NSG 300: Foundations of Nursing - Evidence-Based Practice and Vital Signs

Evidence-Based Practice (EBP)

• Definition: A problem-solving approach integrating best evidence, clinical expertise, and patient preferences for clinical decision-making.
• Importance:
  • Nurses work in an era of accountability focused on quality and cost.
  • Public awareness of health and medical errors demands effective practices.
  • Guides nurses in making timely and appropriate clinical decisions.
• Practice:
  • Use best evidence from textbooks and current literature, not outdated sources.
  • Critical thinking is essential to applying relevant evidence to patient care.
  • A systematic step-by-step approach ensures best practices.
• Steps in EBP:
  • Cultivate a spirit of inquiry; question and analyze current practices.
  • Develop a clinical question using the PICOT format:
    • P: Patient/Population
    • I: Intervention
    • C: Comparison
    • O: Outcome
    • T: Time
  • Search and appraise evidence; integrate changes into practice.
  • Evaluate outcomes and share findings to promote practice change.

Nursing Process

• Assessment: Systematic collection of data to determine health status and history.
• Critical Thinking: Core of nursing competence; improves practice and reduces errors.
• Individualized Care: Develop and implement patient-centered plans.

Vital Signs

• Components:
  • Temperature
  • Pulse
  • Blood Pressure
  • Respiratory Rate
  • Oxygen Saturation (and possibly pain as the fifth vital sign)
• Importance:
  • Reflects health status and evaluates treatment response.
  • Sudden or progressive changes indicate alterations in condition.

Temperature

• Normal range: 98.6°F (37°C) in adults; varies with age and factors like exercise and stress.
• Factors Affecting Temperature:
  • Age, circadian rhythms, stress, environment, hormonal changes.
  • Fever is a defense mechanism and indicates infection.

Pulse

• Indicator of circulatory status; measured at several sites.
• Factors Affecting Pulse:
  • Exercise, stress, medications, health condition.
• Assessment Parameters:
  • Rate: Normal varies by age.
  • Rhythm: Assess for regularity or dysrhythmias.
  • Strength: Amplitude reflecting blood volume and heart contraction.
  • Equality: Compare bilaterally except carotid pulse.

Respiratory Rate

• Passive process regulated by respiratory center; normal rate 12-20 breaths per minute.
• Assessment:
  • Observe inspiration and expiration cycles.
  • Alterations indicate clinical deterioration.
• Measurement of Oxygen Saturation: Indirect via pulse oximetry.

Blood Pressure

• Indicator of cardiovascular health; measures systolic and diastolic pressure.
• Factors Influencing BP:
  • Cardiac output, vascular resistance, blood volume, and elasticity.
• Hypertension: Asymptomatic but risk for cardiovascular events.
• Methods:
  • Direct (invasive) and indirect (non-invasive).

Case Study: Ms. Coburn

• 26-year-old with high BP, headaches, tiredness.
• Management:
  • Lifestyle changes: Exercise, reduced salt intake, smoking cessation.
  • Monitoring BP at home with electronic devices.

References

• Potter, Perry, Stockard, and Hall (2023). Fundamentals of Nursing.

For further clarification, contact your course instructor.