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[Audio] Chapter 5 Evidence-Based Practice Copyright © 2021, Elsevier Inc. All Rights Reserved. m8.

[Audio] Copyright © 2021, Elsevier Inc. All Rights Reserved. The Need for Evidence-Based Practice Evidence-based care Looks for the very best scientific and clinical evidence for treating and managing a problem Improves quality, safety, and enhances the patient experience Improves patient outcomes Empowers clinicians Reduces costs The best scientific evidence comes from well-designed, systematically conducted research studies found in scientific, peer-reviewed journals..

[Audio] Shown is Figure 5.1 from the textbook: Model for evidence-based clinical decision making..

[Audio] Sources of evidence Textbooks Articles from nursing and health care literature Peer-reviewed journals Practice guidelines Application of evidence Differ based on patients’ values, state of health, preferences, concerns, or expectations. Involves ethical and accountable professional nursing practice. Use critical thinking skills..

[Audio] Performance Improvement A formal approach for the analysis of health care–related processes Outcomes measures Performance improvement programs Begins at staff level in identifying quality problems Sentinel events Active errors Latent errors PI combined with EBP is the foundation for excellent patient care and outcomes..

[Audio] The Relationship between EBP, Research, and PI (1 of 2) Although EBP, research, and PI are closely related, they are separate processes in nursing practice that all require the use of the best evidence to provide high quality patient care. EBP: Use of information from research and other sources to determine safe and effective nursing care with the goal of improving patient care and outcomes Research: Systematic inquiry answers questions, solves problems, and contributes to the generalizable knowledge base of nursing; may or may not improve patient care PI: Improves local work processes to improve patient outcomes and health system efficiency; results usually not generalizable.

[Audio] The Relationship between EBP, Research, and QI (2 of 2).

[Audio] Chapter 6 Health and Wellness Copyright © 2021, Elsevier Inc. All Rights Reserved..

[Audio] Healthy People Provides evidence-based, 10-year national objectives for promoting health and preventing disease Healthy People 2030 Promotes a society in which all people live long, healthy lives Identifies leading health indicators which are high-priority health issues in the United States.

[Audio] Definition of Health A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO, 1947, 2018) A state of being that people define in relation to their own values, personality, and lifestyle.

[Audio] Health Belief Model Shown is Figure 6.1 from the textbook: Health belief model. (Data from Becker M, Maiman L: Sociobehavioral determinants of compliance with health and medical care recommendations, Med Care 13[1]:10, 1975.).

[Audio] Health Promotion Model Shown is Figure 6.2 from the textbook: Health promotion model (revised). (Redrawn from Pender NJ, Murdaugh CL, Parsons MA: Health promotion in nursing practice, ed 5, Upper Saddle River, NJ, 2006, Prentice Hall.).

[Audio] Copyright © 2021, Elsevier Inc. All Rights Reserved. Models of Health and Illness (2 of 2) Maslow’s Hierarchy of Needs Used to understand the interrelationships of basic human needs Holistic Health Model Attempts to create conditions that promote optimal health Shown is Figure 6.3 from the textbook: Maslow's hierarchy of needs. (Redrawn from Maslow AH: Motivation and personality, ed 3, Upper Saddle River, NJ, 1970, Prentice Hall.).

[Audio] Variables Influencing Health and Health Beliefs and Practices Internal variables Developmental stage Intellectual background Perception of functioning Emotional factors Spiritual factors External variables Family role and practices Social determinants of health Culture.

[Audio] Copyright © 2021, Elsevier Inc. All Rights Reserved. Health Promotion, Wellness, and Illness Prevention Health promotion Helps individuals maintain or enhance their present health. Health education Helps people develop a greater understanding of their health and how to better manage their health risks. Illness prevention Protects people from actual or potential threats to health. Review Box 6.2 in the textbook..

[Audio] Three Levels of Prevention Primary Prevention True prevention that lowers the chances that a disease will develop Secondary Prevention Focuses on those who have health problems or illnesses and are at risk for developing complications or worsening conditions Tertiary Prevention Occurs when a defect or disability is permanent or irreversible.

[Audio] Quick Quiz 3 (1 of 2) 3. You will use the concept of primary prevention when instructing a patient to: A. get a flu shot every year. B. take a blood pressure reading every day. C. explore hiring a patient with a known disability. D. undergo physical therapy following a cerebrovascular accident. No input is needed to proceed..

[Audio] Quick Quiz 3 (2 of 2) Answer: A. get a flu shot every year..

[Audio] Risk Factors Variables that increase the vulnerability of an individual or a group to an illness or accident Risk factors include: Nonmodifiable risk factors Modifiable risk factors Environment.

[Audio] Risk Factor Modification and Changing Health Behaviors Once identified, implement health education and counseling Transtheoretical Model of Change Precontemplation- not intending to make changes in next 6 months Contemplation-Considering a change in 6 months Preparation-making small changes in preparation for a change in the next month Action- Actively engaged in strategies to change behavior: last up to 6 months Maintenance-Sustained change over time: begins 6 months after action and continues indefinitely Review Box 6.4 in the textbook..

[Audio] Risk Factor Identification and Changing Health Behaviors Identify risk factors Assessment Health risk appraisal forms Implement education and counseling Wellness strategies Understand the stages of change Transtheoretical Model of Change.

[Audio] Copyright © 2021, Elsevier Inc. All Rights Reserved. Illness A state in which a person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired Acute Illness Short duration and severe Chronic Illness Persists longer than 6 months Affects functioning.

[Audio] Illness (2 of 3) Illness behavior Involves how people monitor their bodies and define and interpret their symptoms Variables influencing illness and illness behavior Internal variables External variables.

[Audio] Illness (3 of 3) Impact of illness on the patient and family Behavioral and emotional changes Impact on body image Impact on self-concept Impact on family roles Impact on family dynamics.

[Audio] Copyright © 2021, Elsevier Inc. All Rights Reserved. Impact of Illness on the Patient and Family Behavioral and emotional changes Impact on body image Impact on self-concept Impact on family roles Impact on family dynamics.

[Audio] Caring for Yourself Eat a nutritious diet Get adequate sleep Engage in exercise and relaxation activities Establish a good work-family balance Engage in regular nonwork activities. Develop coping skills Allowing personal time for grieving Focus on spiritual health Find a mentor.