Points Range: (2-2.

5)
Correctly identifies and relates EBP to patient

EBP: Smoking Cessation Interventions and Strategies

Identify: Smoking has been identified as one of the most significant causes of avoidable death
and disease. Nurse initiated advice should be considered front-line therapy. Identifying persons
who smoke is essential in implementing nursing interventions to properly educate and motivate
the patient to seek guidance and therapy toward smoking cessation. Patient’s name is J.B. in
room 3214. Admitted to the hospital on 10/31/18 by Dr. Mbachu for chest pain and a pulmonary
embolism in his R lung. Chart reads “chest pain” but patient corrected with stating that “he never
experienced any chest pain – only back pain”. Because of billing issues, certain tests can’t be
given unless the official diagnosis includes chest pain. Patient’s most recent vitals were temp
97.6F, HR 71, R 17, BP 144/75, SaO2 97%, and pain 5/10. I am concerned about keeping the
patient’s pain under control and monitoring his sinus rhythms because he had a “4-second pause”
yesterday 11/01/18 and the day before 10/31/18. I am also concerned because he started taking
Warfarin yesterday 11/01/18 but wasn’t educated on the smoking cessation the importance of
preventing bleeding. I educated him that he should brush his teeth with a soft-bristle toothbrush
and shave with an electric razor, but I think the information should be reviewed again before he
is discharged.
B: Patient has a history of abdominal pain, anxiety disorder, heart palpitations, and hypertension.
Family history of cancer, diabetes, and congestive heart failure. Past surgeries include
Appendectomy, Tonsillectomy and Adenoidectomy. He has no listed allergies and no given
allergies when questioned.
A: Patient is awake, alert, oriented to time and place, conversant, independent, very cooperative,
and friendly. However, he was very anxious about
being discharged that day (11/02/18) and needing a note signed by Hematologist for work. The
anxiety was alleviated after the note was signed. Skin
is warm and dry with no breakdown. He has an “IV-Lock” on his L antecubital that was put in at
Portage before he was transferred here. He is not
receiving any fluids, but it was used to inject dye for an echocardiogram and the dressing was
changed today. He is on a regular diet. Most of the
time, he describes his pain as “tolerable” and rates it as a “4 or 5/10” but the pain is worse after
coughing. He started taking Lisinopril (an ACE inhibitor) yesterday (11/02/18) and has been
experiencing a dry, persistent, non-productive cough as a side-effect. Diminished lung sounds
due to pain when the patient inhales deeply, but no adventitious sounds noted. Normal heart
sounds and sinus rhythm with no adventitious sounds. I also recommend adjusting the patient’s
Norco (Hydrocodone-acetaminophen) and Tylenol (acetaminophen) doses so that the total of
acetaminophen
does not exceed 4,000 mg per day. I also recommend the patient should be educated again on
assessing for bleeding, using a soft-bristle toothbrush,
using an electric razor, and avoiding
Despite the increase in public knowledge, and the push for smoke exposure reduction, the
prevalence of smoking continues to represent a threat to the health and wellbeing of active and
passive smokers alike. Programs that encourage smokers to quit have been described as effective
tools in promoting health and reducing the burden of disease related to smoking.
Despite the potential impact of cessation programs on smoking, many smokers enter and exit the
health care system every day without receiving advice about this important health risk. In order
to effectively implement smoking cessation strategies, establishing the best available evidence
relating to this area of health care is a significant first step

Points Range: (2-2.5)

Appropriately compares and contrasts nursing interventions of patient care based upon EBP recommendations.

EBP: Smoking Cessation Interventions and Strategies

Identify: Nurse initiated advice should be considered front-line therapy. Identifying persons who
smoke is essential in implementing nursing interventions to properly educate and motivate the
patient to seek guidance and therapy toward smoking cessation.
Rationale: The cessation of smoking has been proven to decrease the risk of acute conditions
and should especially be prioritized in patients with multiple co-morbidities.

Points Range: (2.2.5)

Appropriately identifies and evaluates self- care activities as it relates to professional practice

Connections: Best Practice Information Sheet relates to client on 11/2 because PE resulted from
multiple risk factors including smoking and other lifestyle habits. The nurse failed to learn
complete pt. history of smoking activity and missed the opportunity to effectively educate about
grave risks and guide the pt. toward health-promoting behavior of smoking cessation.
Outcome: Interventions performed would involve the pt. in his care and promote independence
as the pt. takes control of their health. Nurse establishes rapport and promotes pt. compliance and
accountability in addition to decreasing pt anxiety. Physiological benefits of smoking cessation
follow emotional, psychosocial, environmental benefits of new lifestyle choice. Pt. is more likely
to follow smoking cessation plan and reduce risk of PE, DVT and death. Positive results
encourage pt. additional health promoting activities will follow.
Interventions: identity accurate timeline of smoking history, determine measures required to
promote pt. success in smoking cessation; determine therapeutic, non-pharmaceutical methods
along with medications needed to ease transition. Pt. quit "cold turkey" but old habits likely to
resume w/in 3 months of quitting. Pt. quit after PE signifying additional pt. education is needed
about tobacco use as a critical risk factor in health emergencies/acute conditions, contributors to
comorbidities. Nurse follow up with patient in incrementally decreasing frequency as pt. remains
successful. Goal should always remain ongoing and nurse will follow up at 6 month, anniversary
and annually.
 Points Range: (2-2.5)
Follows APA guidelines that includes title page, running head, and reference page with
minimum of 2 references, in text citations that are referenced. 1 or less APA errors 1 or less
spelling, grammar and/or punctuation errors

1. Find a best practice sheet from JBI or Cochrane database related to a patient you have taken care of this
semester.
2. The best practice needs to be relevant to your patient. For example: MJ, 46 year old female with diabetes and
non-healing ulcers. Find a best practice sheet for care of the patient with diabetic wounds and/or non healing
ulcers.
3. Identify the key components of the best practice guidelines and evaluate if appropriate nursing interventions
were implemented for the patient. Describe how the nursing interventions followed best practice guidelines
or not follow guidelines and the patient's overall response.
4. Evaluate how you provided care to this patient and how the knowledge gained will impact your professional
nursing practice.
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and password as requested.