Question

Complete all of your lesson materials and assigned readings. Make sure that you are focusing on:

• An example of an evidence-based practice (EBP) project
• How EBP projects can improve patient care

1. Give an example of an evidence-based practice (EBP) project that you have either been a part of or have knowledge regarding. 2 Points

2. Describe how the EBP project can improve patient care. 2 Points

Answer 1

PRESENTATION

Mary is aged 42 years ,divorced with 2 children ,employed part time and cares for her mother who has Alzheimer's disease.

PAST HISTORY

Mary has no significant past history,although she frequently makes appointments with her GP and practice nurse about problems experienced by her and her children.She was moderately depressed following her divorce 5 years ago and was offered antidepressants but declined them.She was referred for 6 sessions of counselling,which led to some improvement in her symptoms.

ASSESSMENT

Mary complaints of feeling stressed all the time and constantly worries about anything and everything..She describes herself as always having been a worrier but her anxiety has become much worse in the past 12 months since her mother became unwell, and she no longer feels that she can control these thoughts.when worried,Mary feels tension in her shoulders,stomach and legs,fer heart races and sometimes she finds it difficult to breathe.Her sleep is poor with difficulty getting of to sleep due to worrying and frequent wakening.She feels tired and irritable.She does not drink any alcohol.

other criteria on examination

Consider the diagnosis of GAD in people presenting with anxiety or significant worry, and in people who attend primary care frequently who:

**have a chronic physical health problem or

**do not have a physical health problem but are seeking reassurance about somatic symptoms (particularly older people and people from minority ethnic groups) or

**are repeatedly worrying about a wide range of different issues

When a person with known or suspected GAD attends primary care seeking reassurance about a chronic physical health problem or somatic symptoms and/or repeated worrying, consider with the person whether some of their symptoms may be due to GAD.

For people who may have GAD, conduct a comprehensive assessment that does not rely solely on the number, severity and duration of symptoms, but also considers the degree of distress and functional impairment.

As part of the comprehensive assessment, consider how the following factors might have affected the development, course and severity of the person's GAD:

**any comorbid depressive disorder or other anxiety disorder

**any comorbid substance misuse

**any comorbid medical condition

**a history of mental health disorders

**past experience of, and response to, treatments.

Effective interventions with rationale

Interact with patient in a peaceful manner.

The nurse or health care provider can transmit his or her own anxiety to the hypersensitive patient. The patient’s feeling of stability increases in a calm and non-threatening environment

Converse using a simple language and brief statements.

When experiencing moderate to severe anxiety, patients may be unable to understand anything more than simple, clear, and brief instruction.

Allow patient to talk about anxious feelings and examine anxiety-provoking situations if they are identifiable.

Talking about anxiety-producing situations and anxious feeling can help the patient perceive the situation realistically and recognize factors leading to the anxious feelings.

Non effective interventions

Providing misleading information to the patient.

Communicate with rough language.

sitting alone in a closed room

Stress reduction techniques

Take a break from the stressor.If the anxiety is caused due to some stressors like family issues,economical issues,or any medical related problems ,it is vital to aviod these stress by some other deviating techniques.your anxiety is related to job problems you should take a break from there.  But when you give yourself permission to step away from it, you let yourself have time to do something else, which can help you have a new perspective or practice techniques to feel less overwhelmed. It’s important to not avoid your stress (those bills have to be paid sometime), but even just 20-minutes to take care of yourself is helpful.

Exercise.exercise is an another important technique to overcome stress and fear.The research keeps growing — exercise benefits your mind just as well as your body.. But even a 20-minute walk, run, swim or dance session in the midst of a stressful time can give an immediate effect that can last for several hours.

Deep breathing exercise.

Breathe in deeply and slowly through your nose,expanding your lower rib cage, and letting your abdomen move forward.

Hold for a count of three to five.

Breathe out slowly and completely through pursed lips.

Don't force your breathe out.

Rest and repeat 10 times every hour.

Brief

Anxiety is a mental health disorder characterized by feelings of worry ,anxiety or fear that are strong enough to interfere with one's daily activities .Examples of anxiety disorders includes panic attacks,obsessive compulsive disorder and post traumatic stress disorder.It is more than 10 million cases per year.It can be managed by counselling or medication including antidepressants.