Evidence-based practice is gaining tremendous popularity in a fair majority of healthcare disciplines the world over. It is a problem-solving approach vital in the delivery of healthcare, and it involves the conscientious employment of current best evidence to make the most informed decisions about patient care. Its central principle is typically contingent on the best research evidence wholly dependent on if and why a particular treatment works effectively, clinical judgment and experience levels, probable risks and benefits of the treatment to the patient, as well as the patient preferences and core values. With respect to all these principles and considerations, the module can thus be efficiently incorporated to cure a wide range of diseases and chronic illnesses, and a classic example is a patient with gold stage 4 Chronic Obstructive Pulmonary Disease, COPD.
COPD is a progressive lung disease that is a frequent cause of regular hospitalizations, extensive medications, and a significantly reduced quality of life. It is majorly characterized by chronic inflammatory conditions that result in continuous airway obstruction and drastically dwindled lung function. It is classified in four stages, whereby gold stage 4 is the last and most severe stage. Patients with this condition have lived with it for a considerable number of years, eventually resulting in extreme lung damage and aggravating, disabling dyspnea symptoms. While its reversal is not possible, a lot can be done to manage the symptoms that mainly include worsening coughing, tiredness, shortness of breath, mucus, frequent flare-ups, and the likelihood of chronic respiratory failure (Christensen, Titlestad, & Huniche, 2017).
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Standard treatment procedures for this condition include the use of corticoids, bronchodilators, oxygen, optional antibiotics, among others. For a patient with gold stage 4, long-term and high-intensity Non-invasive ventilation technique based on evidence-based research is arguably the best technique that helps expand the quality and quantity of their life. It is an internationally accepted treatment plan for severe COPD, especially considering that it is uniquely configured to effectively provide proper treatment and therapy for COPD patients including those in the severe stage.
As such, the patient with gold stage 4 COPD will immensely benefit from this treatment plan. However, since treatment using NIV is normally evaluated as an indicator of the severe stage, adequate knowledge of the patient’s perspectives on treatment is vital. Assessing the patient’s mental and physical condition is important prior to the treatment. Based on these assessments, the NIV treatment can be considered, for instance, if there are apparent biomarkers that the patient is at the end stage. These include co-morbidity and extreme low lung functioning. It works most efficaciously if the patient receives as much Non-Invasive Ventilation as possible, especially during the first twenty-four hours. It should also be given at sixteen and twelve hours on the second and third days respectively. Critical factors that determine the outcome of the NIV treatment include the patient’s ability to handle or tolerate the mask, meeting the recommended hours, as well as synchronizing breathing with the machine (Christensen, Titlestad, & Huniche, 2017).
Treatment with this NIV approach is uniquely configured to conform with the patient’s condition, which is why it is administered by dint of a mask that tightly fits around the mouth and nose of the patient. This treatment plan will significantly alleviate the symptoms of the disease and will thus be immensely beneficial to the patient going forward. It is tailored to fit patients’ needs through Continuous Positive Airway Pressure, Inspiratory Positive Airway Pressure, and Expiratory Positive Airway Pressure, which are all analogous. As such, it reduces the work of breathing substantially, aids alveolar recruitment, improves ventilation and perfusion, and decreases shunt. Alongside improving alveolar gas exchange as well as removal of carbon dioxide, NIV coupled with other standard medications and pulmonary rehab thus immensely helps to improve the patient’s quality and quantity of life.
Conclusively, it is worth noting that special nursing skills are critically needed when commencing NIV treatment with the COPD patient. Adequate skills consisting of technical proficiency, aiding the patient cope with anxiety, predictability during the care process, physical presence, information on the NIV machine, among others, are exceptionally handy.
References
Christensen, H., Titlestad, I., & Huniche, L. (December 10, 2017). Development of non-invasive ventilation treatment practice for patients with chronic obstructive pulmonary disease: Results from a participatory research project. Sage Open Medicine Journal , 5-11.
