Comprehensive Patient Assessment ON Abnormal Uterine Bleeding

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Abnormal Uterine bleeding

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INTRODUCTION

Abnormal uterine bleeding is unusual or heavy bleeding from the womb through the vagina. It occurs at any time during the menstrual cycle, this include even in routine menstrual period. This paper will discuss the nursing challenges in helping the patients who are suffering from such conditions. It will also discuss the problem statement, the purpose of the change proposal, the literature in UTI, evaluation of literature, change theory, evidence-based practice, barriers and how to overcome them.

BACKGROUND

Nurses play a crucial role in offering good health services to their patients. They are also tasked with providing leadership in the health system and hospitals. However, the nurses are faced with a lot of challenges in the process of attending to their patients (Huston, 2013). The nurses must therefore fully commit and dedicate themselves to their roles.

In the execution of their mandates, they are encounter violence that originates from either their colleagues or the patients. The data provided by the Occupation Health Safety Network shows that the workstations violence increased in 2012 and 2014 in the nursing profession. Other challenges encountered include; short staffing, long working hours, hazards in the workplace (Ersek, & Wilson, 2003). These problems could be solved by ensuring that by formulating laws that would help reduce violence, employing enough staff, allowing the nurses to have resting time and ensuring they wear an antiviral face mask. By solving these problems, the nurses will be able to provide the best care to patients suffering from illness such as uterine bleeding and provide the treatment methods.

PROBLEM STATEMENT

It is important for the hospital management to understand the issues that the nurses encounter while performing their normal activities (Leon, & Knapp, 2008). This will help the management to know the areas of improvement and to facilitate it. This will enhance service delivery to the patients.

PURPOSE OF THE PROPOSAL

The aim of the proposal was to comprehend the barriers to service delivery in the nursing sector. Overcoming these barriers will not only motivate the nurses but also the will provide the best care to the patients (McCoy, 2009). Well served patients will always come back because they are very satisfied with what they are getting from healthcare.

PICOT: In ICU patients, is the birth control pills treatment better compared to endometrial ablation procedure for treating abnormal uterine bleeding in women in a period of 21 days.

Background

There are many methods of treating patients who are suffering from heavy uterine bleeding. These methods may be hormonal or surgical contraceptives. The patients need to comprehend the advantages and disadvantages of these methods. This will help them make the best choice (Andrade, Sandarsh, Chethan, & Nagesh, 2010). This section will evaluate whether the birth control pills are better in reducing heavy discharge compared to the endometrial ablation procedure.

Methods

In this study, science Web search, MEDLINE and EMBASE were used. The period of study was 2015. The major focus of Search Web was to identify additional studies on the conference proceedings. The study gave the assignment to two authors to carry out their research independently.

Conclusion

From the two studies, it was established that the use of birth controls is more effective compared to the endometrial ablation in the treatment of the abnormal uterine bleeding. This was good for the patients who had intentions of getting pregnancies.

LITERATURE SEARCH STRATEGY

There were several methods used in getting information about the abnormal uterine bleeding. The techniques used include questionnaires, interviews, stories from documents and reports (Thakar, Ayers, Clarkson, Stanton, & Manyonda, 2002). The research design employed includes narrative, case study, grounded theory, and phenomenological design.

EVALUATION OF LITERATURE

Questions were developed in order to help to carry out the research. These questions will provide the required information on the treatment of the heavy bleeding. These questions were made available to the patients through questionnaires (Ranjit, & Kissoon, 2011). Other methods used are sampling, interviews, and documents.

The first question was, what are the methods of treating heavy bleeding? The methods are birth control pills, use of estrogen and contraceptives, endometrial ablation, dilation and curettage, and abnormal hysterectomy. The second question was, do the birth control pills completely treat heavy periods? When the right does is administered the birth control pills are effective in ending heavy abnormal uterine bleeding (Gage, Yan, Milligan, Waterman, Culverhouse, Rich, & Radford, 2006). The third question was on how to help patients with abnormal bleeding. The patients manage the heavy periods by visiting the clinical officers and seeking advice on the best method of treatment.

The fourth question determined how effective is the endometrial ablation in the treatment of heavy periods. It is a surgical method and not preferred by patients because it prevents the application of other methods of endometrium monitoring in the treatment of abnormal uterine bleeding. The fifth question sought to determine the number of females suffering from heavy periods. The study established that 15-30% of the women were suffering from the abnormal bleeding. The six-question was, what is the rate of mortality of abnormal bleeding? The research established that the rate of mortality had increased to 15%. The next question determined the age of women that are more vulnerable. Females are more vulnerable during their reproductive age (Andrade, Sandarsh, Chethan, & Nagesh, 2010). The last question compared the treatment methods and discovered that the use of birth control pills was the most preferred compared to other methods. The conclusion was that birth control pills are better compared to endometrial ablation treatment method.

APPLICABLE CHANGE THEORY

Rogers’ Change Theory

This Everette Rogers’ theory had five stages. The five stages included; alertness, interest, assessment, execution, and adoption. This theory is used in change projects that are long-term. The theory is fruitful when the employees opposed to changes adopt it (Funnell, & Rogers, 2011). This is a result of them hearing from nurses who have implemented it.

PROPOSED IMPLEMENTATION PLAN

The evidence-based practice should be included in the nursing curriculum. The EBP will help in integrating the values of the patients, clinical values and the best evidence in the decision making of the patients. Through this the outcomes of the patients are positive. The knowledge gained by the nurses will enable them to give the patients the bests care to lead to high satisfaction.

POTENTIAL BARRIERS TO EBP IMPLEMENTATION

The potential barriers to implementing the evidence-based practice in nursing include;

Time and Knowledge: Lack of adequate time to implement the EPB is a major challenge. To add on that inadequate knowledge of evidence-based practice is also an important barrier (Houser, 2010). All stakeholders should be involved, this will help in building trust and will enable the nurses to learn and provide an input to the project.

Resistance: The implementation of EBP may face a challenge of resistance from nurses who are not willing to change. This can be solved by ensuring the administration support is adequate (Grol, & Wensing, 2004). The administration may encourage their staff by showing them projects that used the technique and how it became successful. The management should also create a culture that supports evidence-based practice.

CONCLUSION

In conclusion, the abnormal uterine bleeding is a condition that mostly affects women at their reproductive stage of life. The preventive measures include the use of birth control pills, estrogen and contraceptives, and endometrial ablation. The patients should seek medical advice on the best treatment method for their conditions. From the study, the use of birth controls was more preferred for the patients suffering from abnormal uterine bleeding.

References

Huston, (2013). Professional issues in nursing: Challenges and opportunities. Lippincott Williams & Wilkins.

McCoy, (2009). Professional development in rural nursing: Challenges and opportunities. The Journal of Continuing Education in Nursing40(3), 128-131.

Leon, & Knapp, (2008). Involving family systems in critical care nursing: challenges and opportunities. Dimensions of critical care nursing27(6), 255-262.

Ersek, & Wilson, (2003). The challenges and opportunities in providing end-of-life care in nursing homes. Journal of Palliative Medicine6(1), 45-57.

Andrade, Sandarsh, Chethan, & Nagesh, (2010). Serotonin reuptake inhibitor antidepressants and abnormal bleeding: a review for clinicians and a reconsideration of mechanisms. The Journal of clinical psychiatry71(12), 1565-1575.

Thakar, Ayers, Clarkson, Stanton, & Manyonda, (2002). Outcomes after total versus a subtotal abdominal hysterectomy. New England journal of medicine347(17), 1318-1325.

Ranjit, & Kissoon, (2011). Dengue hemorrhagic fever and shock syndromes. Pediatric Critical Care Medicine12(1), 90-100.

Gage, Yan, Milligan, Waterman, Culverhouse, Rich, & Radford, (2006). Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). American heart journal151(3), 713-719.

Andrade, Sandarsh, Chethan, & Nagesh, (2010). Serotonin reuptake inhibitor antidepressants and abnormal bleeding: a review for clinicians and a reconsideration of mechanisms. The Journal of clinical psychiatry71(12), 1565-1575.

World Health Organization, Special Programme for Research, Training in Tropical Diseases, World Health Organization. Department of Control of Neglected Tropical Diseases, World Health Organization. Epidemic, & Pandemic Alert. (2009). Dengue: guidelines for diagnosis, treatment, prevention, and control. World Health Organization.

Segal, Dzik, & Transfusion Medicine/Hemostasis Clinical Trials Network. (2005). The paucity of studies to support that abnormal coagulation test results predict bleeding in the setting of invasive procedures: an evidence‐based review. Transfusion45(9), 1413-1425.

Funnell, & Rogers, (2011). Purposeful program theory: Effective use of theories of change and logic models(Vol. 31). John Wiley & Sons.

Houser, (2010). Evidence-based practice. Jones & Bartlett Publishers.

Grol, & Wensing, (2004). What drives change? Barriers to and incentives for achieving evidence-based practice. Medical Journal of Australia180(6 Suppl), S57.




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