Using the evidence in practice

I choose urinary Tract Infection as an acute and episodic condition.

Recently there is a new FDA warning regarding the use of Fluoroquinolone Antibacterial Drug. FDA recommends that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with sinusitis, bronchitis, and uncomplicated urinary tract infections who have other treatment options. For patients with these conditions, fluoroquinolones should be reserved for those who do not have alternative treatment options. My preceptor made a decision to follow this guideline regarding the prescription of ATB for uncomplicated urinary tract infection.

According to the recommendation, treatment of choice for uncomplicated UTI is as:

First line treatment – 3 days of Sulfa or 5 to 7 days of Nitrofurantoin.

Second line treatment – 3 days of Quinolone (contraindicated in pregnancy) or 7 days of Amoxicillin.

I accessed the website by using word urinary tract infection in search and found this FDA recommendation/warning which I was already made aware last week during the encounter with a patient who diagnosed with urinary tract infection. This website is really a good source to learn about FDA approved recommendations regarding different diagnosis and treatments associated with them. I have seen some other recommendations which are currently used by my workplace but I was not sure why we do the things like this, my thinking was it’s a way to do things. It is a good source to enhance knowledge and to keep up to date with recent information. This guideline is going to be followed in my clinical setting.

Reference:

Specialty, B. C. (n.d.). Urinary tract infection. Retrieved September 25, 2016, from http://www.guideline.gov/summary/34419/urinary-tract-infection

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Getting started blog

New skills learned during the first semester are:

·     Detailed history taking, physical examination, making a diagnosis, and prescription of drugs in certain conditions.

·     Assessment of adults throughout the stages of chronic illness.

·     Distinguishes between normal and abnormal change with aging and diagnoses commonly occurring complications of chronic health problems.

·     Exposed to common mental health and substance abuse problems such as anxiety, depression, obesity, alcohol, and drug abuse.

·     Learned to use the latest technological innovations to enhance access to the programs clinical site is using.

Learning goals for N679L – 

·     Synthesize assessment data to diagnose and manage patient health and illness needs

·     Focus more on making a differential diagnosis so that it help to provide more safe, evidence-based, patient-centered care that reflects ethical clinical judgment and inter-professional collaboration.

·     Integratively assesses, diagnose, plan, implement, and evaluate cost-effective healthcare strategies.

·     Evaluate health needs of populations I’m dealing with in clinical site for necessary teaching and education to promote health and prevent illness/injury.

·     Continue professional growth through continuing education of current semester course material and engage in lifelong learning and the professional development of self and others.

·     How to make appropriate referrals to other health care professionals and community resources for individuals and families.

I get to know numerous diagnosis, procedures, and medications in my journey of FNP; some from those are Pap smear, colposcopy, correct prescription of narcotics.

The first week in woman’s health specialty was full of excitement to learn about new procedures as well as nervousness to talk about questions related to sexual health of patients. It was not too bad with the guidance of a proficient and experienced preceptor.

Reference:

Sales, A., Smith, J., Curran, G., & Kochevar, L. (2006). Models, Strategies, and Tools: Theory in Implementing Evidence-Based Findings into Health Care Practice. Journal of General Internal Medicine, 21(Suppl 2), S43–S49. http://doi.org/10.1111/j.1525-1497.2006.00362.x