Introduction
The identified practical issue the paper will address is osteoarthritis (OA) in women above the age of 55 years.
The Evidence-based practice (EBP) project will present acupuncture as a pain management method for a patient with osteoarthritic pain problems.
The major factor causing OA consists of excess weight, injury or overuse, genes, and other developmental issues.
At least 80 percent of people over 55 will show x-ray symptoms of Osteoarthritis in at least one joint (Cherniack & Cherniack, 2013).
Pain management is a challenge to these patients.
Treatment options include medication, surgery, and therapy.
According to Bahrami-Taghamaki et al. (2014), acupuncture for thousands of years has been practiced and has played a significant role in pain relief.
Acupuncturists use this treatment method to relieve pain by inserting slender metallic needles at specific points on the body.
A well-inserted needle sends a signal to the brain along the spinal cord. This triggers a release of enkephalins and endorphins, transmitters that reduce pain sensation.
Similarly, other studies suggest that inserting the acupuncture needle triggers cortisol production. Cortisol is a hormone that assists in controlling inflammation (Manyanga et al., 2014).
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Aim of the project:
- Suggestion for acupuncture therapy for Osteoarthritis patients.
- Symptom management of OA
- Pain alleviation for the OA patients
- Improving functional status, especially on the joint performance, as well as enabling easy and painless movement by the patient
- Controlling disease progress
PICOT Question
In women above 55 years old suffering from osteoarthritis of the lower back (P), how does acupuncture (I) compared to the adjunct standard medication therapy (C) decrease pain (O) within six months? (T).
(P)- Population: the population will comprise women aged 55 years and above who are ailing from OA of the lower back.
(I)-intervention: acupuncture treatment method that will be given to the subjects.
(C)- Comparison: adjunct standard medication therapy will be used.
(O)- Outcome: Pain alleviation and increased joint functionality from the subjects under acupuncture treatment
(T)-Time: the outcome will be measured after six months.
Significance
Adopting the acupuncture treatment method is important to manage the effects and suffering of OA patients.
Several identified harmful effects of Non-steroidal Anti-inflammatory Drugs (NSAIDs) have been identified. Over 12,000 hospitalizations and 2,000 deaths are related to NSAID complications annually (Pelletier, 2010). Acupuncture is, therefore, the best alternative to adjunct standard medication therapy.
In females over 55 years and above, the body is on a declining scale for most of its biological functions. Concerning the toxicity and unsafe side effects of adjunct standard medication therapy, it is recommendable that this age group of women turns to proven alternative methods such as acupuncture.
Evidence Review and Synthesis
The project got the most relevant literature for Evidence-Based Practiced from some of the most reputable search sites such as ProQuest (South’s Online Library), PubMed, and Medline, among others.
I filtered my search to ensure that I only accessed peer-reviewed academic journal articles.
I filtered the sources by the title of the books and articles I was looking for. Specifically,
I typed “Evidence-Based Practice” in the search box and selected articles and books that could be read in their pdf forms or website Hotmail versions.
Summary of “Keeper” studies
There is a wealth of clinical literature supporting the usefulness of acupuncture in treating elderly patients suffering from osteoarthritis.
Some of the studies used in the project include:
- A study by Bahrami-Taghamaki et al. (2014) argued that with the recent increased awareness of acupuncture’s benefits in for managingonic back pain by both patients and professionals, the technique could be adjusted to become more beneficial than before.
- In a study by Iloth et al. (2014), the authors argue that although there is evidence showing that acupuncture is an effective method in managing chronic pain, it is unclear which method is the most effective.
- Manheimer et al. (2015) also conducted a systematic review to show the efficacy of acupuncture in treating low back pain.
- Furthermore, a study by Manyanga et al. (2014) evaluated the utility of acupuncture in managing osteoarthritis.
- Finally, the study by White et al. (2012) provides a trial showing the effectiveness of acupuncture using patients with knee osteoarthritis who would otherwise be referred to an orthopedic surgeon.
Methods
The project will use a quasi-experimental study design by using a randomized controlled trial of the acupuncture therapies on the sample population of women beyond 55 years with osteoarthritis.
Procedure/intervention
One group of participants will get administered acupuncture intervention by qualified acupuncturists, while the other group will be administered using the standard adjuvant treatment by qualified health professionals.
Then, a comparison of the result from each of the two groups of providers will enable the researcher to assess the accuracy and practicality of the evidence gathered from the literature review that acupuncture offers a better solution to pain problems in women over 55 years with osteoarthritis.
Setting
The study will be set at the health facilities serving the patients who meet the topic criteria according to verified medical records by the sample population, the health providers.
Instruments/scales
A chart audit tracks change from the study’s onset to the end.
VAS for determining pain level
Confidentiality
The free will of patients will be sought by use of consent forms after a thorough explanation of the study contents as required by the Institutional Research Board (IRB).
Other ethical considerations like the patients’ integrity and confidentiality will be observed using pseudonyms and coded data.
Data collection
Johns Hopkins nursing evidence-based practice model (JHNEBP) will be used as the vehicle to guide the nursing change and process in the study in addition to current applications of Prochaska’s trans-theoretical model of behavior change as a means of effecting behavior change among the health provides to be used as the sample population.
Aligning stakeholders
A stakeholder is a person who is interested in a particular project and benefits from it.
The stakeholders who will be involved in this project include
- Clinician (will be providing the healthcare recommendations on osteoarthritis)
- Staff nurses (assist in the care of the women who are suffering from osteoarthritis.)
- consultant
- Nurse coordinator (will collect, analyze, organize and distribute information about the EBP project).
- nurse director (chief decision maker)
- women above 55 suffering from osteoarthritis
- The Gathering Point Community Acupuncture (the project owner)