1 – A medical diagnosis deals with a disease or medical condition. A nursing diagnosis deals with the human response to actual or potential health problems and life processes. For example, a medical diagnosis of CVA or stroke provides information about the patient’s pathology. The complimentary nursing diagnosis of impaired verbal communication, the risk for falls, interrupted family process, and powerlessness provide a more holistic understanding of the impact of that stroke on this particular patient and his family. They also direct nursing interventions to obtain patient-specific outcomes. The ANA provides leadership in determining the goals, objectives, and professional practice of nursing. ANA defines nursing as a “caring – based practice in which the process of diagnosis and treatment are applied to human experiences of health and illness”(ANA,1994). Nurses are accountable for their decisions and make them in collaboration with a multidisciplinary health care team. Nurses assess patients, plan, implement, and evaluate interventions to help patients cope with problems that arise in response to signs and symptoms of illnesses or preventive self-care activities. Physicians do not complete all treatments or personal care because all professional resources need to be appropriately deligated for the best availability of resources. A nursing problem is noted during assessments often from a condition or disease of a patient. It ranges from the care needs of the patient from the time they step foot in the health care environment, during the doctor’s diagnosis and to the assessment of patient needs after the care. The nursing problem assessment requires a comprehensive collection of data on the patient. PICOT stands for population/patient problem, intervention, comparison, outcome, and time. A clinical question needs to be directly relevant to the patient or problem at hand and phrased in such a way as to facilitate the search for an answer. PICOT makes this process easier. It is mnemonic for the important parts of a well-built clinical question. It also helps formulate the search strategy by identifying the key concepts that need to be in the article that can answer the question. PICOT questions should fall under therapy/prevention, diagnosis, etiology, and prognosis. To make an appropriate intervention PICOT should be based on evidence-based practice.

Wilcro

2- A medical diagnosis deals with a disease or medical condition. A nursing diagnosis deals with the human response to actual or potential health problems and life processes. For example, a medical diagnosis of CVA or stroke provides information about the patient’s pathology. The complimentary nursing diagnosis of impaired verbal communication, the risk for falls, interrupted family process, and powerlessness provide a more holistic understanding of the impact of that stroke on this particular patient and his family. They also direct nursing interventions to obtain patient-specific outcomes. The ANA provides leadership in determining the goals, objectives, and professional practice of nursing. ANA defines nursing as a “caring – based practice in which the process of diagnosis and treatment are applied to human experiences of health and illness”(ANA,1994). Nurses are accountable for their decisions and make them in collaboration with a multidisciplinary health care team. Nurses assess patients, plan, implement, and evaluate interventions to help patients cope with problems that arise in response to signs and symptoms of illnesses or preventive self-care activities. Physicians do not complete all treatments or personal care because all professional resources need to be appropriately deligated for the best availability of resources. A nursing problem is noted during assessments often from a condition or disease of a patient. It ranges from the care needs of the patient from the time they step foot in the health care environment, during the doctor’s diagnosis and to the assessment of patient needs after the care. The nursing problem assessment requires a comprehensive collection of data on the patient. PICOT stands for population/patient problem, intervention, comparison, outcome, and time. A clinical question needs to be directly relevant to the patient or problem at hand and phrased in such a way as to facilitate the search for an answer. PICOT makes this process easier. It is mnemonic for the important parts of a well-built clinical question. It also helps formulate the search strategy by identifying the key concepts that need to be in the article that can answer the question. PICOT questions should fall under therapy/prevention, diagnosis, etiology, and prognosis. To make an appropriate intervention PICOT should be based on evidence-based practice.

Chereg

3- Identify two areas of nursing practice, which evidence-based practice has improved patient outcomes. State the study and its impact on patient care. How have these findings changed your nursing practice? Please support your response with a minimum of two supporting peer reviewed articles.

Evidence-based practice (EBP) paves the way for nurses to provide safe and effective care to patients. In order to achieve better outcomes, nurses can apply research with clinical knowledge, patient values, and actively engage in learning and research. The evolving health care system can maintain or change the way nurses apply their practice based on continued research and incorporating new and effective ways to improve patient outcomes.

Shoulder dystocia is a birth emergency that occurs in approximately 1% of all births. Shoulder dystocia can be followed by broken clavicle or humerus, brachial plexus injury, fetal hypoxia, or death. Although risk factors for shoulder dystocia include previous birth complicated by shoulder dystocia, maternal obesity, excessive prenatal weight gain, fetal macrosomia, gestational diabetes, and instrumental delivery, shoulder dystocia is not predictable. Perinatal nurses can reduce the risk for shoulder dystocia by teaching mothers about optimal weight gain in pregnancy and assisting mothers with diabetes to prevent hyperglycemia through diet management and medication use. Nurses are there with the patients through the labor and have continued to care for the patient. Nurses are trained to notice the signs of shoulder dystocia and notify the physician come to the delivery stat. During childbirth preparation or early labor, nurses can educate mothers about position changes and maneuvers used for shoulder dystocia. Nurses play a vital role in obtaining assistance during a shoulder dystocia, keeping time, assisting with maneuvers such as suprapubic pressure, and documenting the dystocia management. Nurses can assist mothers and families to review the shoulder dystocia and any newborn injuries in the postpartum period, thereby reducing confusion and anxiety. Regular drills and case reviews help build nursing shoulder dystocia management skills.

Shoulder dystocia is one of the most anxiety-provoking emergencies encountered by physicians practicing maternity care. Typically defined as a delivery in which additional maneuvers are required to deliver the fetus after normal gentle downward traction has failed, shoulder dystocia occurs when the fetal anterior shoulder impacts against the maternal symphysis following delivery of the vertex. Less commonly, shoulder dystocia results from impaction of the posterior shoulder on the sacral promontory.1The physician is there to try and fix the problem, but the nurse has spent time during the pregnancy with the patient to help avoid the situation. The nurse is also now the steps to take during the emergencies.

P-laboring patient,I-labor risk, C-help to remove potential risk factors, O-positive outcome(no dystocia), T-the time it took to acheive a safe labor.

Elocam

4- Medical research is invaluable to discovery and improving outcomes, just as nursing research. Aristotle said it best, “The whole is greater than the sum of its parts.” In other words, when individual parts are connected together to form one entity, they are worth more than if the parts were in silos. Applying this quote to research, every type of research all works together to improve patient outcomes.

A good illustration occurred during the Ebola crisis some years ago.

• Medical research – addressed the cause of the virus
• Pharmaceutical research – developed a pharmacological treatment for the virus
• Public Health – focused on prevention, and education to reduce the spread of the virus
• Nursing research – addressed the impact on the pt and family affected by the disease
• Mental Health research – addressed the psychosocial effect on both healthcare providers and pts/families

The knowledge gained from each type of research served to build upon the current body of knowledge. One type alone would be ineffective in treating and ultimately reducing the risk and incidence of this deadly virus.

The key to remember is that all research has value. Just as, all members of the healthcare team each have a role to play.