APA 200 words, 2 references ( from 2019-present) and 2 intext citation
Response by visiting the websites they shared and offering additional examples of EBP or alternative views/interpretations shared in the’ posts below.
Respond 1 :Mutiat
Evidence-based practice (EBP) is a core part of delivering quality care interventions to patients with diverse health conditions (Melnyk et al., 2022). The Centers for Disease Control and Prevention (CDC) is the U.S.’s leading science-based, data-driven, and service entity whose main mandate is protecting public health. CDC’s vision is to equitably protect the health, safety, and security of American citizens and residents. The organization’s mission is to work 24/7 to protect America from threats that include health, safety, and security, both in foreign lands and at home. The CDC focuses on public health aspects like food security and safety, health and weight, tobacco and smoking campaigns, and vaccination initiatives.
Evidence-based practice (EBP) appears on the organization’s website through its mission, vision, and pledge. The pledge to the American people of being a diligent steward of resources, offering an environment for intellectual and personal growth and integrity, basing public health decisions on the highest quality scientific evidence, prioritizing the common good, and treating all people with respect, dignity, and honesty all demonstrate its grounding in EBP. In 2022, the organization also launched its Moving Forward model focused on redefining and modernizing its structures, systems, and processes in developing and using science and programs to improve healthcare. These aspects all illustrate the importance of EBP to the organization (CDC, 2022). CDC’s work is based on EBP as it illustrates that it makes decisions based on the best and quality scientific data to meet public preferences and concerns. For instance, its Moving Forward initiative is founded on EBP since it focuses on improving approaches to health issues impacting populations and individual patients.
The information on the CDC’s website is rich and offers more insight into the organization’s vision and mission. CDC’s pledge to Americans shows its unrelenting efforts to improve healthcare within the nation and for its population. Therefore, the website has changed my perception as it shows beyond doubt that it is a critical implementer of EBP (Mellerson et al., 2020). For instance, its approach to the future changes my perception as it shows its commitment to improving the lives of American citizens and residents.
References
Centers for Disease Control and Prevention (CDC) (2022). About CDC: Mission, Role and
Pledge.
Mellerson, J. L., Street, E., Knighton, C., Calhoun, K., Seither, R., & Underwood, J. M. (2020).
Centers for Disease Control and Prevention’s school vaccination assessment: Collaboration With us state, local, and territorial immunization programs, 2012–2018. American Journal of Public Health, 110(7), 1092–1097.
Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing &
healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Respond 2: Jessica
Evidence-based practice is something that I am familiar with since working in healthcare. I had no idea what it meant prior to working in healthcare. As I was reading the chapter for this week, I noticed the authors mentioned that there are an alarming number of healthcare systems and medical staff not implementing evidence-based practice. (Melnyk & Fineout-Overholt, 2023) That is worrisome but I feel blessed to be a part of two organizations that choose to stay up to date on evidence-based practice.
I was looking through websites and I found a Medicare page that is highlighting the evidence-based practice that is being covered for the people enrolled. The focus is on prevention, and it now covers some preventative medicine and wellness visits. (U.S. Department of Health & Human Services, 2023) I looked around on the Center for Medicare and Medicaid website. There is a lot of good information related to evidence-based practice. I landed on a quality improvement and intervention page. One of the links lead me to a flyer for stakeholders to use to present information to and implement change within their organization. (U.S. Centers for Medicare & Medicaid Services, 2012) The flyer details steps to take to improve health equity to the population that you choose. It then gives you step by step guidance to get started on the progress within your organization. The flyer is seven pages long and it has a fill-in section for each step. I am glad I found this because it will be useful during my career.
While I was researching, I had a hard time deciding what to choose because almost every website I clicked had evidence-based practice mentioned. Evidence-based practice is growing but we are not where we need to be yet. As we progress healthcare will become better. I am excited to be a part of the change.
Reference
Melnyk, B., & Fineout-Overholt, E. (2023). Evidence-Based Practice in Nursing & Healthcare. Philadelphia: Wolters Kluwer.
U.S. Centers for Medicare & Medicaid Services. (2012, March). Quality Improvement & Interventions. Retrieved from Centers for Medicare & Medicaid Services:
U.S. Department of Health & Human Services. (2023, November). Medicare Wellness Visits. Retrieved from Centers for Medicare & Medicaid Services:
Response by respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not.
APA 150-200 words, 2 references and 2 intext citation
Respond 3: Cody
The Genetics Involved
Cystic fibrosis is a rare genetic condition that is carried by approximately 4% of the United States Caucasian population. It is an autosomal recessive mutation, which means that for the genetic disorder to be expressed, the child must inherit the mutated gene from both parents. While 4% are carriers less than that are affected by the disorder. The parents can be carriers of the cystic fibrosis gene mutation and do not necessarily need to have the cystic fibrosis diagnosis (Alverson, n.d.; National Cancer…, n.d.).
The Cells Involved and the Physiological Response
The gene causes a defect in the Cystic Fibrosis Transmembrane Conductance Regulator protein (CFTR) which is found in exocrine and epithelial tissues such as skin, lungs, liver, gastrointestinal and reproductive tract. The mutation causes decreased chloride secretion in these tissues, making the cells retain more water while thickening secretions. Swollen cells have ineffective cilia, and, along with thickened mucus, patients are very susceptible to recurrent pulmonary infections from atypical organisms such as Pseudomonas aeruginosa or Burkholderia cepacia. Constant pulmonary infections cause chronic inflammation, which can break down the parenchyma in their lungs and lead to bronchiectasis, leading to death or the need for a lung transplant. Often, these patients’ airways are colonized with sometimes difficult-to-treat bacteria, which causes chronic inflammation and makes bronchiectasis more likely (Alverson, n.d.; McCance & Huether, 2019).
Explanation of Symptoms
The lack of fever could be due to colonization and not necessarily an acute infection. The patient’s primary symptoms would indicate bronchiectasis, a common but serious condition of cystic fibrosis. The productive cough and upper lobe crackles could indicate impaired mucus clearance due to thick secretions and probable scarring from previous lung infections. Her diminished lower lobe breath sounds are concerning for the potential of hemorrhagic pneumonia. The patient is tachypneic and tachycardic with labored respirations, which could indicate hypoxia, and I would be curious to know what her oxygen saturation is (McCance & Huether, 2019).
Influential Characteristics
I was unable to identify another characteristic that would change your response to cystic fibrosis, but the disorder does show up more in Caucasian individuals. Since the responsible gene is recessive, its expression is not always guaranteed, but genetic counseling prior to conceiving a child would be recommended for people who have a family history.
References
Alverson, B. (n.d.).
Cystic Fibrosis (CF): Pathology . Retrieved from
to an external site.
McCance, K. L. & Huether, S. E. (2019).
Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
National Cancer Institute at the National Institutes of Health. (n.d.).
Autosomal recessive inheritance. Retrieved from
to an external site.
Respond 4. Todd.
The role genetics plays in the disease.
Cystic fibrosis (CF) is a genetic disease that is caused by mutations in the CFTR gene (Mitchell, n.d.) which causes a defect in chloride transport, leading to thickened mucous secretions in the airways. CF is an autosomal recessive disorder that can occur if the person’s parents (who are unaffected) each carry a copy of the mutated gene.
Why the patient is presenting with the specific symptoms described.
According to Alverson (n.d.), because of a defect in chloride transport, thickened mucous secretions in the airways can cause pulmonary disease resulting in the person with CF being more vulnerable to infection-causing organisms. In this case study, the patient is presenting with labored breathing, increased respiration, and diminished breath sounds in the lower lobes due to poor airflow from the secretions. This increase in fluid in the lungs from the secretions is also the likely culprit for the crackling sounds in the upper lobes. The patient has been coughing in response to the secretions as a mechanism to clear them from their airway, with the fatigue being a byproduct of all these symptoms with the patient’s decreased respiratory functioning, and poor nutrition due to loss of appetite which is a hallmark of CF.
The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
According to Alverson (n.d.), CF results in a “gradual degradation of pulmonary mechanics and pulmonary function.” The physiologic response that this patient is experiencing is due to the mucous secretions obstructing their airway, resulting in the previously mentioned symptoms. Most CF patients develop sinus disease with chronic cough (Chen et al., 2021). Additionally, the impaired gas exchange caused by this disease has resulted in compensatory mechanisms (Kraemer et al., 2009) to improve oxygenation, such as increased respiration and cough.
The cells that are involved in this process.
The cells involved in the CF disease process are the epithelial cells in the patient’s airway (Berical et al., 2019). The diminished or missing functional CFTR protein in these cells leads to thick, sticky mucous present in the patient’s pulmonary system (Berical et al., 2019).
How another characteristic (e.g., gender, genetics) would change your response.
CF is equally present in both males and females since the main risk factor is both parents carrying the mutated gene (Mitchell, n.d.). In the United States, CF is more common in Caucasians than it is in non-white ethnic groups, with CF being the most common lethal genetic disease among white people (DiMango et al., 2021).
References
Alverson, B. (n.d.).
Cystic Fibrosis (CF): Pathology [Video Lecture]. Walden University.
to an external site.
Berical, A., Lee, R. E., Randell, S. H., & Hawkins, F. (2019). Challenges Facing Airway Epithelial Cell-Based Therapy for Cystic Fibrosis.
Frontiers in pharmacology,
10, 74.
Chen, Q., Shen, Y., & Zheng, J. (2021). A review of cystic fibrosis: Basic and clinical aspects.
Animal models and experimental medicine,
4(3), 220–232.
to an external site.
DiMango, E., Simpson, K., Menten, E., Keating, C., Fan, W., & Leu, C. (2021). Health Disparities among adults cared for at an urban cystic fibrosis program.
Orphanet Journal of Rare Diseases,
16(1).
Kraemer, R., Latzin, P., Pramana, I., Ballinari, P., Gallati, S., & Frey, U. (2009). Long-term gas exchange characteristics as markers of deterioration in patients with cystic fibrosis.
Respiratory research,
10(1), 106.
Mitchell, R. (n.d.)
Subcellular Organization: Movement across Membranes [PowerPoint Slides]. Walden University.
