PICO/Theory Assignment Krystle Harrison DeSales University Applied Research NU 530 Dr. Tricia Bernecker October 12, 2017 PICO/Theory Assignment 1) Identify a clinical question • Among dementia patients does the use of restraint free interventions versus restraints help improve patient safety and dementia behaviors? 2) Construct PICO questions using table provided. • PICO Table Population Dementia patients Intervention Restraint free interventions Comparison Restraint Outcome Improve patient safety and dementia behaviors 3) Identify theories that may serve as the theoretical underpinning to your clinical/PICO question, minimum of three: • Johnson's Behaviour System Model • Progressively Lowered Stress Threshold (PLST) Model • Need-driven Dementia-compromised Behavior …show more content…
379) • Analyze the theory as a whole in terms of your clinical/PICO question The PLST Model has principles of care that include decreasing stressors and providing a safe and predictable environment for people with dementia. The principles of care can help improve patient safety and dementia behaviors by using interventions that are restraint free, including but not limited to modifying the person’s environment to support losses and promote safe function. (Touhy & Jett, 2012, p. 379) Evaluation Criteria for the Assignment Criteria Points Possible Properly worded PICO question, and completed table 20 points Three theories identified 20 points One theory described and analyzed 30 points Reference page 10 points Proper use of APA format, grammar, punctuation and spelling 10
Takahashi’s past wishes will help the healthcare team understand the patient’s current quality of life relative to her being before the onset of dementia and even prior to the stroke. A person’s quality of life appears different to different people, hence the disagreement among grandchildren. Mrs. Takahashi has a 5-10% chance of returning to a life of meaningful quality with aggressive treatment that will more than likely include significant suffering. Physicians in the past have noted that when treating patients similar to Mrs. Takahashi the healing process was not always effective, patients were susceptible to other illnesses, and mobility was fixed to a wheelchair or bed at best. A study conducted by Morrison and Siu (2000) followed acutely ill patients with end stage dementia and a poor prognosis to determine if emphasis should switch from curative interventions to palliative care. The first group of participants included demented patients with either pneumonia or hip fractures, and the second group included cognitively intact older adults with similar injuries. The researchers found that for the elderly with pneumonia, the mortality rate was 53% in demented patients and only 13% for non-demented patients. An identical trend was seen in the participants with hip fractures, producing a mortality rate of 55% in demented patients and 12% in non-demented individuals. Both types of participants received an equal amount of intense procedures yet mortality rates drastically differed, leading to the conclusion that healthcare teams should focus their efforts to enhance comfort in the demented patient population (Morrison & Siu 2000). Given the poor prognosis, the Ethics Committee finds it imperative that the healthcare team learn more about Mrs. Takahashi’s preferences and family relationships prior to dementia and recommend treating the patient via palliative care if there is no substantial improvement in her health after a limited time of aggressive
Study shows good success in safe discharge planning with informed discharge decision, will reduce hospital readmission (Bauer et al 2009). However, poor experience of failed discharge is being cited in numerous reports ((Francis 2013). Hospital discharge team must ensure that patient and their carer 's expectation are managed and discharge team are able to identifying the goals and concerns in a timely manner to avoid any further delay in discharge process. Care co-ordinator should lead the discharge process and they should be the families ' first point of contact. Patient with known Alzheimer 's, dementia should have written information to ensure that personal information is availibable
Aging is a natural part of human life. With modern technologies and medical innovations, the society has been able to prolong life and thus increase the number of older adults in the society. Normal part of aging are inevitable physiological and psychological changes, which need to be understood and addressed by nurses in order to provide appropriate care for older adults. Presenting patient’s description with appropriate data, I will utilize Watson’s Caring theory (2008) to assess the lower order need of activity-inactivity relative to this older adult patient cared for in the hospitalized environment. The integration of theory, research and best practice guidelines will be used to plan nursing interventions and strategies to meet the health needs of older adults in health care. Watson’s (2008) fourth caritas process of developing and sustaining a helping-trusting caring relationship will be used to describe the nursing implementations which were utilized in providing safe and competent care for older adult.
Physical restraint, according to Health Care Financing Administration, can be defined as any handling, physical and mechanical methods applied to a patient with the aim of denying him or her the freedom of movement or access to his or her own body (Di Lorenzo et al., 2011). It may involve use of belts or ties that restrain movement of an individual such as seclusion. Seclusion refers to isolation from others, often done in a room that’s I avoid of any furniture and has a small observable window as the only connection to the outside world (Chandler, 2012). The use of physical restraint in handling patients has been on debate for several years now. In most countries such Italy, it
Taking this into consideration the nurse began to carry out a risk assessment and care plan to address the issues recognised. According to the National Institute for Health and Care Excellence (NICE) (2015) health and social care staff should identify the specific needs of people with dementia and their carers arising from ill health, physical disability, sensory impairment, communication difficulties, problems with nutrition, poor oral health and learning disabilities. Care plans should record and address these
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Of nursing home staff interviewed in 2004, nearly 40% admitted to committing at least one psychologically abusive act toward a resident and 10% admitted to physically abusing a resident in the preceding year.[1] Not only are nursing home residents at risk of being abused by their caretakers but they are also at risk of being restrained, which may lead to a form of abuse. With five percent of the elderly population, or one to two million instances of elder abuse occurring yearly there is no doubt that elder abuse deserves serious consideration.[2]
We all know someone who has been placed in a health care setting such as a rest home or hospital because their needed care is out of their families own ability; whether it’s our own grandma or the neighbor’s great aunt. Many people in this day and age are getting care from health care workers on a daily basis and need constant watch and care. Many of those in the older population are put into rest homes where they can spend the rest of their lives in comfort, while others are placed in hospitals to recover from a stroke or a mental illness. At times, many patients become abusive or unresponsive by choice or not. Because of this abuse and also less control over thoughts and feeling restraints are used to keep them safe. Many believe that last statement; that they are completely safe. With my knowledge, the use of physical and chemical restraints in geriatric health care settings, such as rest homes, should be lessened because they cause injury, require patients to need more care and they take away necessary freedoms.
Every older people suffering from dementia or any mental illness should contribute to decision-making process if able on about the services the resident gets and is empowered to practice choice and control over his or her way of life. Healthcare professionals need to offer residents with dementia significant parts in making their own particular care plans. We should give the majority of the residents as much decision as possible around both their care and environment.
Many seniors around the world are being abused and harmed in some substantial way often by people who are directly responsible for their care (Robinson, 2016). Neglect of all forms causes harm to a patients overall well-being. Neglect happens in 60% of people and physical abuse happens to 15% of people (Franklin, 2013). There are three different types of neglect that can happen especially to the elderly. The three types of neglect are mental, emotional and physical neglect. Mental neglect, is basically ignoring or just not showing care or love for the patient. Emotional neglect is not only ignoring, but isolating the patient from others. Physical neglect which is causing physical injury to the body from rough handleing or non-supervision. Neglect is damaging not only to a body but also to the mind and over all
In an article written by Samantha P. Ziglar, BSN, RN, she describes the main purpose of restraints through her eyes in the medical field. Ziglar states that at least one in every four patients will be restrained at least once, that’s 79.715 million people in the United States (Population). “Specific reasons include fall prevention, limiting wandering behavior and preventing dislodging or interference of therapeutic devices, and controlling violent or agitated behavior” (Ziglar 1). Ziglar emphasises the growing problem among restraints; improper use among nurses. “Patient safety should be every nurse’s top priority; therefore, nurses need to have a thorough knowledge base of the risks and benefits of using physical restraints” (1). As a result of what a nurse needs, restraints are required to succeed in his or her profession, making their patient as safe and comfortable as possible. The purpose of restraints as a whole is to provide patient protection. Ziglar lists the pros and cons of the use of restraints. Some major
In conclusion, the clinical and statistical approaches in psychology can be beneficial to clinicians depending on the types of situations or specific areas that are being observed. As I mentioned earlier in my paper, the statistical method is useful when results are large and from heterogeneous samples and when they pertain to objective and specific areas. The clinical approach is beneficial in circumstances where situations are unforeseen rendering statistical tests moot. In addition, they are also useful when the interest in an individual case is high. Due to each individual being different and unique in their own way, I believe that clinicians should not rely heavily on statistical predictions and prepackaged treatments as opposed to clinical judgment and individual patients.
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