evidence based practice

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Introduction
Evidence Based Practice (EBP) is defined as “The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external evidence from systematic research” (Gerrish & Lacey, 2010). EBP is critically important in today’s clinical settings because of its potential to save both nursing time and healthcare dollars (Gerrish & Lacey, 2010). Using the evidence to guide practice streamlines nursing care. Practices that are not necessary are eliminated, and ineffective practices are replaced with practices that result in the desired outcomes. Using research also decreases the need for trial-and-error methods for finding what works best. In each case, nursing time is not spent on ineffective procedures or trying numerous interventions before finding the “right” one and nursing time is spent where it can be most effective (Gerrish & Lacey, 2010). This essay will explore the given case study of Mr Armitage using an EBP approach to provide best care for two of his main issues which are type 2 diabetes and obesity. Rationales will be provided as why these issues are the main focus and questions will be developed to guide search strategies. An outline will be given on finding the evidence: concepts used, databases and included in this section will be a search table. The evidence chosen will be appraised and key findings will be discussed along with the best practice for Mr Armitage and how this practice can be implemented.

Mr. Armitage is a 50-year old male of Aboriginal descent. His major complaints are: Shortness of breath, dizziness, frequent urination, occasional tinnitus. He has a five year history of ill controlled Type-2 diabetes mellitus. This was diagnosed in 2004 after a 2-year hiatus of symptoms that were suggestive of hyperglycemia. His general state of health is fair; he reports bouts of dizziness, dry mouth, frequent urination, occasional tinnitus, weight gain and slow healing of minor wounds. He is clinically obese with a relative sedate life-style. Mr. Armitage is married and has two adult children, one of whom helps him and his wife with their grocery store business. The Armitages live about an hour from their business and commute daily by automobile. Both report that the commute is, at times, stressful for both. It appears that the high cholesterol, apnea, hypertension and type-II diabetes that Mr. Armitage is experiencing may have some potential genetic predispositions as well as lifestyle issues. His father died of coronary disease at age 78 and his uncle at age 72. Mr. Armitage reports no allergies, but does admit that he has been unable to remain on a healthy diet (low-glycemic) due to work schedules and pressures (time etc.). He drinks alcohol in moderation and limits sugary sodas, but admits to not drinking enough water during most days. He sleeps less than 8 hours, but because of frequent urination and apnea, he does not feel that he ever gets enough sleep. His current medical regimen includes an 80mg low dose of aspirin and a statin that he admits to not using regularly. Problems and guiding questions

Using the model of Evidence Based Practice, outlining the chosen issues presented by Mr. Armitage is needed. Evidence for these issues should be primarily scholarly, with the bulk of the materials available from peer-reviewed journals or publications, even Web-Based materials, as long as those materials are written by qualified scholars and/or medical professionals.

Type II Diabetes: II Diabetes, also known as diabetes mellitus, is also called non-insulin-dependent diabetes or adult onset diabetes. It is a medical disorder that, due to a number of factors codependent with the modern world, is characterized by higher than normal blood glucose levels that play havoc with insulin deficiency and resistance....