Write RESEARCH SYNTHESIS, THE CLINICAL PROTOCOL
USES RUBRIC AND MUST FOLLOW INSTRUCTIONS
APA 6.0 REQUIRED
Refer to the “CLC Assignment: Evidence-Based Project (EBP) Student Guide” for additional guidance. (attached)
ACCURATELY REPORTS INFORMATION FROM THE SOURCES USING DIFFERENT PHRASES AND SENTENCES
ORGANIZED IN SUCH A WAY THAT READERS CAN IMMEDIATELY SEE WHERE THE INFORMATION FROM THE SOURCES OVERLAP
CLARIFIES SOURCES AND HELPS THE READER UNDERSTAND THEM IN RELATION TO EACH OTHER
“THERE ARE VARIETY OF WAYS TO COMPLETE THE CLINICAL PROTOCOL AND IMPLEMENTATION, FOR EXAMPLE YOU COULD USE EXISTING MODELS SUCH AS THE IOWA MODEL OF EVIDENCE BASED PRACTICE ALONG WITH KOTTER’S 8 STEP CHANGE MODEL AS THE ROADMAP FOR THESE SECTIONS. REMEMBER THIS SHOULD BE A HIGH-LEVEL OVERVIEW OF THE PROTOCOL AND IMPLEMENTATION PLAN.”
ARTICLE WE WORKED ON SO FAR, YOU HAVE TO ADD RESEARCH SYNTHESIS, THE CLINICAL PROTOCOL TO THIS
Evidence based practice (EBP) has made a huge impact in nursing throughout history. Nurses have the ability to change their practice and improve outcomes for their patients first hand. It has become an interdisciplinary approach within clinical practice that has paved the way health care professionals safely and ethically practice medicine. The idea of EBP incorporates individual experience with evidence-based research to create the most clinical sound practices and guidelines. The following paper will discuss and identify a clinical question that will be followed with a problem statement regarding an evidence-based practice that could enhance the care of end of life patients.
The authors of the paper have collectively crafted four relatable foreground questions that will shape the content of the evidence-based practice project.According to Polit and Beck (2016), a foreground question can be answered by up-to-date research evidence. EBP assists in diagnosis, treatment, and prognosis in the healthcare field.
- How can healthcare providers optimize pain control in end of life and hospice patients?
- Are there alternatives to pain medicine that would be an adjunct to therapy; such as a
- Do healthcare providers adequately address the pain and suffering of end-of-life and hospice patients experience?
- In a dilemma, should practitioners choose patients to have a quality of life or quantity of life?
Nurses, as well as physicians, working with hospice often face more ethical dilemmas than those assisting patients of any other age group. Euthanasia is forbidden as such in the United States and is only applicable in some states under particular circumstances. Addressing this issue with the patients is probably one of the most challenging ethical dilemmas faced by geriatric nurses. The nurse has a greater opportunity than the physician to create a relationship, so it will generally be the geriatric nurse that will inform the patient about his/her right to file a non-resuscitation order. While doing so, it is necessary that the nurse explains the patient the relevance of such non-resuscitation order, as it will prevent physicians and nurses from resuscitating him if he needs it if he has filed such order. (Rainer et al., 2018).
Advance health practitioners face dilemmas whether to advocate for patients for a decent quality of life or a quantity of life (Buppert, 2017). According to the most recent statistics, 1.63 million Medicare beneficiaries were enrolled in hospice for one day or longer in 2016 (National Hospice and Palliative Care Organization, 2018).While hospice facilities can provide a variety of support, most patients and their families utilize this service for end-of-life care (National Hospice and Palliative Care Organization, 2018).Moreover, although patients enter hospice with a range of principle diagnoses, one issue that is a common thread for these patients is pain management at end-of-life and during the dying process.However, Dr. Susan Glod reported in an article for the New England Journal of Medicine that due to the opioid epidemic in recent years, hospice patients could be “victims” of the changes to opioid prescribing policies in the past few years (Glod, 2017). One recent study revealed the significance of nursing home patients enlisted in hospice care with pain at 60% (Hunnicut, Tjia, & Lapane, 2017).Though nurses are now in a difficult position concerning their approach to hospice patients with chronic pain, they still must address this aspect of care.The American Nurses’ Association (2018), position statement regarding the nurse’s duties for end-of-life care states the following:
“Decisions about care at the end of a person’s life often involve quality-of-life considerations. Nurses are obligated to provide care that includes the promotion of comfort, relief of pain and other symptoms, and support for patients, families, and others close to the patient.” (para. 3).
Given this information along with the literature reviewed at this time, it is essential to closely examine the relationship between the presence of pain and treatment of pain in end-of-life patients and hospice patients.
American Nurses Association. (2018). Nurses’ roles and responsibilities in providing care and support at the end of life. Retrieved from https://www.nursingworld.org/practice-policy/nursi…
Coyne, P., Mulvenon, C., & Paice, J. A. (2018). American society for pain management nursing and hospice and palliative nurses association position statement: Pain management at the end of life. Pain Management Nursing, 19(1), 3-7. doi:10.1016/j.pmn.2017.10.019
Glod, S. (2017). The other victims of the opioid epidemic. New England Journal of Medicine, 376, 2101-2102. DOI: 10.1056/NEJMp1702188
Harrison, K. L., & Connor, S. R. (2016). First Medicare demonstration of concurrent provision of curative and hospice services for end-of-life care. The American Journal of Public Health, 106(8), 1405. Retrieved from http://eds.b.ebscohost.com.lopes.idm.oclc.org/eds/…
Hunnicutt, J. N., Tjia, J., & Lapane, K. L. (2017). Hospice use and pain management in elderly nursing home residents with cancer. Journal of Pain and Symptom Management, 53(3). 561-570. doi:10.1016/j.jpainsymman.2016.10.369
Kirby, E. G. (2018). Patient centered care and turnover in hospice care organizations. Journal of Health & Human Services Administration, 41(1), 26. Retrieved from http://eds.b.ebscohost.com.lopes.idm.oclc.org/eds/…
National Hospice and Palliative Care Organization. (2018). NHPCO facts and figures: Hospice care in America. Retrieved from https://www.nhpco.org/hospice-statistics-research-…
Polit, D. F., & Beck, C. T. (2016). Nursing research: Generating and assessing evidence for
nursing practice (10th ed.). Retrieved from http://gcumedia.com
Reddy, A., Yennurajalingam, S., & Bruera, E. (n.d). “Whatever my mother wants”: Barriers to
adequate pain management. Journal of Palliative Medicine, 16(6), 709-712. doi:10.1089/jpm.2012.0189
Reynolds, J., Drew, D., & Dunwoody, C. (2013). American society for pain management nursing position statement: Pain management at the end of life. Pain Management Nursing, 14(3), 172. Doi:10.1016/j.pmn.2013.07.002
Sanders, S., Herr, K. A., Fine, P. G., Fiala, C., Tang, X., & Forcucci, C. (2013). An examination of adherence to pain medication plans in older cancer patients in hospice care. Journal of Pain and Symptom Management, 45(1), 43. Doi:10.1016/j.jpainsymman.2012.01.007
CLC – EBP Develop Clinical Guideline and Implementation Plan