NUR2300: Evidence-Based Practice for Asthma Patient Care Analysis

This report delves into evidence-based practices for asthma patients, particularly focusing on the application of intravenous magnesium sulfate in children. The research explores the benefits of integrating evidence-based practice, including the best available research, clinical expertise, and patient preferences, to improve patient outcomes. The report discusses the causes of asthma in children, the importance of communication between nurses, parents, and patients, and the role of asthma action plans in reducing attacks. It also highlights the significance of self-management techniques, such as proper inhaler usage and environmental control, to minimize asthma triggers. The report emphasizes the need for continuous learning, guideline implementation, and parental involvement in the patient's care. Furthermore, the report examines the role of nurses in educating and supporting both patients and their families to promote better asthma management, reduce hospitalizations, and improve the overall quality of life for those affected by the condition.

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Running head: EVIDENCE- BASED PRACTICE FOR ASTHMA PATIENTS
Evidence- Based Practice for Asthma Patients
Name
Institution

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EVIDENCE- BASED PRACTICE FOR ASTHMA PATIENTS
Evidence- Based Practice for Asthma Patients
Evidence-based practice is the incorporation of the patients’ needs, best clinical research
available and clinical experience which brings out the best outcomes from the patient (Parrish,
2018). It stands as a collective name for sub-branches which include; evidence-based dentistry,
evidence-based medicine, evidence-based public health, evidence-based nursing and may more.
This kind of practice in medicine gained its name in the 1990s where David Sackett and his
associates researched about it. It is a kind of practice in medicine that is dependent on evidence
and research.
It is based on two principles and that is; pursuing the highest degree of evidence
and skill and patient’s values. Pursuing the highest level of evidence available should be done
using an evidence-based practice process to get the right results (Rice, 2011). Whenever there is
a need to describe an intervention where science is not fully applicable, the second principle of
EBP should be applied. The second principle encompasses matching the values of the patient and
the clinical skill available (Rice, 2011).
Asthma is a lung infection that is normally characterized by coughing, wheezing and lack
of breath. It affects all age groups but is more prevalent with children. It costs the Australian
government 1.2 billion dollars annually to treat and manage asthma (Australian Bureau of
Statistics, 2018). Between 2012 and 2014, it killed about one thousand people and according to
the chief executive of Asthma Australia, the deaths could have been prevented. These deaths
could be prevented and the money used for treatment could be used to improve infrastructure in
the country and therefore a better way should be found to deal with asthma.

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EVIDENCE- BASED PRACTICE FOR ASTHMA PATIENTS
Can management and quality learning of nurses using intravenous magnetic sulfate
reduce the infection of asthma in children? Asthma is known to attack children more than adults
and stays with them until when they are adults. If asthma can be treated when children are still
young, they will grow up with high chances of survival. This research needs to be done so that
less few people will have attacks of asthma, less money will be channeled to treat asthma and
there will be fewer deaths related to asthma. Population or the problem in this question is
infections of asthma in children, intervention is using intravenous magnesium sulfate, the
comparison is the usage of antibiotics and intravenous beta-agonists, and outcome of interest is
the reduction of the effects of infection in childhood years. The key search terms will include
names such as antibiotics, asthma and intravenous magnesium sulfate.
In Therapeutic uses of magnesium (2009), Guerrera cites that magnesium is applicable to
patients suffering from severe acute asthma. Intravenous and nebulized magnesium sulfate for
treating acute asthma in adults and children: a systematic review and meta-analysis (2013)
presents a conclusion that intravenous magnesium sulfate with the addition of beta 2 agonists
reduced the number of children being hospitalized due to asthma. In research done by
Ingemansson, Evidence-based practice for children with asthma in primary care: quality of
management and effects of learning, it was found that more guidelines were required for there to
be fewer infections of asthma in children.
Asthma has affected children in Australia and has been cited to be one of the few
countries that rate the highest number in the world. At a young age, more boys are affected with
asthma than girls and at the age of fifteen years and above, the ladies are the ones who are
affected more (National Health Survey, 2018). Causes of asthma in children include; a mother
who used to smoke during pregnancy, obesity and family members with sicknesses such as hay

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EVIDENCE- BASED PRACTICE FOR ASTHMA PATIENTS
fever, asthma or eczema (Papoutsakis, 2013). Moreover, there is a lot of warm air in Australia
that holds a lot of dust that also causes asthma, others were subjected to lots of cold dry air when
they were really young, early- based viral infections while others were diagnosed with it when
they were still infants (Sly, Kusel & Holt, 2010). For long-time asthma has been treated with
antibiotics alone, inhalers and flu shots. This has proved that another way is needed to fight
asthma when children are not yet grown up.
That is where evidence-based practice comes in. It is not a method that only uses the
normal medication but also the use of the best expertise in the field, research evidence, and the
patient's preferences. Now the level and type of asthma vary across the room which are caused
by different trigger attacks (Lötvall, 2011). Thus, understanding which type of asthma a distinct
child is suffering from will make the treatment simpler and will bring forth better outcomes and
evidence-based practice brings forth such outcomes.
Communication between nurses and parents of the patients and the patients has been
found to reduce the number of those being hospitalized at an early age (Miles et al., 2017). This
method is supported through the evidence-based practice and is said that when there is
communication better self- management is used which reduces the chances of one avoiding
places that can trigger their type of asthma. Another reason for communication is that the patient
can get his tailor-made methods to use and avoid different things that act as triggers.
In the book, Evidence-based practice for children with asthma in primary care: quality
of management and effects of learning, the author shows how evidence-based care can improve
the treatment of asthma. Most importantly he found that guidelines were very important in
evidence-based practice and that more learning was required so that the right diagnosis is made.

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EVIDENCE- BASED PRACTICE FOR ASTHMA PATIENTS
On experiences, feedbacks from patients of the experiences they have had were important for
guidelines that were to be used for the treatment and management of asthma.
One way of using EBP is to use inhalers and intravenous magnesium sulfate concurrently
(Shan et al., 2013). These drugs can be taken every single day because they prevent
inflammation along with their respiratory system. When their lungs and airways are inflamed,
they find it difficult to breathe. If they are reminded to stay away from the things that trigger the
inflammations which primarily leads to an attack they will have fewer attacks. Maintaining
constant communication with them would be effective since it will remind them to take their
medications on time, stay away and know what to do in times of attacks (Farzandipour,
Nabovati, Sharif, Arani, & Anvari, 2017). The patients should also be taught how to use the
inhaler so that they can always know how to administer it to themselves and will not have to
depend on their parents or guardians. Constant visits to the clinic would keep track of how many
times they have missed their inhalers and how they are finding the treatment. In this way, their
values and preferences will be considered and nurses will be able to use their research and
clinical expertise to give the best treatment.
Another advantage in using the evidence-based practice is because if a particular patient
is affected by some environmental factors, they will be able to know how to counter-attack the
effects of the same. This means the professional will have to be versed in knowledge when it
comes to knowing what can be done when in particular season effects that trigger attacks are
abundant. The professional can administer some vaccine against the reaction of the
environmental factor so that an attack will not be caused by the same.
All through the year, the patients together with their parents can record how the attacks
varied (Munde, 2017). This way they will be able to know when is the time that the attacks are

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EVIDENCE- BASED PRACTICE FOR ASTHMA PATIENTS
high and find out what causes attacks in those times. Self- management will be used to always
prepare for the high attacks season and in the process, the experience will be gained. In the long
run, those attacks in those particular seasons when attacks are high will reduce tremendously.
Practitioners also need to teach parents what to do whenever a patient is having an attack
at home and depending on the severity they may be advised when to go to the hospital (Munde,
2017). The child may be told to sit upright and take ten puffs of their inhaler at intervals of thirty
to sixty seconds. Self- management always saves a lot of time since the patient does not need to
wait for the arrival of the ambulance. After the attack the practitioner should visit the patient to
find out why there was an attack, was it caused by the ineffectiveness of the medication they had
been using, was it a trigger or was it simply negligence of using the drugs and being less
sensitive of the environment the patient was in (Munde, 2017). Thus, it will not only be an
administration of other drugs but it will be about pointing out where the real problem lay while
undergoing the medication.
Nurses can also encourage the parents to be supportive of the patients so that the patients
cannot just endure while taking the treatment but that they will fully participate in taking care of
themselves. If the children feel the support without pressure they will be able to take care of
themselves better and improvement will be witnessed much earlier. The parents to the patients
may also feel discouraged and fail to attend fully to their children and thus they too should have
talks with nurses to also be encouraged that if managed well, asthma will not cause any vital
change in the family (Kennedy et al., 217). Nurses on the other hand have to give themselves to
the learning of evidence based medicine for asthma in children so that more solutions can be
found.

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EVIDENCE- BASED PRACTICE FOR ASTHMA PATIENTS
Parents should also take the asthma action plan which contains directions of how a
particular child should take medication, what are the possible triggers, identification of flare-ups
and how to manage them, knowledge of how to manage a full-blown flare-up and when to go for
emergency care (Kelso, 2016). An asthma action plan helps in the reduction of asthma attacks
(Kouri, Boulet, Kaplan & Gupta, 2017). Some parents even give out the plan to the teachers and
other caregivers so that whenever he is not around he is assured that his child is safe. The plan
should be reviewed every six months and depending on the progress of the child, the clinician
will be able to change some things. Whenever a change is made on the plan, every person
associated with the child should be given a copy. The center for evidence-based medicine was
used to get the critical appraisal for systematic reviews.
Asthma action plans have been cited to reduce the number of times patients visit the
emergency room and also has improved the quality of life both for the patient and the family
(Kouri, Boulet, Kaplan & Gupta, 2017). The issue is that these plans have not been fully
effective because most practitioners do not complete the details of the yellow zone in the plan.
For it to be fully effective and efficient the yellow zone must be filled out too. Teaching parents
to handle the patients at the yellow zone will reduce the attacks and the frequency to the hospital.
When magnesium sulfate is used with a combination of inhalers and other practices,
quick recovery can be guaranteed. When parents are brought on board to take part in the
treatment and the patients themselves know how to take care of themselves, asthma attacks will
reduce and in the long run as they grow up, asthma will not be a disease that is dominative.
Fewer people will be affected by it (van Aalderen, 2012). Thus, when treated early asthma can
seize to be an epidemic.

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EVIDENCE- BASED PRACTICE FOR ASTHMA PATIENTS
References
Ahanchian, H., Jones, C. M., Chen, Y. S., & Sly, P. D. (2012). Respiratory viral infections in
children with asthma: do they matter and can we prevent them?. BMC pediatrics, 12(1),
147.
Farzandipour, M., Nabovati, E., Sharif, R., Arani, M. H., & Anvari, S. (2017). Patient self-
management of asthma using mobile health applications: a systematic review of the
functionalities and effects. Applied clinical informatics, 8(04), 1068-1081.
Guerrera, M., Volpa, S., & Mao, J. (2009). Therapeutic uses of magnesium. - PubMed - NCBI.
Retrieved 8 September 2019, from https://www.ncbi.nlm.nih.gov/pubmed/19621856
Ingemansson, M. (2016). Evidence-based practice for children with asthma in primary care:
quality of management and effects of learning. Inst för kvinnors och barns hälsa/Dept of
Women's and Children's Health.
Kelso, J. M. (2016). Do written asthma action plans improve outcomes?. Pediatric allergy,
immunology, and pulmonology, 29(1), 2-5.
Kouri, A., Boulet, L. P., Kaplan, A., & Gupta, S. (2017). An evidence-based, point-of-care tool
to guide completion of asthma action plans in practice. European Respiratory
Journal, 49(5), 1602238.
Kennedy, S., Bailey, R., Jaffee, K., Markus, A., Gerstein, M., Stevens, D. M., ... & Mitchell, H.
(2017). Effectiveness of evidence-based asthma interventions. Pediatrics, 139(6),
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Lötvall, J., Akdis, C. A., Bacharier, L. B., Bjermer, L., Casale, T. B., Custovic, A., ... &
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(2017). Barriers and facilitators of effective self-management in asthma: systematic
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Matziou, V. (2013). Childhood overweight/obesity and asthma: is there a link? A
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Shan, Z., Rong, Y., Yang, W., Wang, D., Yao, P., Xie, J., & Liu, L. (2013). Intravenous and
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systematic review and meta-analysis. Respiratory medicine, 107(3), 321-330.
van Aalderen, W. M. (2012). Childhood asthma: diagnosis and treatment. Scientifica, 2012.

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