Psychotherapy is a talk therapy in which people work with trained professional therapists to discuss their problems and learn new skills. Psychotherapy can help depressed individuals to talk about their experiences and feel listened to, gain insight into and often some measure of control over the thinking processes that lead to depressed moods, explore the contribution of past experiences to present day distress, and learn practical coping skills that can help decrease the likelihood of developing future depressive episodes. As mentioned previously, many different professions train their members as psychotherapists. Psychotherapists may be psychologists, social workers, trained nurses, psychiatrists, counselors, psychoanalysts, or even professionals from other disciplines.
Clinical inquiry and question - Paper Example Clinical inquiry and question - Part 65 In order to employ evidence-based practice, development must begin with clinical inquiry and question - Clinical inquiry and question introduction.
The purpose of this paper is to utilize PICO to identify the clinical question, describe two evidence-based practice models, identify search terms which determined the clinical question, describe the number of articles retrieved from searching, and the relationship between levels of evidence and grades of recommendations based on an evidence grading system.
PICO Asking a focused clinical question is the first step to obtaining evidence-based answers. The PICO question is a useful model is used to formulate clinical questions. Using the PICO method, the following clinical question was formulated: In emergency department patients requiring procedural conscious sedation, how does spectrograph monitoring compare to standard pulse geometry in the early identification of acute respiratory depression?
The five model steps are: The ACE model allows investigators to cycle familiar processes through the research star model in order Depression-evidence based practice essay implement and guide effective, quality practice improvement.
The model was designed in three key stages, including: This model provides comprehensive user-friendly tools to address the practice question and guide each aspect of the evidence-based practice process.
Evidence-based practice models provide the framework to guide the evaluation of current practice and methodically progress toward improvement in healthcare and outcomes.
Both models have the potential to be used across a variety of settings, include guidance for practice change, and emphasizes translation.
Clinical Question Procedural conscious sedation has become a common emergency department clinical practice used to lessen pain and anxiety for patients requiring certain medical procedures. However, the primary cause of morbidity in conscious sedated patients is drug-induced respiratory depression Reworks, Monitoring for respiratory depression requires not only healthcare providers proficient in critical care, but also extensive monitoring equipment.
Standard monitoring includes pulse geometry, which is a continuous method of monitoring oxygenation by measuring arterial hemoglobin saturation Esp. However, spectrograph is the continuous measurement of end-tidal carbon dioxide ETC throughout respiration to determine if HyperCard is present and may be more useful in determining early hyperventilation and respiration.
Consequently, do emergency department patients undergoing procedural conscious sedation who are monitored with spectrograph, as compared to the standard pulse geometry, have better outcomes due to earlier detection of respiratory depression?
Evidence Search In order to reveal what research exists regarding spectrograph monitoring for emergency department procedural sedation, searches were performed and recorded of the Pumped and OBESE databases, as summarized in Appendix A.
Further refinement to include only randomized controlled trials and articles less than 10 years old generated 25 hits. Of those results, three articles were chose to be included in the literature review.
Next, OBESE was searched using the same key terms and limited to articles less than 10 years old, 14 articles resulted many of which were overlapping from Pumped.
Of these findings, one article was selected for the literature review. Evidence Grading System Upon assessment and evaluation of the four selected articles, as summarized in Appendix B, the Evidence-Based Review Matrix, it is evident that spectrograph can be used to augment monitoring for respiratory depression during procedural sedation in the emergency department.
Three articles reviewed clearly demonstrated that spectrograph use recognized respiratory depression earlier than standard monitoring only.
The one article that weakly proved that destination was recognized with pulse geometry sooner than spectrograph had software problems and providers had difficulty determining a baseline ETC.
Also, in this randomized-controlled trial all subjects in this study were monitored with both pulse geometry and spectrograph, the randomization was of the sedation medication.
One systematic review existed among the four research articles investigating the use of spectrograph during procedural sedation in the emergency department. This systematic review took the data from multiple studies and combined them into tables, in order to assess and rank each article in terms of the level and quality of evidence, and relevance and applicability to practice.
The review was effective in concluding end-tidal CO is a more responsive indicator f respiratory depression than Esp. Of the final two randomized-controlled trials, the first investigated 1 32 patients, randomly assigned to the control group blinded spectrograph or study group spectrographundergoing procedural sedation in the emergency department.The present study would focus evidence based practice on depression.
The dysfunctional families exhibited least of these characters, indicating high rates of psychosocial and clinical depression.
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Keywords: Major depression, elderly, evidence-based practice, primary care, home health care, barriers to depression care, collaborative depression care Introduction Clinical depression is prevalent among older adults and negatively affects functional status, quality of life and mortality, while increasing health care costs and taking a toll on.
Clinical Practice Review for Major Depressive Disorder. Diagnostic and Statistical Manual of Mental Disorders Numerous effective, evidence-based first- and second-line treatments for MDD are available, and for patients with more chronic or treatment-resistant depression, many treatment strategies have shown promise.
MDD Clinical. ORIGINAL RESEARCH Implementation of an Evidence-Based Depression Care Management Program (PEARLS): Perspectives From Staff and Former Clients.
More Essay Examples on. Population: emergency department patients requiring procedural conscious sedation Intervention: phonograph monitoring Compare: standard pulse geometry Outcome: early recognition of respiratory depression Evidence-Based Practice Models Evidence-based practice nursing models contribute conceptually to the implementation of evidence based nursing practice.
Evidence Based Practice Essay. evaluated and critiqued is due to evidence based practice. Evidence based practice is a method of problem solving, which includes identifying the clinical problem, searching literature, evaluating the research evidence and then deciding on the interventions (White ).