Evidence Based Project Assignment

[Name of the Institute]

Evidence Based Project Assignment

Problem Identification

In this paper I will be focusing on the issue of my area of nursing practice. I happen to be associated with the care of Rheumatoid Arthritis patients. Most of these patients are last stage patients with a little hope of survival. Nursing such patients is one of the most difficult tasks for any nurse, as there are a number of factors and problems associated with them. The basic problem I observe in my area of practice is communicating with dying patients. I believe doctors are pretty straight forward in their opinion about the medical condition of a patients and the responsibility of dealing with dying patients rests on nurses, as they are in regular contact with the patients. Most nurses are not aware of how to deal with the situation or how to break the terrible news to the patient or what to say to them when patients are aware of their nearing death. The role and responsibility of a nurse in such cases is not just limited to physical or medical condition of a patient but also include the care of emotions and psychological impact on the patient after hearing the news of his or her own death.

Change Agents

There has to be specified and structured training sessions for nurses in this area for practice. They should make aware of the disease and how they should communicate the possibilities and progressions to the patients. Hospital management and local nursing associations can play a significant role to train nurses in dealing and communicating with such patients. Also, the help of external agents, motivational speakers and doctors could be taken in the training process. I believe that with the assistance and training of these agents, nurses would be able to deal Rheumatoid Arthritis patients and help them with the progressions of their disease (Hill, 2006).

Practice Change

RA is an incurable and usually progressive disease that results in joint deformity and impaired function. Patients with RA who lack adequate knowledge of their condition and its treatment are less able to participate in decisions regarding treatment options, adhere to complex treatment regimens, and monitor their own condition. Patient education for the patient with RA is indicated to the following.

Improve patient knowledge regarding the disease and its treatment, enabling active participation by the patient in disease management and enhancing the patient's self-efficacy and ability to cope with the condition.

Decrease disability, pain, and depression.

Improve adherence to prescribed pharmacologic and nonpharmacologic treatments, including exercise.

Optimize functional status.

Improve health outcomes and quality of life (Kanter, 1989).

Potential Barriers

Most patients hearing of their fatal disease reacts by saying, "No, It cannot be true." This denial is common in both those who are told right from the beginning their illness and those that are not explicitly told them and they came to that conclusion themselves. The denial, at least partial denial, is common in almost all patients, not only during the early stages of the disease or to learn of the ...