Evidence-Based Practice

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The Case Study
Mr Miller, a computer programmer, is a moderately obese 51 year old man with type 2 diabetes, first diagnosed 8 years ago. He is trying to quit his smoking habit of some 30 years. Recently at work they offered him an employer-subsidised treatment with nicotine patches to help him quit smoking. However this had previously failed once before and he was reluctant to take bupropion as it was an antidepressant, a group of drugs which he had concerns about. No diabetes complications have been detected thus far and his blood sugar levels appear well controlled. He does have osteoarthritis that has manifested in both knees (which harbour old sporting injuries). His blood pressure has recently become mildly elevated, averaging 160/94 mmHg during his past two visits. You are aware that Mr Miller regularly searches the internet if he has a health question. You also find out that his wife has encouraged him to take large doses of vitamin E and fish oil for his heart, glucosamine for his knees, and St John’s Wort to help him stop smoking, based on health information gained from their internet searches. While looking at the evidence for blood pressure control you decide to see what you can find on whether these “over the counter” self treatments, reduce the risk for coronary heart disease and if they have any side effects.
Your task:
You may use the example of Mr Miller or describe another patient you have come across who frequently uses various therapies of unproven efficacy and potentially harmful effects. You are required to:
• Outline how you will introduce EBP to your patient and to any significant others of relevance, how you will provide advice, and how you will approach any potential areas of sensitivity. Explain how you will communicate with and work effectively with them to ensure that he/she is able to make informed choices in his/her own health care.
• Develop a care plan for this person, including a list of significant problems, goals and needs. The plan should be patient-centred and include his/her own role in the care.
• Your approach to the assignment will depend upon your role within the health team and the characteristics of the service within which you work. Please consider the issues from this perspective. You may adapt this plan to fit accordingly.
The assignment should be 3500 – 4000 words (excluding references).
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