Theoretical Framework and EBP Blog

Health belief theory 

The Health Belief Model (HBM) is a psychological model that attempts to explain and predict health behaviors. This is done by focusing on the attitudes and beliefs of individuals. The HBM was first developed in the 1950s by social psychologists Hochbaum, Rosenstock and Kegels working in the U.S. Public Health Services.

Case # 1- Mrs. M.K. is 56-year-old white female came to the clinic with hypertension. She has a history of non-compliance related to her medications. She has a family history of heart diseases. On this visit, she mentioned her concern regarding getting heart disease as her husband is asking her to change behavior related to non-compliance, her blood pressure is on the higher side and the patient is asking for help.

According to the Health belief model:

  1. Perceived susceptibility- It is one’s opinion of chances of getting a condition. Mrs. M.K. is on stage where she is thinking she can get heart diseases based on her hypertension and family history.
  2. Perceived severity- One’s opinion of how serious a condition and its consequences are, Mrs. M.K. understand the severity of her hypertension and its effects on the body.
  3. Perceived benefits- One’s belief in the efficacy of the advised action to reduce risk or seriousness of impact. Mrs. M.K. understand the benefits of taking blood pressure medicine.
  4. Perceived barriers- One’s opinion of the tangible and psychological costs of the advised action. She has a blue cross medical insurance that can cover the cost of her medicines.
  5. Motivation: Patient is really motivated to change non- compliance behavior.
  6. Modifying factors: She has some positive modifying factors such as family support, patient satisfaction related to her provider guidance. 

    Reference:

    Health Belief Model. (n.d.). Retrieved May 30, 2016, from http://currentnursing.com/nursing_theory/health_belief_model.html

     

Safety in practice

Two common areas where errors occur in the clinical setting are related to:

  • giving immunizations with the correct documentation

Giving proper vaccination is as important as giving correct medicine to patients. Most common errors occurred when prescribers failed to recognize the correct age of patient for vaccination and staff is not updated regarding the new recommendations for the vaccines. To avoid these type of mistakes staff should receive ongoing education, such as whenever vaccine administration recommendations are updated, or when new vaccines are added to the facility’s inventory, to maintain staff competency.

Some other examples of immunization errors are:

Drug administered at inappropriate site

Drug administration error

Incorrect drug dosage form administered

Incorrect drug administration duration

Incorrect route of drug administration

Multiple uses of a single-use product

Wrong technique in drug usage process

  • writing prescriptions

Prescription errors are a major problem among medication errors. Errors often arise from a lack of knowledge about drugs, including indications and contraindications, appropriate doses, maximum dosages, routes and drug interactions. At my clinical site prescribers always attend seminars and meetings related to new research in medicine field. If they are doubtful regarding doses they always confirm with recommended doses through medicine sites or books.

Communication failure: When communication failed between prescriber, assistants and pharmacies errors occurred such as poor handwriting, misinterpreted verbal orders, use of abbreviations and missing decimals are some sources or errors. Read back the orders can help to prevent these errors.

Reference:

Velo, G. P., & Minuz, P. (2009). Medication errors: prescribing faults and prescription errors. British Journal of Clinical Pharmacology67(6), 624–628. http://doi.org/10.1111/j.1365-2125.2009.03425.x

Vaccine Administration. (2015). Retrieved May 18, 2016 from http://www.cdc/gov/vaccines/pubs/pinkbook/vac-admin.html

Safety in practice

Two common areas where errors occur in the clinical setting are related to:

  • giving immunizations with the correct documentation

Giving proper vaccination is as important as giving correct medicine to patients. Most common errors occurred when prescribers failed to recognize the correct age of patient for vaccination and staff is not updated regarding the new recommendations for the vaccines. To avoid these type of mistakes staff should receive ongoing education, such as whenever vaccine administration recommendations are updated, or when new vaccines are added to the facility’s inventory, to maintain staff competency.

Some other examples of immunization errors are:

Drug administered at inappropriate site

Drug administration error

Incorrect drug dosage form administered

Incorrect drug administration duration

Incorrect route of drug administration

Multiple uses of a single-use product

Wrong technique in drug usage process

  • writing prescriptions

Prescription errors are a major problem among medication errors. Errors often arise from a lack of knowledge about drugs, including indications and contraindications, appropriate doses, maximum dosages, routes and drug interactions.

Communication failure: When communication failed between prescriber, assistants and pharmacies errors occurred such as poor handwriting, misinterpreted verbal orders, use of abbreviations and missing decimals are some sources or errors. Read back the orders can help to prevent these errors.

Reference:

Velo, G. P., & Minuz, P. (2009). Medication errors: prescribing faults and prescription errors. British Journal of Clinical Pharmacology67(6), 624–628. http://doi.org/10.1111/j.1365-2125.2009.03425.x

Vaccine Administration. (2015). Retrieved May 18, 2016, from http://www.cdc/gov/vaccines/pubs/pinkbook/vac-admin.html

 

Getting Started Blog

  • Preceptor’s expectations and concerns of working with an NP student

Direct questioning is the biggest thing on which my preceptor wants to focus. It helps to stimulate thinking and allow the student to share observations and interpretations with the preceptor.

Critical thinking needs to be applied while addressing each patient and feedback from preceptor will be given frequently.

Actively participate in making the assessment, plan and clear all doubts same time.

  • How your preceptor is applying the clinical thinking process to patient care.

critical thinking in nursing is an essential component of professional accountability and quality nursing care.

Applied research-based knowledge while addressing patient’s concerns.

Using decision-making skills and clinical judgement.

Focus on problem-solving skills and maintain the professional practice.

  • Drugs used in practice this week

Tramadol 50mg PO BID for pain management

Adderall 10mg PO once a day for ADHD

Claritin 10mg PO one time daily for allergy

Acyclovir 800mg PO every 4hrs for 7days for Shingles

My first week in clinical practice was awesome and I learned a lot of new things such as how to interact with patients in the clinic setting as I always worked in the hospital setting, the environment was a little bit different.