L.L. is a 67-year-old male who has been diagnosed with BPH. He is having difficulty with urination. He is currently on Cozaar 100 mg for HTN and his BP is well controlled. He is taking no other medications. The doctor has recommended medication for his BPH, but he would like to try a herbal supplement before taking a prescription medication.

1. Would you recommend a herbal supplement in L.L’s case?

2. If so, what herbal supplement would he take?

3. What is the recommended dosage?

4. What are possible side effects of the herbal supplement?

5. What warnings should you give L.L. before he starts the herbal supplement.

Assignment: Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
• Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
• Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
• Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 2, “Asking Compelling Clinical Questions” (pp. 33–54)
Chapter 3, “Finding Relevant Evidence to Answer Clinical Questions” (pp. 55–92)

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80. https://doi.org/10.18438/B8WS5N
Note: You will access this article from the Walden Library databases.

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010a). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. doi:10.1097/01.NAJ.0000368959.11129.79
Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. American Journal of Nursing, 109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58
Note: You will access this article from the Walden Library databases.

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41–47. doi:10.1097/01.NAJ.0000372071.24134.7e
Note: You will access this article from the Walden Library databases.

Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981

Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

Walden University Library. (n.d.-d). Evidence-based practice research: Joanna Briggs Institute search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/jbisearchhelp

Walden University Library. (n.d.-e). Evidence-based practice research: MEDLINE search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/medlinesearchhelp

Walden University Library. (n.d.-h). Quick Answers: How do I find a systematic review article related to health, medicine, or nursing? Retrieved September 6, 2019, from https://academicanswers.waldenu.edu/faq/72670

Walden University Library. (n.d.-i). Systematic review. Retrieved January 22, 2020, from https://academicguides.waldenu.edu/library/healthevidence/types#s-lg-box-1520654

Required Media

Laureate Education (Producer). (2018). Searching the Evidence [Video file]. Baltimore, MD: Author.

THIS IS THE MODULE 2 TO COMPLETE THIS ASSIGNMENT

 

The PICOT format is used to formulate questions in evidence-based practice. It is a beneficial method as it enables a researcher to identify the most effective and useful resources used in evidence-based practice and healthcare research. P stands for the population or the patient’s problem. In this threshold, one explains who is the patient, their health status, and demographic data. I stand for the interventions that should be performed on the patient. For instance, they may be tests, therapies, or medications. C stands for Comparison. It indicates other alternative plans that the healthcare practitioner may conduct on the patient. O stands for the outcomes that the health practitioner seeks. T stands for the time frame that should be used (Lira & Rocha, 2019).

One of the clinical issues that are faced in the US is an opioid overdose. The problem has increased with more reported cases of people dying from opioid overdose daily. It is estimated that more than 130 people die daily from opioid misuse. Therefore, the opioid crisis can be used to formulate a good PICOT question. Over time, self-administered drugs such as naloxone, also known as Narcan, have been developed to curb opioid misuse (Narcan, n.d).

In this case, the PICOT question that will be suitable and effective is “Can opioid users who have access to naloxone be compared to those without access to naloxone at the risk of having a fatal opioid overdose?”

In searching for peer-reviewed articles and research papers about the topic, some keywords should be used to ease the search. Some of the keywords used in this search include opioid overdose, the use of naloxone to curb opioid effects, the risk of overdosing among opioid users, overdose, emergency department, prevention, and death and opioid misuse. The databases that is used in this search include Ebsco, PubMed, and ProQuest.

When I searched how opioid users with access to naloxone and those without access to naloxone compared to the risk of suffering from an opioid overdose, there were 504 results. I narrowed down the research by limiting it only to academic journals, and the results were reduced to 120. I narrowed the research further by only limiting it to the peer-reviewed articles written within the last five years, and the results were reduced to 85.

When I searched how naloxone prevents opioid misuse, there were ten results. When the search was narrowed down to only peer-reviewed articles written in the last five years, the results were reduced to 2. When I replaced the word naloxone with Narcan, the results increased to 161, which included peer-reviewed articles written in the last five years. When I searched the term opioid overdose, the results increased further to 8432. However, when I searched for opioid overdose prevention, the search results decreased to 4483.

There are some strategies that can be used to increase the rigor and the effectiveness of the database search. According to Melnyk and Fineout-Overholt (2018), one of the factors that contribute to effectiveness in a database search is using the right databases. Some databases have been equipped with peer-reviewed articles in one field. Therefore, it is wise to search in the relevant database. For instance, when searching about healthcare issues, one should search in healthcare databases for better results.

Additionally, to come up with effective and rigorous searches, one should search in numerous databases. That gives access to the most relevant searches as different databases may contain different articles. Also, one should use the appropriate vocabulary. That will ensure that the search results are relevant to the topic of interest. Finally, one should combine terms and concepts suing the Boolean operators to ensure that the search results are effective and relevant to the topic of interest.

 

References

Lira, R. P. C., & Rocha, E. M. (2019). PICOT: Imprescriptible items in a clinical research question. Arquivos brasileiros de oftalmologia, 82(2), 1-1.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Narcan. (n.d). Retrieved June 19, 2019, from https://www.narcan.com/

The following post is from another student. Please react adding other extra imformation relate to the post.

Short answer

Less than 10 % similarity

References APA

 

Question 1

At my care facility, we have had a system to monitor errors, and this is in alliance with the Patient Safety regulations set by the state and the World Health Organization (WHO). These system, however, consists mostly of complying with rules and filing of incident reports after an error was found. This reactive system lives little room for being proactive and catching errors before they happened. Therefore, as of last year, our facility has implemented guidelines that are more proactive in nature. Some of the priority areas as outlined by the World Health Organization’s World Alliance for Patient Safety and the Collaborating Centre are to do quarterly training in identifying and reporting medical errors, implement reporting guidelines that are not punitive in nature, but rather informative; this way no one is afraid to speak up, and lastly, identify the events that are “near misses” and develop a plan to make these less frequent (Grawn, Thom & Walters, 2015).

Question 2

The Institute of Medicine and Joint Commission published a study, “To Err Is Human”, which discuss in part that healthcare teams who fail to collaborate have increased mortality and failure-to-rescue (deaths within 30 days of admission among patients who experienced specific complications) rate” (Grawn, Thom & Walters, 2015). Nowadays there are partnership recommendations in position for healthcare facilities demanding implementation of “interdisciplinary practice plans” for accreditation by Joint Commission (Fewster-Thuente & Velsor-Friedrich, 2008). Effective communication is crucial to reducing medical errors and improving patient outcomes. The opportunity to act as a healthcare team is essential for improved patient care and the opportunity to provide care that’s “patient-centered and valued” (Ezziane et al., 2014).

Question 3

The Institute of Medicine’s four-pronged approach to reducing medical mistakes are: “(1) an analysis of errors at your practice site that have caused some degree of patient harm, and (2) an analysis of your aggregate medication-error data. The other 2 prongs, of equal importance, are both proactive in nature and include (3) an analysis of “near misses” (errors that have the potential to reach the patient or cause patient harm) and (4) an analysis of errors that have occurred in other organizations” (Westrick & Dempski, 2009, p. 117).

These elements entail being reactive, being proactive, analyze the mistakes, and correct them. All of these are reportable and should be taken into consideration at organizational evaluations consistently.

References

Grawn, S., Thom, F. & Walters, I. (2015). Building efficient medical teams in professional medical care. Journal of Organizational Management, 16(9), 28-36. doi:10.1108/14777261211251508

Fewster-Thuente, L., & Velsor-Friedrich, B. (2008). Interdisciplinary collaboration for healthcare professionals. Nursing Administration Quarterly, 32(1), 40-48. doi:10.1097/01.NAQ.0000305946.31193.61

Westrick, S. J., & Dempski, K. (2009). Essentials of nursing law and ethics. Sudbury, MA: Jones and Bartlett.

Please react to this student post. APA style, and less than 10 % similarity

The social determinants of health (SDOH)are generally answerable for health disparities. SDH are the conditions wherein individuals are conceived, develop, work, live, and age, and the more extensive arrangement of powers and frameworks forming the states of day by day life. These powers and frameworks incorporate monetary arrangements and frameworks, improvement plans, accepted practices, social approaches, and political frameworks (Rodriguez,2015).

For Healthy people 2020 the social determinants of health are: Social and Community context, Education, Health and Health Care, Economic Stability, and Environment. Social and physical determinants influence a wide scope of wellbeing, working, and personal satisfaction results. can influence in health and personal satisfaction results some time before we need clinical consideration, and these variables clarify to a limited extent why a few people are more advantageous than others. One social determinant has the potential to be a barrier to home care or care management service is the is the language and communication. Even when both client and nurse speak the same language, communication problems may occur because of varying cultural contexts in which words have different meanings to different people.

The level of education we have, the access to health care, our working status, and the environmental conditions we live influence our health. People living in slums are in risk drink contaminated water and get any waterborne disease. Communities with lower average incomes are disproportionately affected by poor environmental circumstances(Masto,2020).Many people without economic stability and low level education may cannot afford medical treatments or not really understand the medical information , others don’t even have transportation accessibility.

References

Masto, L. (2020). Why social determinants of health matter in clinical care. Retrieved from https://diatribe.org/why-social-determinants-health-matter-clinical-care

Rodriguez. (2015). Social determinants of health. Retrieved from https://www.who.int/social_determinants/health.

 this is an old assignment that the professor allows me to do it. Pless less than 10 % similatity

Please answer the following Discussion Question. Please be certain to answer the three questions on this week DQ and to provide a well-developed and complete answer to receive credit. Also, please ensure to have read the assigned chapters for the current week.

Case Study, Chapter 3, Developing Effective Leaders to Meet 21st-Century Health Care Challenges

An experienced registered professional nurse has just been promoted as the nurse manager of a nursing unit. The nurse had been a very effective leader on the unit prior to the promotion of becoming the nurse manager. The new nurse manager is making a list of essential characteristic of effective leaders.

1. What are factors that are driving the need for innovative and transformational leaders in health care for the 21st century?

2. What are essential characteristics of an effective leader that the new nurse manager needs to incorporate into the nursing unit culture?

3. The nurse manager is reviewing the strengths and weaknesses of three leadership models: transactional, transformational, and complexity. What are the essential characteristics of the three leadership models? Which model do you think is most effective to use in leading a nursing unit? Why?