Q uality of care for hospitalized medical risk for pressure ulcers. Arch intern Med. 161(12): 1549-54 Potter, P. and Perry, A. 2004. Fundamentals of Nursing. Mosby. Erickson-Owens D. A. , Kennedy, H. P. (2001) Fostering evidence-based care in clinical teaching. Journal of Midwifery Womens Helath,(46), 137-145 Ferguson,L. , Day, R. A. (2005). Evidence-based nursing education: Myth or reality? Journal of Nursing Education, (44) 107-115. Don’t waste time! Our writers will create an original "Integration of Evidence-Based Practice in Nursing" essay for you Create order

Law Case Review of Spangler vs. Federal Home Loan Bank of...

Introduction Spangler v. Federal Home Loan Bank of Des Moines illustrates at least some of the difficulties for employers in dealing with FMLA regulations. Due to the Courts interpretation of the FMLA notice requirement, a manager might cope with Spangler differently depending on when that manager is allowed to manage Spangler. The Courts decision regarding Spangler was a mixed bag, agreeable and understandable in some respects but unduly burdensome on employers in other respects. In their current state, the FMLA regulations are considerably troublesome and burdensome for employers. Body As a Manager, What would you do to cope with Spangler? A manager could cope with Spangler in several ways, depending on when the manager was allowed to manage. After Spanglers call of September 16, 1998 in which she stated that she would not be in because of depression again (Riley, 2002), a conscientious manager would have no choice but to err on the side of caution by treating her message as a request for FMLA leave (Guerin England, 2012, p. 298), believing that the Bank must either grant the FMLA leave or seek certification of her ongoing serious condition (Nelson, Spring 2005, p. 619). Despite the fact that Spangler was in no danger of becoming Employee of the Month, the Bank is held to know that: she suffered from diagnosed depression; she took leaves in the past due to her depression; and she said it was depression again (Riley, 2002). Consequently, at least in the

Political Science 101 Essay Example For Students

Political Science 101 Essay Terrorism: Do you ever fear for your life when you board a plane? Ten or fifteen years ago most people would most likely say no. Today however, people have been changing their minds about terrorists. The bombings of Pam Am flight 103 and more recently the Oklahoma City Federal Building have put a new fear into the hearts of Americans. Terrorism is on the rise and our government needs to begin to crack down on it. First, a review of some of the atrocities that have been experienced by Americans over the last few years: * April, 1983: The U. S. Embassy in Beirut, Lebanon, was bombed, leaving 16 dead and more than 100 injured. * October, 1983: The U.S. Marine barracks in Beirut was bombed, resulting in 241 deaths. * June 9, 1985: TWA Flight 847 was hijacked. U.S. Navy diver Robert Stethem, who was on board, was brutally murdered, his body dumped on the airport tarmac. * February, 1988: Marine Lt. Col. William Higgins-part of the United Nations peacekeeping force in Lebanon-was kidnapped and later murdered. * December, 1988: Pan Am Flight 103 was blown up over Lockerbie, Scotland, with 270 killed. * February, 1993: New York Citys World Trade Center was bombed by Islamic extremists, leaving six dead and hundreds injured. * March, 1995: American diplomatic personnel were murdered in a hail of machine gun fire on the streets of Karachi, Pakistan. (USA Today, Jan. 1996. Louis J. Freeh) Theses are only acts that were committed by groups outside the states. The death toll for incidents committed by people within our own borders is much higher. These are the reasons that America needs to start getting tough on terrorists and their acts of insanity. Americans have historically enjoyed more freedoms than the citizens of most any other country in the world. We have the freedoms of speech, religion, press, etc. We also have the freedom to life, liberty, and the pursuit of happiness. What if these freedoms somehow came into conflict? Terrorism is one of those issues that brings about such an argument. Do Americans want to prevent such horrible acts as the Oklahoma city bombing? I would say that most Americans would agree that yes, we need to prevent events like that from occurring again. The question is: How much freedom will you give up to have a right to life? This very inquiry is presenting quite a stir in congress. For us to be safe, the government realizes that we, as the American public, must give up some of our privacy and freedom. We also need to empower the FBI, CIA and other government agencies with the tools they require to stop these threats on the American way of life. Ronald Reagan, in 1982, first designated the FBI as our lead agency in counter-terrorism. The FBI was further giver power, though congressional bills in 1984 and 1986, to be able to pursue terrorists overseas. This was a good initial effort, but in todays growing technological age, the FBI needs to have more tools for going after these rebels. For instance, there is the subject of court-approved wire tapping. In todays world it is not hard to come across encryption devices that make wire tapping obsolete. The government agencies in charge of tapping lines need the most sophisticated equipment to make wire tapping of any use. Another problem that the government is encountering is tracking suspected terrorists. The government has a hard time attaining phone records, credit card receipts, and so on. These things arent absolutely necessary to catch terrorists, but they making the tracking of certain groups and leaders much easier. Basically, it is a zero-sum game. If you give up so much freedom, then the government has that much easier a time zeroing in on potential threats to the American people. Also, as a result of the recent bombings, President Clinton has assigned hundreds of new agents in the FBI to take care of this increasing threat. The FBI, to be really effective in stopping terrorism, must also have connections to its overseas counterparts. .ufc8bc1d92712b2a60b5df88c27d4b9b0 , .ufc8bc1d92712b2a60b5df88c27d4b9b0 .postImageUrl , .ufc8bc1d92712b2a60b5df88c27d4b9b0 .centered-text-area { min-height: 80px; position: relative; } .ufc8bc1d92712b2a60b5df88c27d4b9b0 , .ufc8bc1d92712b2a60b5df88c27d4b9b0:hover , .ufc8bc1d92712b2a60b5df88c27d4b9b0:visited , .ufc8bc1d92712b2a60b5df88c27d4b9b0:active { border:0!important; } .ufc8bc1d92712b2a60b5df88c27d4b9b0 .clearfix:after { content: ""; display: table; clear: both; } .ufc8bc1d92712b2a60b5df88c27d4b9b0 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ufc8bc1d92712b2a60b5df88c27d4b9b0:active , .ufc8bc1d92712b2a60b5df88c27d4b9b0:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ufc8bc1d92712b2a60b5df88c27d4b9b0 .centered-text-area { width: 100%; position: relative ; } .ufc8bc1d92712b2a60b5df88c27d4b9b0 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ufc8bc1d92712b2a60b5df88c27d4b9b0 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ufc8bc1d92712b2a60b5df88c27d4b9b0 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ufc8bc1d92712b2a60b5df88c27d4b9b0:hover .ctaButton { background-color: #34495E!important; } .ufc8bc1d92712b2a60b5df88c27d4b9b0 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ufc8bc1d92712b2a60b5df88c27d4b9b0 .ufc8bc1d92712b2a60b5df88c27d4b9b0-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ufc8bc1d92712b2a60b5df88c27d4b9b0:after { content: ""; display: block; clear: both; } READ: Introduction to Ancient Fine Arts Essay There are currently 23 FBI attaches in other countries that have also found the threat of terrorism both growing and frightening, that is agents that work closely with the governments of other countries. These agents are actually .

Pepsi Vision and Mission free essay sample

Headquartered in Purchase, New York, with Research and Development Headquarters in Valhalla, The Pepsi Cola Company began in 1898 by a Pharmacist and Industrialist Caleb Bradham, but it only became known as PepsiCo when it merged with Frito Lay in 1965. Until 1997, it also owned KFC, Pizza Hut, and Taco Bell, but these fast-food restaurants were spun off into Tricon Global Restaurants, now Yum! Brands, Inc. PepsiCo purchased Tropicana in 1998, and Quaker Oats in 2001. In December 2005, PepsiCo surpassed Coca-Cola Company in market value for the first time in 112 years since both companies began to compete. PEPSICO INDIA: PepsiCo gained entry to India in 1988 by creating a joint venture with the Punjab government-owned Punjab Agro Industrial Corporation (PAIC) and Voltas India Limited. This joint venture marketed and sold Lehar Pepsi until 1991, when the use of foreign brands was allowed; PepsiCo bought out its partners and ended the joint venture in 1994. 5] Others claim that firstly Pepsi was banned from import in India, in 1970, for having refused to release the list of its ingredients and in 1993, the ban was lifted, with Pepsi arriving on the market shortly afterwards. We will write a custom essay sample on Pepsi Vision and Mission or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page PepsiCos responsibility is to continually improve all aspects of the world in which we operate – environment, social, economic – creating a better tomorrow than today. Our MISSION is put into action through programs and a focus on environmental stewardship, activities to benefit society, and a commitment to build shareholder value by making PepsiCo a truly sustainable company. Our VISION is to be the worlds premier consumer Products Company focused on convenient foods and beverages. We seek to produce financial rewards to investors as we provide opportunities for growth and enrichment to our employees, our business partners and the communities in which we operate. And in everything we do, we strive for honesty, fairness and integrity. As PepsiCo has become one of the country’s leading food and beverage companies, now they are focusing even globally. PepsiCo has built an expensive food and beverage business. PepsiCo `nourishes consumers with a range of products from treats to healthy eats that deliver joy as well as nutrition and always, good taste. PepsiCo has become one of the largest multinational investors in the country; PepsiCo has established a business which aims to serve the long term dynamic needs of consumers in India. PepsiCoprovides various opportunities to the employees like they provide direct and indirect employment to around 150000 people.

Toxic Chemicals from Peeing in the Pool

Toxic Chemicals from Peeing in the Pool Lets face it. Its not just babies who pee in the pool! Is that guy on the other side of the pool trying to look cool or is he concentrating on a little public urination? You dont know, because there isnt a chemical you can put in the pool as a urine indicator that wouldnt be toxic or respond to a whole host of other fluids. The Water Quality and Health Council conducted a survey that revealed one in five Americans admit to urinating in the pool. So, unless that pool was filled an hour ago, youre swimming in pee. But, urine doesnt just sit there in the water or harmlessly disperse. It reacts with chemical treatments in the water. For the same reason you dont want to rinse out a really nasty kitty litter box with bleach, you might not want to inhale too deeply in a pool full of people. The chemical reactions form two particularly nasty compounds: cyanogen chloride (CNCl) and trichloramine (NCl3). In high concentrations, these are chemical warfare agents. In the minute quantities produced in a pool, you wont die, but youre not doing your lungs any favors, not to mention your nervous and circulatory systems. Chlorine treatments, in particular, react with uric acid from urine to form toxic chemicals. The pool treatments themselves often aggravate respiratory and other health problems, since chlorine is (you guessed it) a toxic chemical agent. Its really not something to worry about, as researchers have found levels of the chemicals are lower than the World Health Organization (WHO) limits for public drinking water. However, if it bothers you, you have a few options. Swim in an outdoor pool rather than an indoor one, so vapors become diluted in the air rather than trapped in an enclosed space. Switch to a different pool disinfection method. Or, you can build your very own private pool and resist the urge to pee in it. Reference:  Volatile Disinfection Byproducts Resulting from Chlorination of Uric Acid: Implications for Swimming Pools,  Lushi Lian, Yue E, Jing Li, and Ernest R. Blatchley , III,  Environ. Sci. Technol.,  2014,  48  (6), pp 3210–3217.

Cmo afecta la ley HB87 de Georgia a los indocumentados

Cmo afecta la ley HB87 de Georgia a los indocumentados La ley de Georgia HB 87, considerada como restrictiva de la inmigracià ³n, impone castigos a los inmigrantes indocumentados que viven dentro de las fronteras de ese estado. Y es que aunque las leyes de la inmigracià ³n son federales y, por lo tanto, son iguales todo Estados Unidos sin importan donde se resida lo cierto es que cada estado puede pasar medidas de apoyo a los migrantes, legales y/o indocumentados o, por el contrario, restrictivas de los derechos de los sin papeles. Ese à ºltimo es el caso de Georgia, pero no es el à ºnico. Destacan en ese sentido las leyes de Arizona, Alabama y Carolina del Sur. Si usted es uno de los 480 mil indocumentados que vive en Georgia o se planea mudarse a vivir a ese estado es conveniente saber los puntos bsicos de la ley HB-87 tal y como se aplica en la actualidad despuà ©s de que varias organizaciones demandaran con à ©xito irregular la suspensià ³n de algunas partes de la ley. Cà ³mo afecta la ley de Georgia HB-87 a los indocumentados En primer lugar, en aplicacià ³n de la ley de Georgia HB-87 las empresas con ms de un cierto nà ºmero de trabajadores deben utilizar el programa federal e-Verify para garantizar que sus los empleados son ciudadanos americanos o estn legalmente autorizados para trabajar en Estados Unidos. Asà ­, todas las agencias estatales y todos los empresarios privados con ms de 500 empleados deben verificar el estatus legal de todos los nuevos trabajadores. Desde el 1 de julio de 2012, est obligacià ³n se ha extendido a todas las empresas con ms de 100 empleados y desde el uno de enero de 2013 se extender a todas que tengan ms de 10 trabajadores. Adems, la utilizacià ³n de documentos falsos como licencias de manejar, tarjetas de la seguridad social o green cards con el objeto de obtener empleo est castigado con multas de hasta $250,000 y con penas de prisià ³n por un mximo de 15 aà ±os. Asimismo, todas las peticiones de ayudas para la vivienda o para la compra de alimentos (food stamps) debern acompaà ±arse por la presentacià ³n de determinada documentacià ³n que pruebe el estatus legal del solicitante. Y quiz lo ms digno de resaltar es que  la policà ­a estatal y local puede verificar el estatus migratorio de las personas a las que para o detiene. Es lo que se conoce como la polà ­tica de muà ©strame los papeles (show me your papers, en inglà ©s). Es de destacar que se autoriza a la policà ­a a pedir los papeles pero no se hace mandatorio que debe hacerlo. Asà ­, por ejemplo, las fuerzas del orden del estado de Georgia podrn pedir papeles para verificar el estatus migratorio de las personas que manejen un auto sin la debida licencia. Disposicià ³n de la ley de inmigracià ³n de Georgia HB-87 que est suspendida   Por decisià ³n de la Corte de Apelaciones de Atlanta sigue en suspenso la seccià ³n de la ley que penaliza a todas las personas que a sabiendas, acogen en sus viviendas o transportan a un inmigrante indocumentado cuando se est cometiendo un delito. Derechos de los migrantes indocumentados Los migrantes indocumentados, a pesar de su estatus, tambià ©n tienen derechos si son arrestados o parados. En estos casos es muy importante que reciban un buen asesoramiento legal si sus caminos cruzan el de las autoridades y, por su puesto, si reciben una citacià ³n para presentarse en una corte de Inmigracià ³n, ya que el no hacerlo tiene consecuencia una orden de deportacià ³n (de la que es posible no saber que se tiene). Adems, en casos de arresto o/y inicio de procedimiento de deportacià ³n conviene consultar con un abogado si es conveniente solicitar una salida voluntaria, ya que puede tener ventajas si no hay forma legal de parar la deportacià ³n. Por à ºltimo, destacar que incluso en Georgia los muchachos con la Accià ³n Diferida aprobada (DACA, por sus siglas en inglà ©s) pueden obtener la licencia de manejar. Y que hay ciertos beneficios sociales mà ­nimos reconocidos por las leyes federales que se tienen que cumplir, como el acceso a Wic para el caso de bebà ©s, infantes y embarazadas o la asistencia en clà ­nicas comunitarias e incluso en ER de hospitales en los casos de peligro para la vida. Este artà ­culo es informativo. No es asistencia legal para ningà ºn caso concreto.

How movies affect the audience Term Paper Example | Topics and Well Written Essays - 1500 words

How movies affect the audience - Term Paper Example For example, most films in Bollywood in India feature more on strong family values. There are only little or no sex and violent scenes. In Nollywood, located in Nigeria, most films have their basis on the reality that most Africans face, such as family struggles, faith conflicts and achieving a balance between modernity and traditional values. In most cases, the films are depicted in a satirical outlook. The South Korean film industry also focuses on what most Asians go through, the historical and personal impacts of life events. In all these film industries, the films have had an impact on viewers. For example, films in Nigeria have raised concerns in most African countries with people worrying that there will be â€Å"Nigerianization† of their cultures given that their films possess a lot of Nigerian culture and dialect. How does the effect of the film impact on the audience? In Hollywood, perhaps the films cannot be said to have the same effect such as making the rest of Europe â€Å"Americanized†, but the effect is still notable. Even when a person is one of the healthiest, watching certain films is likely to have an effect on a person in ways they cannot imagine. The films have cuts, camera angles and scenes that change and these are the film aspects that have an effect on human behavior, views and decision-making process (Plantinga, 2009). Admittedly most people are never conscious about the cuts that film editors make in a film. Camera angles also change so many times in a scene, but people are usually too engulfed in the film to notice such changes. To keep most audiences in America and the rest of the world entertained, filmmakers are well aware that making certain shift cuts in certain scenes have more impact than if the same cuts are made in other scenes of a film. Cutting that occur s in the films might seem very unrealistic, but moving the