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Posted: October 31st, 2023
Using Evidence Based Practice in Planning Nursing Care. Evidence-Based Practice Paper
In this evaluative paper, you will examine the nurse’s role in promoting health and wellness for patients across the lifespan and the use of evidence-based practice in planning care. In the first part of this paper, you will discuss the roles and responsibilities of the nurse in relationship to health promotion, risk reduction, and disease management. In the second part, you will discuss the disease and use evidence from scientific literature to support your conclusions for care of the patient. You will select one disease that affect two different age groups for your topic. You will use at least three evidence-based resources to support your work, at least one must be a peer-reviewed journal article.
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Part 1:
Discuss the responsibilities of the nurse related to health promotion, risk reduction, and disease management. The incorporation of evidence-based practice is a professional responsibility; explain the benefits and strategies for its use. Give examples and details.
How does the nurse use the nursing process to plan care to promote health, risk reduction, and disease management?
Explain the benefits of using evidence-based practice in planning nursing care.
Discuss strategies for including evidence-based practice in planning nursing care.
Part 2:
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Choose one disease from any of the units in this course (or two diseases that impact two age groups) and compare the evidence-based pathophysiology, diagnosis, risk factors, and treatment as applied to patients of different age groups. You must use evidence from appropriate resources to support your conclusions on care for patients of different age groups.
Explain the pathophysiology and etiology of the disease(s), including impact of age.
Examine the impact of age on risk factors.
Differentiate between the diagnostic processes for the two age groups.
Compare the treatment of the disease(s), based on age, using scientific and evidence-based information.
Using Evidence Based Practice in Planning Nursing Care
As a nurse, promoting health, reducing risks, and managing disease across the lifespan are important responsibilities. Incorporating evidence-based practice is a professional duty that benefits both nurses and patients. The nursing process is a strategic way for nurses to thoughtfully plan care using current best evidence.
Part 1:
The nurse uses the nursing process—assessment, diagnosis, planning, implementation, and Assessment—to systematically promote health and wellness for all patients (American Nurses Association [ANA], 2017). During assessment, the nurse collects subjective and objective data on the patient's health history, current condition, and relevant socioeconomic factors. This comprehensive assessment informs diagnosis, where the nurse analyzes the data to identify actual or potential health problems and their defining characteristics.
In the planning stage, the nurse establishes goals and expected outcomes with the patient, then develops an individualized plan of care based on best practices. Evidence-based guidelines ensure the planned interventions and treatments reflect the most recent research findings and are most likely to achieve the desired outcomes (Melnyk & Fineout-Overholt, 2019). Strategies for including evidence-based practice in planning include searching databases like CINAHL and PubMed for the latest systematic reviews and randomized controlled trials on relevant topics. The nurse also consults sources like UptoDate which synthesize evidence into clinical best practice recommendations.
Part 2:
This paper will compare hypertension and type 2 diabetes, two chronic diseases that impact older and younger adult populations differently. Hypertension, or high blood pressure, is a major risk factor for cardiovascular disease—the leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2021). While the pathophysiology of hypertension involves various genetic and environmental factors that narrow arteries and increase cardiac workload, advancing age is itself a nonmodifiable risk factor due to stiffening of blood vessels over time (Mayo Clinic, 2022).
Diagnosis of hypertension is based on multiple blood pressure readings over time, with higher cutoffs for diagnostic thresholds in older versus younger adults (American Heart Association, 2021). Lifestyle modifications like diet, exercise, weight control, and limiting alcohol/sodium intake are first-line treatment strategies across age groups. However, older adults often require medication in addition to lifestyle changes to achieve target blood pressure goals due to age-related vascular changes (James et al., 2018).
Type 2 diabetes, caused by the body's ineffective use of insulin, also increases in prevalence with age. While both genetic predisposition and obesity put younger adults at higher risk, natural aging processes impair insulin secretion and sensitivity in older adults (ADA, 2022). Diagnosis is similar between age groups based on hemoglobin A1c levels, but treatment varies more significantly. In addition to lifestyle modifications and oral hypoglycemic agents, some older adults with type 2 diabetes may need insulin therapy or management of diabetes-related complications like neuropathy or kidney disease (Qaseem et al., 2018).
In conclusion, the nurse plays a vital role in promoting health and preventing disease across diverse patient populations. Incorporating evidence-based practice grounded in current research ensures the highest quality, most effective care tailored to each unique individual and their stage of life.
American Heart Association. (2021). Understanding blood pressure readings. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings
American Nurses Association. (2017). Nursing process. https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/nursing-process/
American Diabetes Association. (2022). Statistics about diabetes. https://www.diabetes.org/about-us/statistics/about-diabetes
Centers for Disease Control and Prevention. (2021). Heart disease facts. https://www.cdc.gov/heartdisease/facts.htm
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., ... & Smith, S. C. (2018). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5), 507-520.
Mayo Clinic. (2022). High blood pressure (hypertension). https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Qaseem, A., Wilt, T. J., Kansagara, D., Horwitch, C., Barry, M. J., & Forciea, M. A. (2018). Hemoglobin A1c targets for glycemic control with pharmacologic therapy for nonpregnant adults with type 2 diabetes mellitus: a guidance statement update from the American College of Physicians. Annals of internal medicine, 168(8), 569-576.
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