Evidence-Based Practice Report: Dementia, Brain Exercises, and Nursing

This report delves into evidence-based practices (EBP) for dementia care, specifically examining the role of brain exercises in mitigating cognitive decline. The study utilizes the PICO framework to formulate the research question: "Does brain exercises stop dementia from progressing?" The report analyzes data from databases like MEDLINE and PubMed, employing keywords such as "Nurse," "Older," and "brain exercises." The Caldwell framework is used to critically evaluate the selected studies. The findings suggest that brain exercises, including activities like puzzles, games, and mental calculations, can positively impact dementia patients. The report also highlights the importance of nurses in implementing EBP, and recommends regular brain exercises as a means of reducing dementia prevalence. The study also explores the use of Lewin's force field model to implement the research into practice.

Running head: EBP
Evidence-Based Practice (EBP)
Name of Student
Name of Institution

EBP 1
Evidence-Based Practice (EBP)
Part-1:
Introduction
Evidence-based practice is "the ability to think critically using knowledge and skills by
nurses while providing mental illness patients with acute care" (Nursing and Midwifery Council
of Australia). NMC in their code of conduct also give nurses and midwives the responsibility of
providing communication in a more dignified way to their patients since living with dementia
causes challenges in communication (Grove, Gray & Faan, 2019). Furthermore, nurses vested
with the task of enhancing their patient’s mood by creating a healthy environment that sets the
mood (Bundy & Minihane, 2018). Likewise, the National Nursing and Midwifery Council of
Australia hold that are responsible for promoting equity and fairness in the treatment of mental
illness patients (Chaafont et al., 2018).
According to the recent statistical records, “around 447,115 people in Australia are living
with dementia as well as it is the most common type of mental illness among older people”
(Dementia Australia, 2019). Hamer, Sharma and Batty’s study (2018), described dementia as a
mental illness that messes up with an individual’s ability to think well coupled with running their
daily activities (Henderson et al., 2019). In considering the harmful effects, dementia has, this
paper focuses on discussing the problem that relates to the decrease in dementia among older
adults (Loprinzi et al., 2019). The study is systematically conducted to find out the correct
answer to the question (Rohan, Capitulo, and OʼBrien-Abel, 2019). Finally, the paper as well
looks at the stability and limitations of the study on suppressing dementia together with the
related disorders it comes with.

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The reasoning behind this research topic is that people mostly within the age bracket
between 65 to 69 years in Australia have a mental disorder (dementia), and by 2025, these
numbers will have doubled (Townsend & Morgan, 2017). Way, Fisher, and Chenery-Morris
(2019), critically, defined the symptom of dementia: "dementia caused by the damage to brain
cells." Because of this, the communication of cells with one another is curtailed, thereby altering
the emotions and thinking the behavior of an individual (Young et al., 2018).
Part 2:
In doing research, the first milestone is always formulating research questions linked to
the topic. A well-built question will propose study by the help of PICO criteria, which allows
formulating the problem by breaking it into four parts, namely population, intervention,
comparison and outcome (Bundy and Minihane, 2018). As evidenced in table-01, this study
deploys the PICO design, which helps to formulate the question: “Does brain exercises stop
dementia from progressing?” The survey only has a specified category of people (old) to respond
to the problem: "In what ways do brain exercises help maintain the brain inactive state among
people aged 65 and above years?" (Chalfont et al., 2018). The comparison thus is producing by
default.
Table-01 PICO Grid
P Population Patients with age 65 and over
I Intervention Brain exercises
C Comparison Inapplicable
O Outcome Reduced dementia growth

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In response to the study query, MEDLINE (Ovid) and PubMed databases are used. The
articles used to stipulate a deep understanding of how brain exercises can help to lower the
growth of dementia. Ellis (2019), highlighted among other training methods for dementia
patients puzzles and games that can be used to help reduce the loss of memory. In doing this, the
role of nurses in decreasing mental issues in dementia patients is critical (Hamer, Sharma &
Batty, 2018).
Data, which is secondary, is collected using quantitative and qualitative methods of
research. Besides, statistical figures from documents published articles, and search engines such
as Google scholar are used. Moreover, “the Cumulative Index to Nursing and Allied Health
(CINAHL), MEDLINE and PubMed” is used (Henderson et al., 2019). The method is
appropriate for the formulation of the study answer because it enables a systematic way to
produce detailed reports and quality outcomes (Loprinzi et al., 2019).
The keywords and data used in this study include Nurse, Older, and brain exercises.
Searching, putting quote marks was necessary because truncation is deployed in searching
phrases which have diverse endings with utilizing designated symbols (Rohan, Capitulo, and
OʼBrien-Abel, 2019; Watson, Parker and Swain, 2018). For example, with the word Nurse, there
are different results produced like Nursing, Nurses, and Nursery, which means the research, was
producing hits containing Nurse. So, it was researched by using Nurs*. Similar is like the
example of older; therefore, search tools like "?" was used to find the specific word (Young et
al., 2018). Boolean operators played a specific role in research such as ‘or,' ‘and,' ‘not’ are used

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to bring together key terms. Table A in the appendix section is showing the Boolean operators
used in the study, whereas; Appendix B has the incorporation and barring benchmark data
(Townsend & Morgan, 2017).
Table-02 is showing the total outcomes received after including and excluding
information regarding the chosen papers (Way, Fisher and Chenery-Morris, 2019). In totality,
there were 45 responses, 30 of which were ditched since they all were irrelevant considering the
PICO question. Around 12 article abstracts were read. Regardless, three remained that were of
poor quality. Finally, nine articles on the "Effects of brain exercises on dementia patients aged 65
and above" were exhaustively read since they correspond with the PICO methodology and the
study problem and 33 were excluded (Unbehaun et al., 2018).
Table-02 Search results
Database Number of hits No of Abstracts read Full read papers overall
Medline (Ovid) 15 4 3
PubMed 30 8 6
Several instruments can be used to criticize a topic; for instance, CASP, Caldwell, but
this study used Caldwell (Bundy & Minihane, 2018). The main reason for settling on this
instrument is its ability to provide a more reliable framework for criticizing qualitative studies
and evaluate the outcomes of Guure, Ibrahim and Adam, (2017). Furthermore, the Caldwell too
and quantitative analysis is the most appropriate method that applies to students engaging in
advanced research as well as critics to the medical and health works (Chalfont et al., 2018;

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Leung, Trevena & Waters, 2016). According to Guure, Ibrahim, and Adam (2017), studies
relating to healthcare and nursing are mostly backed up by robust discussions and professional
experiences of different clinical and medical practitioners. Therefore, the Caldwell framework
provides the green light for the suppositions of these professionals to be assembled in one
document for critique to determine the relevance of various experiences and approaches selected
for research (Ellis, 2019; Leung, Trevena & Waters, 2016). According to Guure, Ibrahim, and
Adam, (2017), the Caldwell framework is usually utilized to provide researchers with the much
needed relevant structure. For instance, the researcher can find out the shortcomings and
strengths of his study, just like this very essay on evidence-based practice has some limitations
and strengths. Furthermore, the research adheres to a more rigid time frame since the data used is
not older than the past five past years. However, because of the quantitative nature of the data, it
consumes time whereas quantitative research has numerical data to analyse the results, but it
cannot be used to explain human experiences or observation critically (Henderson et al., 2019;
Butler, Hall & Copnell, 2016).
Investigations by Guure, Ibrahim, and Adam, (2017) more vividly showed secondary
and primary results of physical and brain exercise on the patient’s mental health (dementia
people). The study applied 3474 pieces of research in evaluating its findings (Rohan, Capitulo,
and OʼBrien-Abel, 2019; Butler, Hall & Copnell, 2016). Besides, the study also made use of
questionnaires to assess the engagement of participants in their day to day and week after week
exercise (Unbehaun et al., 2018). The researcher uses holistic analysis as well as applies other
topics of dementia together with its causes to analyze their findings. Guure, Ibrahim, and Adam,
(2017), in their study, described the various kinds of insanity, such as Alzheimer’s infection and
vascular dementia. According to Guure, Ibrahim, and Adam (2017), “brain exercises are being

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recognized as the essential factor in preventing the progressive growth of dementia.” The study
of Guure, Ibrahim, and Adam (2017) compare the effects of mental exercise on the health of
mentally ill patients. Responses given by participants to the study include: they exercise two to
three times weekly, once every week, 2-3 times a month. Young et al. (2028) mentioned in their
research that mental illness influences a person's quality of life due to its sensitive neurocognitive
or degenerative effects.
Guure, Ibrahim, and Adam, (2017) used various studies like investigations of Bundy and
Minihane (2018), which maintained that regular mental practice could significantly trigger
mental illnesses and dementia. It also positively impacts on older people aged 65 or more.
Furthermore, a study by Chalfont et al. (2018) determined that mental exercises significantly
influence the quality of life of the patient. Nevertheless, Guure, Ibrahim, and Adam (2017), in
their research, confirmed the dominance of mental illness all over the globe. In 2016 alone,
nearly 13,729 people died of dementia and its other types. Furthermore, they intimated that these
numbers would rise from “589,807 to 1076,129 from 2028 to the end of 2058” (Dementia
Australia, 2019). Guure, Ibrahim, and Adam, (2017) applied Prince et al.'s research, which
identified the escalating numbers of people that live with dementia. Furthermore, the study
observed that people diagnosed with dementia survive for only seven to eight years (Loprinzi et
al., 2019; Blease, Lilienfeld & Kelley, 2016). Similar research by Bundy and Minihane (2018)
maintained that mental exercises significantly influence dementia patient's lives. Keeping an
active brain maintains cells in the brain in an active state and also reduces the proximity of other
related infections such as different subtypes of dementia and Alzheimer's syndrome (Rohan,
Capitulo & OʼBrien-Abel, 2019; Aasekjær et al., 2016).

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Several pieces of research have recommended engaging patients with dementia in
rigorous exercises that keep their brain active. Some of these include basic calculations and
arithmetic, singing, playing music, dancing, and loudly reading from books. These activities,
according to Unbehaun et al. (2018), enhance the mortality and morbidity of an individual. A
further investigation in Australia will be instrumental in measuring the contribution of other
factors like the contribution of the duration of exposure to mental exercise on mental health
healing (Watson, Parker & Swain, 2018; Aasekjær et al., 2016). On the other hand, Lewin's force
field model in the study concerning evidence-based practices identified the factors that account
for such situations or disorders such as cognitive impairment (Way, Fisher & Chenery-Morris,
2019; Dobson & Dobson, 2018). Nurses apply evidence-based practices for patients with
dementia to provide them with acute-care (Young et al., 2018).
Conclusion
It is concluded that mental exercises are utilized in the reduction of dementia. Moreover,
should nurses adhere to EBP, for instance, having to conduct sessions with hospitalized dementia
patients, could resolve other cases like thinking and weird behaviour. The ultimate
recommendation of the study is that regular brain exercise such as playing music and arithmetic
and calculations reduce the prevalence of dementia and mental retardation. Patients having
dementia in Australia face many hardships with their social life from which the most critical is a
communication problem. Therefore nurses are the true caretakers of such patients. This
assessment has exceptionally defined the research problem using the PICO framework. It has
also used consistent findings from MEDLINE (Ovid) and PubMed all which availed vital
material on the topic of interest. The study provides mixed outcomes, both primary and

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secondary lastly; the study used Lewin’s force field model to implement the research into
practice.

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