Evidence-Based Health Evaluation and Application
One way to enhance public health and the quality of life among patients is to conduct research and use the findings for evidence-based practices. Study results provide proof for public health improvement initiatives (PHII). The director of Safe Headspace, Alicia Balewa, has successfully applied the PHII to manage PTSD and TBI. The same treatment plan can be useful for Mr. Nowark who seeks service at the Uptown Wellness Centre Clinic. The recommended changes should produce safe, patient-centered outcomes and enhance a positive work environment (Devine et al., 2015). This report provides details on the Safe Headspace PHII or combat veterans and then gives a rationale for personalizing and applying it to Mr. Nowark’s care plan.
Outcomes of the PHII
The anticipated results of this initiative are to improve the mental and psychological well-being of the patient with post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and depression. Specifically, it is expected that the implementation of the evidence-based measures will result in a better mood and memory. Expectedly, the participant will be willing to participate in the management regime of meditation and exercises. Besides the physical and emotional enhancement, the patients also get to interact with each other.
Different treatment approaches were included in PHII, some of which had significant outcomes, while others failed. Moderate aerobic led to 15% muscle improvement, 22% enhanced moods, and 61% better memory. Medication therapy resulted in a 26% pleasant mood and 6% retaining of information. Meditation boosted good feelings by 70% and muscle stability by 6%. Therapeutic techniques such as memory exercise, crossword puzzle, and Soduku failed to show any impact on participants’ mental health. The patients who opted for strength training only achieved a 4% increase in muscle power.
Factors for Success or Failure
The institutional factor that enhanced the success of the program is strong leadership of the Safe Headspace director who was motivated to help veterans because her father was one of the soldiers in Vietnam War. Communication of the instructions for the regime was also done well. However, many participants withdrew due to cultural differences since meditation is popular in East Asia and not in the United States. Another reason for failure is the program environment where all the veterans are elderly hence the motivation to exercise is missing.
To enhance the outcome of PHII the recommendation is to separate patients in two groups: one with comorbid PTSD and TBI and the other group with only one of the conditions. According to Waltzman et al. (2017), “examining these pathologies separately may help to understand the neurobiological basis” for specific symptoms such as memory loss (p.1). When providers show their clients that they understand specific causes for a presenting symptom, they are likely to adhere to the treatment regimen.
Personalizing the PHII Care-Plan to Mr. Nowak
It is vital to understand Mr. Nowak’s specific symptoms and then relate them to the PHII population. He complains of experiencing challenges with his muscle control, possibly related to a traumatic brain injury. The patient also points out that he feels distressed and is worried about the possibility of a rapid decline in his health. Therefore, this client’s care plan will focus on enhancing muscle strength and relieving negative emotions.
The customized treatment plan for Mr. Nowak will only involve moderate aerobic exercise and meditation. The aerobic exercise will improve the patient’s muscle stability by 15% hence alleviate his issues with balance. Mediation will result in a 70% enhancement of positive moves. The adjustment helps ensure a patient-centered approach to care, making the PHII relevant for an individual application. The cost of both practices is negligible since the patient will only require instructions and training, after which they can work at home. Moral support and observation by the nurse and other family caregivers may also be needed to ensure adherence and checkout for any challenges such as falls. There are high chances of dropout, but educating the patient on the treatment benefits will enhance adherence.
Rationale and Justification
There are many considerations for implementing an individualized care plan, including positive outcomes, setting, and convenience with the patient. The two treatment plans – meditation and exercise – that have been selected have the best results for muscle stability and improved emotional state. The other justification is that it will be affordable to the client given that the plan can be done at home without incurring additional cost. Regarding the environment, Krugman et al. (2015) state that nurses prefer working in enclosed office structures. Thus, one of the offices in the clinic can be used for teaching Mr. Nowak the two PHII treatment plan.
Pre-test and post-test questionaries on moods and balance will be used in evaluating the success of the individual care plan. The nurse will prepare a closed-ended questionnaire with questions that explore Mr. Nowak’s state of health answered by the patient and a close relative. Reliability will be achieved through the split-half method such that questions will be changed for pretest and posttests while maintaining the objective. The findings will then be analyzed quantitatively after six months to compare pre-test and post-test outcomes.
Evidence-based healthcare applications are necessary to ensure that new treatment and techniques are applied to achieve better patient results. The initiative has revealed positive outcomes of the PHII that can be personalized for Mr. Nowak’s care plan. The expected result is enhanced balance and positive moods for the patient. Economically, the program is cheap, environmentally, it can be done at home or in an enclosed office and culturally, exercise is common in the United States although meditation is foreign. Evaluation will be done through pre-test and post-test questionnaires that are then analyzed statistically to measure results.
Devine, D. A., Wenger, B., Krugman, M., Zwink, J. E., Shiskowsky, K., Hagman, J., Limon, S., Sanders, C., & Reeves, C. (2015). Part 1. Evidence-based facility design using transforming care at the bedside principles. JONA: The Journal of Nursing Administration, 45(2), 74-83.
Krugman, M., Sanders, C., & Kinney, L. J. (2015). Part 2. Evaluation and outcomes of an evidence-based facility design project. JONA: The Journal of Nursing Administration, 45(2), 84-92.
Waltzman, D., Soman, S., Hantke, N. C., Fairchild, J. K., Kinoshita, L. M., Wintermark, M., J, W. A., Yesavage, J., Williams, L., Adamson, M. M., & Furst, A. J. (2017). Altered microstructural caudate integrity in posttraumatic stress disorder but not traumatic brain injury. PLoS One, 12(1).