American Diabetes Association

Hello Dr. Alters and Classmates,

Over the past weeks the lessons I have learned, feedback and information provided by my lecturer and peers have all taught me many beneficial things that can help to advance my knowledge as a future nurse practitioner. This course has helped to prepare me to meet the many competencies and outcomes including Chamberlain’s Program Outcome #5, Masters Essential VII and NONPF #8 Ethics Competencies.

Chamberlain College of Nursing Program Outcome #5

Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice. (Extraordinary nursing)

In the United States and countries around the world, there has been increased importance placed on evidence-based practice (EBP). Furthermore, there is a direct correlation between evidence based practice and positive patient outcomes. The World Health Organization stresses the importance of evidence based practice in healthcare (Stokke, Olsen, Espehaug, & Nortvedt, 2014). EBP is a system by which decisions about health care should be based on including the best-offered, up-to-date, valid and relevant evidence (Stokke, Olsen, Espehaug, & Nortvedt, 2014). EBP application involves use of the EBP steps and policies that promote collaboration of best available evidence with practitioner knowledge and other recourses (Stokke, Olsen, Espehaug, & Nortvedt, 2014). During my clinical rotation, we utilized many evidence-based resources including organizations such as the United States Preventative Task Force (USPSTF) and American Diabetes Association to educate the patients on important information regarding their health and wellness. The USPSTF is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine (Gray, & Picone, 2016). Guidelines and recommendations presented by the USPSTF are used to improve the health and wellness of all Americans (Gray, & Picone, 2016). Many referrals and plans given to patients were based on these recommendations. For example, women should begin having their mammograms at the age of 40. In addition, screening should take place biennially (Gray, & Picone, 2016). When we have patients entering their late 30’s, we reminded them that it would soon be time for them to start having mammograms done. In addition, with our diabetic patients, we utilized the American Diabetes Association (ADA) information. According to the ADA (American Diabetes Association, 2018).The strongest evidence for diabetes prevention comes from the Diabetes Prevention Program (DPP). The DPP demonstrated that an intensive lifestyle intervention could reduce the incidence of type 2 diabetes by 58% over 3 years (ADA, 2018). By providing evidence-based information from reputable

Masters Essential VIII: Clinical Prevention and Population Health for Improving Health.

The focus of population health initiatives aims to improve the health of the population by focusing on prevention and wellness rather than illness (Crawford, McGinnis, Auerbach, & Golden, 2015). In my clinical rotation there were numerous times where my preceptor would tell me that her main focus as a practitioner is to prevent her patients from developing diseases.  She was constantly reminding me to importance of prevention and why we encourage patients to take preventative methods to their health. For example, all female patients over the age of 40 were recommended to begin routine mammograms. Patients were also taught about the importance of yearly eye exams. Eye problems are common within the aging populations therefore, reminding and advising patients to have yearly eye exams are important to determine if vision may be deteriorating. Applying prevention and population health principles is an important step that we as health care professionals should take to improve the nation’s health.

NONPF: #8 Ethics Competencies

Ethical decision-making refers to the process of evaluating and choosing among alternatives in a manner consistent with ethical principles (Grace, & DRN, 2017). When we as practitioners make ethical decisions, it is necessary to perceive and eliminate immoral options and select the appropriate alternative. Additionally, the process of making ethical decisions requires commitment, awareness and capability (Grace, & DRN, 2017). It is important to make ethical decisions because it can generate and sustain trust; demonstrate respect, responsibility, fairness and caring; and are consistent with good citizenship (Grace, & DRN, 2017). These behaviors provide a foundation for making better decisions by setting the ground rules for our behavior. During my clinical rotation, there was a situation with a patient who was not compliant with his medications and therefore would have extremely elevated glucose levels. Multiple times I was there we would educate the patient on the importance of his medication and taking them as prescribed. No matter how many times we spoke to this particular patient, he still did what he wanted and was noncompliant. Therefore, my preceptor felt that it a good alternative was to alert the wife of the patient’s noncompliance in hopes that this would encourage him to take better care of his health. Another example how I was able to utilize NONPF #8 in my clinical rotation was we had a new patient present to the office for a new patient visit. After our assessment the patient seemed to be avoiding certain questions and information about his life, with his permission, we invited the wife to join us to find out more information or why he was avoiding certain questions. When the wife arrived, we learned that the patient was abusing alcohol and marijuana to the point of injuring himself often. We felt it was in his best interest to refer him to a resource that could assist him with his dependence. It can be difficult as practitioners to address ethical dilemmas, however, it our duty to protect our patients from actions that might cause serious harm to themselves or others. 

I want to thanks Dr. Alters and my classmates for all the knowledge shared, I really enjoyed being able  a part of this class and wish everyone best of luck in their future endeavors.