Evidence-Based Practice Report

Running head: EVIDENCE-BASED PRACTICE REPORT
EVIDENCE-BASED PRACTICE REPORT

EVIDENCE-BASED PRACTICE REPORT 2
Table of contents
Introduction......................................................................................................................................3
Outline of the clinical issue.............................................................................................................3
Clinical question..............................................................................................................................4
Evidence search...............................................................................................................................4
Literature synthesis of best evidence...............................................................................................5
Recommendations for practice change..........................................................................................13
Conclusion.....................................................................................................................................13
References......................................................................................................................................14
Appendices....................................................................................................................................16

EVIDENCE-BASED PRACTICE REPORT 3
Introduction
This report focuses on a specific clinical issue that hedge around the treatment plan of patients
suffering from the diseases. By focusing on the key aspects of the problem, a comprehensive
detail is shared on how evidence-based nursing practice is conducted.
Outline of the clinical issue
The clinical issue related to this assignment is Cognitive impairment. Cognitive impairment
implies the neurological problems that are faced by individuals having memory and thinking
problems (Petersen, 2016). The patient generally has difficulty in learning and recognizing things
around and is unable to lead a normal life. I wish to take up this clinical issue as the primary
subject of my study and prepare a compact plan on evidence-based nursing practices required for
dealing with the patients suffering from the problem. Identifying the problem, I would like to
state that the most common causes behind the problem are dementia, delirium and depression.
Background
Cognitive impairment is caused by an acute sense of depression and dementia that are quite
common in old ages. The older people are at greater risks to suffer from this disease and the
conditions might get worse in case of negligence (Prins & Scheltens, 2015). This disease tends to
affect the mental balance of the human mind and dismantles the sane working of the nerves
leading to severe accidents. Older patients are at greater risks of malnutrition, sudden falls,
incontinence and pressure injuries (Schouws et al.2015). At times, these injuries can be fatal too
and may cause death.
Rationale
According to Kallenberg et al. (2016), there is an estimated number of 447,115 people suffering
from cognitive impairment, especially dementia in Australia as of 2019. Considering it to be a
growing issue, the need to render special attention to these clinical problems covers the subject
of my assignment. Further, it has been estimated that 3 in 10 people over the age of 85 and 1 in
10 people over the age of 65 are suffering from the disease in Australia (Miller et al.2016).

EVIDENCE-BASED PRACTICE REPORT 4
Need for an evidence-based approach
Affecting across 52% of the households in Australia, this clinical issue needs relentless attention
and treatment (Fink et al.2015). Therefore, I wish to intervene with the implementation of an
evidence-based approach in dealing with the clinical issue as it helps in assessing the actual
mental condition and detect the behavioural patterns of the patients assisting them in lowering
the stress levels. This evidence-based approach is significant in maintaining cognitive
functioning by implementing Cognitive Stimulation sessions and pose a strong impact on the
patient’s QOL (Quality of Life).
Clinical question
As discussed in the previous section of the assignment, that as much as 52% of the Australian
households have patients with clinical issues. Considering this problem and the need to impose
an evidence-based nursing practice regime, the PICO format has been used to have a fulfilled
understanding of the exact issue pertaining to the problem.
For older people with cognitive impairment and history of heart attacks, does the application
of cognitive stimulation, reminiscence therapy and cognitive rehabilitation when compared to
medications result in the development and better results of the patient's mental condition?
P (Problem or Patient or Population) Older People suffering from cognitive
impairment
I (intervention/indicator) Non-medication interventions including
cognitive stimulation, rehabilitation therapy
and reminiscence therapy
C (comparison) care as usual with specification treatment
charts on specific patient
O (the outcome of interest) Expected changes in behaviour, cognitive
stimulation, better behavioural attributes,
cognition improvement, ability to move, verbal
fluency and memory restoration

EVIDENCE-BASED PRACTICE REPORT 5
Evidence search
This issue of cognitive impairment has become quite significant in recent times, as there are
greater risks for patients in the long term if it is left untreated. The risks may often lead to
unexpected circumstances and can even lead a patient towards fatal accidents. While conducting
the study, I searched Google scholar to retrieve journals and articles pertaining to the subject.
The evidence-based strategy is was based on assessing the content of several relevant articles
derived from the journals articles including online blogs. The articles belong to recent times
excepting one which belongs to 1997. In order to find out the proper information on the subject
matter, a rigorous search was conducted.
Initially the search criteria belonged to any time, however, later it narrowed down to the most
recent ones slating from 2015. The key search word was evidence-based studies on cognitive
impairment and studies were mostly quantitative in nature with empirical analysis conducted by
the authors. There was no such stringency on the inclusion or exclusion criteria, only the focus
was laid on gaining evidenced studies on cognitive impairment. Out of the entire search criteria,
only the five best articles as per my opinion was selected to conduct the study. Most of the study
is based on associating human responses, prognosis with the development of cognitive
impairment.
A literature synthesis of the best evidence
Evidence table
Author Study design
question
domain
key
information
validity check personal
appraisal
Zuccalà et
al. (2019)
Purpose: This
study paper
aspires to find
out the causes
of cognitive
P: patient
with heart
failure having
cognitive
impairment
The study is
not biased and
has neutral
approach as it
specifies on
I believe that
the author has
tried to focus
on a common
yet serious

EVIDENCE-BASED PRACTICE REPORT 6
impairment in
patients with
mild to
moderate heart
failure.
Level: this is a
level study
paper
design: the
study has been
conducted on
an empirical
basis and
considered the
findings
gathered from
57 patients
having heart
failures of
history of heart
attack
Domain:
human
response
I:
medications
long with
Cognitive
stimulation
C: care as
usual
O: Expected
outcome in
bettering
cognitive
impairment
and helping
patients cope
up with
mental
depression
the impact of
congestive
heart failures
including mild
cardiac arrests
to be the cause
of cognitive
impairment
and depression
in older
patients
author’s
findings and
conclusions:
the author tries
to find out the
implications of
mini-mental
state
examination
(MMSE) in
assessing and
managing the
risk
implications of
cognitive
impairment in
older patients
with heart
history of heart
failure. The
subject by
associating
cardiac arrests
with that of
cognitive
impairments.
Cardiac
diseases are
quite common
in older
patients which
leads to a
sense of
depression and
melancholy.