¶ … patients turn to complementary and alternative medicine (CAM) in pursuit of healing as a last resort following unsuccessful application of traditional or Western medicine. A National Health Interview Survey (NHIS) which also included an aspect of alternative medicine revealed that approximately 38% of adults use alternative medicine (Centers for Disease Control and Prevention, 2012). Some of the drugs attempted to improve human condition include herbal or botanical substances. There have been numerous botanical products inventoried for their medicinal effects. Nurses working in the hospice care lack the basic knowledge in administering alternative medicine on patients. Thus, to ensure efficient administration of treatment using alternative or complimentary therapy, it is necessary to education nurses on practical methods. The nurses as practitioners need to be educated on Bell's three stages for proper administration of alternative procedures.
Contribution to the Future of Healthcare
The model herein described is deduced from theoretical and related research literature as well as from theory of change. This change of design model provides practitioners with a guide in the implementing a combination of alternative and traditional therapy in hospice care practice. The process commences with evaluation of the need for change and ends with integration of the design an evidence-based protocol in the care of patients with end of life expectancy. This model is also useful in primary care setting as well as in acute inpatient units.
Change Model Overview
The Rosswurm and Larrabbee Model here is a guide through a systematic process for the change to evidence-based practice. There is availability of clinical research with significant findings that lay the foundation for change from traditional and intuition-driven practice to evidence-based practice. Medical practitioners require necessary skills as well as resources to help them appraise, synthesize, and diffuse the best evidence into practice. Furthermore, patient results or outcomes need to be consistent with discipline-specific and interdisciplinary accountabilities.
The Applying the Rosswurm and Larrabbee Model
The partnership between researchers and medical practitioners is helpful in facilitating diffusion of evidence-based practice innovations. Therefore, in this proposal, Rosswurm and Larrabbee Model is the chosen option for change.
Step 1: Assess the Need for Change in Practice
To increase hospice care nurses' knowledge in the administration and procedures of alternative medicine the first step involves the introduction of the therapy including Yoga therapy with in-bed postures, Reiki, Aromatherapy, Nutrition, Education in death and dying awareness (Forester, 2012). There is need for hospice nurses to acquire clinical experience and proper over-sight in alternative therapy. This type of therapy is a departure from the typical traditional protocol available to nurses. This is an opportunity for hospice nurses to embrace values of wellness and alternative medicine into the care of patients (Bardia, Barton, Prokop, & Bauer, 2006). It is an opportunity for the nurses to grow career wise and spiritually. This way they can give comfort and care to patients when they most need it, at the transition from this life (Forester, 2012). The PICOT question presented in Milestone 1 is:
Patients admitted to hospice care
I -Combining traditional/Western medicine with alternative/complimentary therapy
C- Patients who are not receiving alternative therapy, such as Reiki therapy, mass- age therapy, aromatherapy therapy but who are only receiving traditional, conventional therapy.
O-Increase in patient symptom control, increase in patient comfort by combining conventional and alternative medicine and therapy.
T-One to six months
Step 2: Link the Problem, Interventions, and Outcomes
The nurses identify and select possible interventions and patient outcomes based on their clinical judgment, system priorities as well as available resources. The care provided in a hospice care is not curative, but helpful toward managing symptoms and pain (Mayoclinic.com, 2011). Medical practitioners need to embrace alternative therapy that has been found to be beneficial in controlling conditions related to this care. Results of studies in this field indicate that certain measures such as gentle touch, stroking, and massage have positive impact on patients in regard to the heart rate, blood pressure, respiration, and even hormone levels (Kow02).
Step 3: Synthesize the Best Evidence
In this stage, medical practitioners as well as researchers undertake a comprehensive literature review on combining traditional/Western medicine with alternative/complimentary therapy. The information is appraised and synthesizing thereafter their evidence compared with clinical judgments as well as related data. Subsequently, they choose to begin a preliminary trial that the nurses can implement and which is highly beneficial in reducing pain and if possible casualty among patients (Rosswurm & Larrabee, 1999).
The three...
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