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Nursing Reference Center with Patient Education Reference Center Supporting Nursing Excellence. Nursing Reference Center with Patient Education Reference Center.
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Nursing Reference Center with Patient Education Reference CenterSupporting Nursing Excellence
Nursing Reference CenterwithPatient Education Reference Center A web-based nursing reference system designed to provide the latest evidence-based clinical information at the point-of-care, for nursing practice, education, and research.
Staff and advanced practice nurses Nursing practice councils Nurse educators and researchers Nursing faculty and students Ancillary health practitioners Case Managers and Discharge Planners Hospital librarians Clinical risk managers Nursing Reference Center with PERC Users
Nursing Reference Center with PERC Components • Quick Lessons &Evidence-based Care Sheets • Nursing Skills & Procedures • Cultural Competencies • Drug Information • Patient Education Handouts • Practice Guidelines & Research Instruments • Legal Cases and Unique Reference Books • Continuing Education Modules
Quick Lessons & Evidence-Based Care Sheets —What’s the Difference? Quick LessonsDocuments that provide nurses with on-the-spot information about diseases and conditions—descriptions, signs and symptoms, interventions, and typical tests to diagnose or measure treatment progress . Evidence-Based Care SheetsDocuments that provide the best available evidence about aspects of a disease or a condition—what we know and what we can do. The evidence is coded as to its strength, which underscores its relevance to evidence based practice.
Determining the Best Available Evidence:Evidence-Based Care Sheets Gravante G, Caruso R, Araco A, & Cervelli V. Infections after plastic procedures: Incidences, etiologies, risk factors and antibiotic prophylaxis. Aesthetic Plastic Surgery 2008; 32(2): 243-251. (RV) M Published meta-analysis SR Published systematic or integrative literature review RCT Published research (randomized controlled trial) RV Published review of the literature RPublished research (not randomized controlled trial)
1 Strength of evidence supporting EBP 2 3
Skills & Procedures Skills are necessary steps to achieve proficiency in specific nursing tasks. Procedure papers outline ways to accomplish the task in practice. Competencies: Papers covering job-specific tasks for which the health care care professional is responsible. Cultural Competencies Papers providing background for practicing culturally sensitive care in diverse populations. Nursing Skills, Procedures & Competencies
Health Beliefs and Attitude Toward Health (1) (6) 11) …believe the general concepts of physical and mental health include eating nutritiously, being physically active, and maintaining harmony within the family… Attitude Toward Illness and Treatment (8) (10) …illness and disease are a result of soul loss caused by ancestral spirits. Signs of an unhealthy body are believed to be visible, such as a rash or persistent cough… such diseases/conditions as hepatitis, tuberculosis, AIDS, lead poisoning, and renal disease are not believed to exist unless signs are visible… Attitude Toward Health Professionals (1) … 10. Smith L. Critical thinking, health policy, and the Hmong culture group, Part 1. Journal of Cultural Diversity 1997; 4(1): 5-12. (RV) Culturally Sensitive Care:the Adolescent Hmong Patient
Additional Components • Point-of-Care Drug Information for Nurses • Davis’s Drug Guide for Nurses • AHFS Drug Information Essentials • Current Drug News and Updates • Unique Reference Books, such as: • Taber’s Cyclopedic Medical Dictionary • Laboratory & Diagnostic Tests with Nursing Implications • Diseases and Disorders: A Nursing Therapeutics Manual • Concept Mapping: a Critical Thinking Approach to Care Planning • Nursing Diagnosis Manual: Planning, Individualizing & Documenting… • Links to journals in CINAHL and MEDLINE for subscribing institutions
Additional Components • Patient Education • Over 4,000 Health Library documents presented in 17 languages, with custom printing and detailed medical illustrations • Continuing Education for Nurses • Over 250 modules offering CEs at no cost to nurses • Health Nursing News • Health Day News with daily FDA, Clinical and Drug Updates
Answering Clinical Questions at the Point of Care
Nursing Clinical Scenario – Ulcerative Colitis Mr. J., 35 years of age, has had severe ulcerative colitis since the age of 19. He is now admitted to the acute care unit for treatment of an acute exacerbation. He makes the decision to undergo colectomy (bowel resection) when his condition stabilizes. • What are immediate nursing actions? • What are red flags? • What tests are ordered? • What are treatments goals? • What are necessary nursing skills and precautions?
Developing Treatment Goals and a Plan The evidence-based plan will include: • Safe administration of multiple potent medications • Fluid & electrolyte management • Nutritional assessment and counseling • Perioperative planning for colectomy • Health education
Hydrocortisone Dosage and Administration for Ulcerative Colitis • …Rectal (as Retention Enema)• Adjunctive treatment of ulcerativecolitis: 100 mg nightly.[a] Some clinicians recommend 100 mg twice daily followed by 100 mg nightly when improvement occurs.[a]… • • Lay on left side during and for 30 minutes after administration to distribute drug throughout the left colon.[a] Retain for ≥1 hour, preferably all night.[a]… • • Symptoms may improve in 3–5 days, followed by proctologic improvement.[a] Discontinue if clinical or proctologic improvement does not occur within 2–3 weeks.[a]… • • Following treatment for >21 days, gradually withdraw use; give every other night for 2–3 weeks, then discontinue.[a]… • Hydrocortisone, Hydrocortisone Acetate, Hydrocortisone Buteprate, Hydrocortisone Butyrate, Hydrocortisone Valerate (Topical) By: McEvoy GK, AHFS Drug Information Essentials, 2006-2007, January 1, 2009
Planning for Colectomy: Surgical Site Infection Protection • …Risk factors(1)(2)…(5)(6) • Patient risk factors • Diabetes mellitus, poor nutritional status, older age, cigarette smoking…patients with chronic illness, coexisting infections at other sites, nares that are colonized with S. aureus,… • Surgical risk factors • Inadequate antiseptic shower or bath, inadequate skin preparation, and lack of antimicrobial prophylaxis… lack of or improper use of surgical barriers, compromised aseptic technique… • Surgical personnel risk factors • Surgical personnel infected or colonized with bacteria and/or who use poor handwashing techniques • Postoperative risk factors • Poor wound management and inadequate patient education upon discharge • (2) Gravante G, Caruso R, Araco A, & Cervelli V. Infections after plastic procedures: Incidences, etiologies, risk factors and antibiotic prophylaxis. Aesthetic Plastic Surgery 2008; 32(2): 243-251. (RV)
Continuing Nursing Education 3. Add
What Did I Learn? • Assessment, treatment goals, and red flags associated with acute UC exacerbation • Administration safety and precautions associated with hydrocortisone • Assessment of nutritional and skin status • The best available evidence for prevention of surgical site infections • Care of the patient with an enterostomy • How to choose, customize, and print patient and family education materials • How to save articles and searches • How to obtain online continuing education credit • How to get full-text journal articles with CINAHL with Full Text • How to search the database for support of evidence-based nursing practice and research
