Systematic Desensitization

Systematic Desensitization
Review of Literature
F. Dudley McGlynn (2010) explored systematic desensitization and results of the study
demonstrated that systematic desensitization is a behavior therapy developed by Joseph Wolpe
(1915–1997) for fear and anxiety. The therapy begins with an assessment that describes the objects
and/or events that elicit fearfulness.
Calos M. Coelho, et al (2009) explored the use of virtual reality in acrophobia research and
treatment and the results of the study demonstrated that in particular, the abstract covers the recent
innovations in the use of VR technology and discusses the benefits it may offer for examining the
main causes of the disorder, allowing for ... Show more content on Helpwriting.net ...
James Lewis Maylar, Paul W Clement ( 2006) explored prediction and comparison of outcome in
systematic desensitization and implosion and the results of the study demonstrated that both at post–
therapy and at 1–month follow–up subjects exposed to desensitization and implosion therapy
showed better results and greater anxiety reduction and behavioral changes than did the control
subjects.
William F. Waters, David G. McDonald, Richard L. Koresko (2006) explored psychophysiological
responses during analogue systematic desensitization and non–relaxation control procedures and the
results of the study demonstrated that SD procedure resulted in significantly less reported fear, fewer
trials to a criterion level of decrease in subjective fear, and significantly greater decreases in ANS
baseline
... Get more on HelpWriting.net ...

The Effects Of Sucrose On Pain
decreases pain is unknown. However, theory supported in animal studies shows the analgesic effects
of sucrose can be reversed by using naltrexone. Further studies show that infants who were born to
mothers being treated with methadone did not demonstrate the same analgesic effects from sucrose.
These findings are essential in demonstrating that the decrease in pain is not similar to the response
elicited by non–nutritive (NNS) sucking and decrease pain through activation of a different
neurological pathway. The main point is the effect of sucrose on pain relief is linked to the
sweetness of the solution, as seen with other sweetening solutions such as glucose (McCall,
DeCristofaro, & Elliott, 2013).
The intended handlers for this intervention ... Show more content on Helpwriting.net ...
Inclusion criteria were children less than 1 year of age. The initial search returned 12 results. The
search was furthered by including randomized control trials that returned seven results including a
randomized control trail by Hatfield, 2008. This randomized control trial is considered Level II
evidence in the hierarchy of evidence for intervention and treatment questions (Melnyl & Fineout–
Overholt, 2015). This specific RCT was chosen from the seven because it discussed immunizations,
sucrose as the intervention and the focused population (1–12 month infants) where the others did
not. The database was searched for main terms for information on the related topic included oral
sucrose, infants, and immunizations. Alternative terms included oral sweeteners, neonates, needles,
and analgesia. MeSH terms included Needles*, Sucrose/*administration & dosage, Pain/*prevention
& control, Punctures/*adverse effects, Sweetening Agents/*administration & dosage, Humans;
Infant; Randomized Controlled Trials as Topic. Inclusion criteria included infants < 1 year of age,
publication dates: 2005–2016, randomized control trial, systematic review, USA, glucose/sucrose,

Pros And Cons Of Evidence Based Practice
In this week's assignment, one will reflect on the American Psychological Association (APA), stated
evidence–based practice to define, refine, and analyze the Evidence–based programs and practice in
psychology (EBPP). Based on the resources found in the warm–up activities, the best evidence–
based programs and practice is defined as the integration of the most effective and available research
with clinical expertise in the structure of patient characteristics such as; culture, and value. This
definition of evidence–based programs and practice (EBPP) is very similar to the definition of the
evidence–based practice implemented by the Institute of Medicine (2001, p. 147). The American
Psychological Association (APA), also reveal that the evidence–based programs (EBP) are put in
place to integrate family counseling, social skills training, and educational assistance. Base on these
resources, the key purpose of applying evidence–based programs and practice are to promote
psychological practice and improve public health by implementing empirically supported principles
of psychological evaluation, case formation, therapeutic relationship, and intervention. The
American Psychological Association (APA) resources also indicate that evidence–based ... Show
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Cons of evidence–based programs also requires greater expertise to interpret its relevance and
starting point, for example, a vast amount of research, documentation and decision making is
required in evidence–based programs. While some studies have shown that evidence–based
programs have been utilized by many organizations, evidence–based programs vary in strength of
their effects and may fail if the quality of evidence is not reviewed in consideration of contextual
factors such as culture and

Systematic Desensitization Essay
Systematic desensitization is a venerable behavior therapy for fear and anxiety. Usually it entails
remaining deeply relaxed while visualizing a series of increasingly fearsome scenes in which the
patient confronts targeted events or situations. There are many theories about how systematic
desensitization reduces fear; most "theories" are post hoc claims that systematic desensitization
instantiates some other training regimen or process such as respondent extinction, habituation,
counterconditioning, or self–efficacy augmentation. Joseph Wolpe's original theory of how
systematic desensitization works appeals to learned inhibition of anxiety that is based on
parasympathetic inhibition of sympathetic activation. Criteria have been developed to ... Show more
content on Helpwriting.net ...
Several now classic experiments show the efficacy of systematic desensitization also. Much research
on the outcomes of systematic desensitization was done in a way that renders it of little value. Large
research on the effects of systematic desensitization disappeared from the literature when exposure
technology replaced systematic desensitization as the treatment of choice for phobic complaints.
However, the earliest case studies and clinical series suffice to support the claim that systematic
desensitization is effective and should be considered when in vivo exposure is not feasible or is
initially refused. A case is described in which a 45–year–old female is treated for dental phobia that
was based on claustrophobia and on social phobia. Systematic desensitization consists of gradual,
imaginal exposure to stimuli organized on a hierarchy constructed using SUDS ratings. Typically,
systematic desensitization is combined with some form of relaxation training. The patient is asked to
sit back in a comfortable chair and practice a relaxation exercise. Once a state of deep relaxation is
attained, the patient is asked to imagine the least upsetting stimulus on the

Phobia And Classical Conditioning
In general, a phobia refers to "extreme [and] irrational fear reactions" (Powell, Honey, & Symbaluk,
2013, p. 190). Phobias are developed through a process called classical conditioning. Classical
conditioning involves "a process in which one stimulus that does not elicit a certain response is
associated with a second stimulus that does; as a result, the first stimulus also comes to elicit a
response" (Powell et al., 2013, pp. 109–110).
The process of classical conditioning follows the procedure from Pavlov's salivation experiment.
Before conditioning, when a bowl of dog food is presented the dog would "naturally" salivate at the
mouth "in response to food". Because this response occurs "automatically" and "prior training" isn't
required for hunger, this reaction is called an unconditioned response (UCR) which "is the response
that is naturally elicited by the [UCS]" (Powell et al., 2013, pp. 112–115). When referring to a
natural response––one is referring to an elicited reaction that is characterized as "an unlearned or
innate reaction to [a] stimulus" (Powell et al., 2013, p. 115). Furthermore, the dog food is considered
an unconditioned stimulus (UCS), which "is a stimulus that naturally elicits a response" (Powell et
al., 2013, p. 115). According to Pavlov's experiment, when a bell chimes without the presentation of
dog food, the dog will not instinctually salivate (Powell et al., 2013, p. 112). Since the bell didn't
initially "elicit salivation" naturally, it's called a neutral stimulus (NS) (Powell et al., 2013, p. 112).
However, through conditioning, as the bell tone pairs with dog food continuously, the dog begins to
salivate. Finally, after the conditioning process is completed, the pairing of "food" and the bell "now
elicits salivation" (Powell et al., 2013, p. 112). Since the dog's salivation required some type of
continual prompting or, "prior training", it's reaction is considered a conditioned response (CR) "and
the [bell]" is the conditioned stimulus (CS). By definition, a conditioned stimulus "is any stimulus
that, although initially neutral, comes to elicit a response because it has been associated with an
unconditioned stimulus" (Powell et al., 2013, p. 115). Responses triggered by a

evidence basedpractice
EVIDENCE BASED PRACTICE INTRODUCTION: Evidence–Based Practice (EBP) is a
thoughtful integration of the best available evidence, coupled with clinical expertise. As such it
enables health practitioners of all varieties to address healthcare questions with an evaluative and
qualitative approach. EBP allows the practitioner to assess current and past research, clinical
guidelines, and other information resources in order to identify relevant literature while
differentiating between high–quality and low–quality findings. UNIT BACKGROUND: Evidence
based practices was founded by Dr.Ardice Cochrane , a British epidemiologist.Cochrane was a
strong proponent ... Show more content on Helpwriting.net ...
Problem focused triggers are identified by healthcare staff through quality improvement,risk
surveillance,benchmarking data,financial data, or recurrent clinical problems.Problem focused
triggers could be clinical problems,or risk management issues. Example:Increased incidence of deep
vein thrombosis and pulmonary emboli in trauma and neurosurgical patients.Diagnosis and proper
treatment of a DVT is a very important task for health care professionals and is meant to prevent
pulmonary embolism.This is an example of an important re tht more research can be conducted to
add into evidence –based practice. Knowledge focused triggers are created when health care staff
read research, listen to scientific papers at research conferences.Knowledge based triggers could be
new research findings that further enhance nursing ,or new practice guidelines. Example: Pain
management .,prevention of skin breakdown , assessing placement of nasogastric tubes, and use of
saline to maintain patency of arterial lines. When selecting a question ,nurses should formulate
questions that are likely to gain support from people within the organization.The priority of the
question should be considered as well as the sevearity of the

Evaluation Of A Quantitative Article Using Melnyk &...
iQuit in Practice
Naughton, F., Jamison, J., Boase, S., Sloan, M., Gilbert, H., Prevost, A. T., & ... Sutton, S. (2014).
Randomized controlled trial to assess the short–term effectiveness of tailored web– and text–based
facilitation of smoking cessation in primary care (iQuit in Practice). Addiction, 109(7), 1184–1193
10p. doi:10.1111/add.12556 The purpose of this paper is to present an analysis of a quantitative
article using Melnyk & Fineout–Overholt's (2015) rapid critical appraisal (RCA) for a randomized
clinical trial. Topics included are the validity of the research, results of the research and how the
information can be applied to the clinical care of my own patient population. This study by
Naughton et al. (2014) was conducted to identify the effectiveness of the iQuit program, a self–help
program supported by text messaging, as an adjunct to smoking cessation education offered in the
primary care setting. The authors report smoking cessation offered in the primary care setting varies
widely but research showed the added option of a self–help program for patients produces a
cessation rate of as much as twice the rate of those patients who were given only in– office
education (Naughton et al.). I find the validity of this study plausible as the participants were
randomized into two groups with one being offered usual care and the second group being offered
usual care plus the iQuit system. The authors completed

Evidence Based Practice Research Paper
Evidence–based practice is a decision making process in which you combine scientific data with
clinical expertise, patient values and circumstances of the patient. (Hoffmann, Bennett 2017). The
World Health Organisation (WHO) defines chronic diseases as those which are caused by non–
reversible pathological changes in the body, are permanent and leave a lingering disability, those
that require ongoing rehabilitation or care. Indigenous Australians experience very high prevalence,
morbidity and mortality from chronic health conditions such as diabetes, cardiovascular, renal and
chronic respiratory disease. Multi morbid and comorbid chronic diseases are increasingly placing a
greater burden on individuals, communities and health care services

Evidence-Based Practice
Evidence–based practice is an approach in the decision making of using the best evidence about the
care of a patient.it is an integration of clinical expertise, patient values and the available evidence
from ongoing research .taking into consideration internal and external influences, it promotes
critical thinking in the application of the evidence in patient care. The impact of EBP has been
echoed in the optimal health care, quality of life and clinical outcomes (Mabbott, 2011). Application
of EBP in the plan of care has resulted in benefits such as reduced costs, decreased variation in care
and nurse satisfaction. The EBP movement is one component essential aimed at transforming the
current knowledge into a plan of care decisions to improve ... Show more content on
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The medical personnel should know the patient in depth, care about their differences, preferences
and values. The priority of concern should be the patient's comfortability. The nurse aims to relive
the patient of pain, ensure continuity of care and involvement in decision making. Measures of
quality of care include structure and process about patient needs. There is need to implement change
in methods and systems aiming at improving quality. Utilization of informatics The new trend in
nursing includes the use of information technology in healthcare. The purpose of computers is to
store patient information and aid in formulation of patient diagnosis supports decision–making
processes Nurses are the backbone of patient care should be educated on EBP competencies to
catapult the implementation and adoption. The helpful habits to ensure success include redesigning
of the healthcare system through teamwork, training the future workforce instilling in them the skills
to improve the system of care, picking up elaborate schemes to include them in research and
adopting multiple perspectives in the reforms The steps to favorable evidence–based

Essay On Evidence Based Practice
Evidence–based practice is defined as the best and recent available scientific research that has been
clinically tested. Most healthcare providers use practice that is supported by evidence to provide
their patients with high–quality services to improve patients' outcome. Balanced Diet and Long–
term Weight Management The main purpose of the first paper "Changes in diet and lifestyle and
Long–term Weight Gain in women and men." is to evaluate the causes of diet has on long–term
weight gain among Americans. This cohort study contains 120, 877 U.S women and men who work
as health professionals. Furthermore, these participants are not obese and not suffering from any
chronic diseases. Their lifestyle and health practices are recorded. For example, the participants'
diet, physical activities, smoking habits, and alcohol use are noted. The researchers follow the
study's participants ... Show more content on Helpwriting.net ...
The participants are selected randomly; they are healthy overweight women form age 25 to 50 years
old. The women are divided into two groups. One group is provided with traditional food, which
means that the participants select their own food using the USDA Food Guide Pyramid. The other
group is putting on meal replacement, which means that these participants have to replace two or
three of their meals per day with study meal replacement drinks or bars. Moreover, all participants
of the study are excepted to follow an energy restricted diet of 5400KJ per day. Although
participants in both groups don't have much weight loss difference, the group eating fortified meal
replacements present more essential nutrient intake compare to the other group. This study main
goal is to encourage health care providers to help patients to increase weight losses and
incorporating fortified foods in their

Postoperative Pain And Anxiety Essay
Analyzing the Effect of Music on Postoperative Pain and Anxiety
The effect of music on postoperative pain and anxiety was studied on an orthopedic unit in a central
Florida hospital (Allred, Byers, & Sole, 2010). The authors clearly identified the problem many total
knee arthroplasty patients experience after surgery is moderate to severe postoperative pain and
increased anxiety. Throughout the introduction of the study, it was stressed the importance and need
for this research to be conducted. The authors discussed the effects of inadequately treated pain and
how health care professionals, including nursing, should make it a priority in a patient's treatment
plan (Allred et al., 2010). Several references were provided supporting the issue ... Show more
The researchers included both a hypothesis and research questions. They stated a hypothesis,
however it is a research hypothesis versus a null hypothesis. A research hypothesis explains there is
correlation between two or more variables. A null hypothesis is a classification of hypotheses that
states there is no connection between the independent and dependent variables. Statistical testing is
performed to determine whether the statement is acceptable or not. Whereas the research question is
an analysis statement detailing the variables and population of the specified research study (Adams,
2015). The hypothesis, the authors were hoping to prove, was whether the use of music would
reduce pain and anxiety in postoperative pain in a particular patient population during a defined time
frame (Allred et al., 2010). An example of a null hypothesis for this study would state music would
have no effect on postoperative pain in a particular patient population during a defined time frame.
There were four research questions the researchers attempted to answer. Three of the four
questioned the effect of music on the patient's pain, anxiety, and physiologic parameters. However
the fourth question pertained to the impact of music on the amount of opioids taken from the
beginning of the intervention until six hours later (Allred et al., 2010). The clinicians had not
mentioned this component of the study before

The Expert Infantryman Badge (EIB)
The Expert Infantryman Badge (EIB) is a noble and prestigious award, awarded to only the most
elite candidates . The history of the EIB was established to give infantry esprit de corps, meaning a
feeling of pride and self–worth, in an otherwise daunting field . The candidates are tested on a
variety of trials which determine the overall fitness and proficiencies in common infantry tasks and
drills. The award allows senior commands to have an understanding of how fit their troops are for
battle, and how proficient training is being conducted . The first testing was conducted in 1944 with
100 Non–Commissioned Officers with only 10 remaining after the testing was completed. The
standards to earn the EIB have changed since 1944 but nevertheless an Infantryman must still be a
master of ... Show more content on Helpwriting.net ...
The Expert Infantryman Badge was established to give an Infantryman a feeling of pride and self–
worth through daunting and grueling tasks, the history of the EIB dates back to World War II
starting with standards that were considered fit, the eligibility of the EIB is very clear with Infantry
in mind. It is an exclusive badge dedicated to the hard work of Infantry, the standards were designed
to be tasks an infantryman would do on a regular basis, along with weapons they will commonly use
in combat situations. The badge also offers great and valuable statistics for command to review and
assess the effectiveness and combat readiness of Infantrymen. With outstanding qualifications from
a unit it may be awarded a streamer to increase Unit pride. The history of the Expert infantryman
badge (EIB) was established in 1944 during World War II, the Award was initiated by Army Chief of
Staff ; George C. Marshall. In 1944 100 Non–commissioned officers (NCO) underwent the testing,
after 3 days of grueling trails only 10 NCOs remained. It was designed to distinguish "Infantrymen
who are trained and fit for battle" stated by Lieutenant General

Systemic Review
Appraisal of Systemic Review
Healthcare workers, especially nurses, have for ultimate goal to provide the best care possible for
patients. Caring for patients does not only include making sure that they are safe and well–taking
care of but it also requires for nurses to act as patients' advocate and ensure that the best methods are
used to provide care. Nurses contribute to ensuring that the patients are as comfortable as possible
and help prevent or reduce pain as much as they can (Dearholt.& Dang, 2012, p. 12P). People have
a different reaction to pain. For some patients being pain–free might be one their ultimate goal while
they are in the hospital and if a nurse can help achieve that goal that will significantly contribute in
making the ... Show more content on Helpwriting.net ...
This rating scale is used to determine whether or not research is worth putting into practice. During
the appraisal of research, there is a different level of evidence that is taking into consideration. There
is three quality rating with five different categories. The quality rating is graded from high, good,
and low or major flaw level of evidence. A high–quality research requires the study to be well
structured and organized with all the necessary elements and definite conclusion. Research is
considered good when the result is within normal limits and the conclusion although not conclusive
can lead to more research. Lastly, a low–quality rating did not provide much information and stayed
inconclusive (Dearholt.& Dang, 2012, p. 12P). There is five level of evidence in which research can
fall under. The level is from I to V. the level I includes all systematic review researches that are
experimental with a randomized controlled trial. These researches might be randomized with or
without meta–analysis.
Level II includes all the systematic review that are quasi–experimental studies. These researches
might be with or without

Current Diagnostic Criteria For Sarabeth 's Disorders
Current diagnostic criteria for SaraBeth's disorders is better explained by criterion A – D in
Obsessive–Compulsive Disorder (OCD) and criterion A – E in Anxiety Disorder due to another
medical condition. OCD criteria A requires that the individual have the presence of obsession and/or
compulsions. SaraBeth reports obsessions of recurrent and persistent thoughts about harm coming to
her parents and although she had attempted to ignore these thoughts she continues with performing
her compulsions. SaraBeth's compulsions are evident by reported repetitive behaviors of performing
ritual prayers, persistent checking on the iron and stove and although SaraBeth can admit that her
fear is unrealistic, she continues the compulsions in order to feel better or to relieve oneself. Criteria
B requires that the obsessions and/or compulsions be time–consuming (more than one hour) or
cause clinically significant distress or impairments in important areas of function. SaraBeth has
stated that can spend three to four hours during the day engaged in checking behaviors. Criteria C
entails that the obsessions–compulsive symptoms are not attributable to the physiological effects of
a substance or another medical condition. SaraBeth currently has no indication of a medical
condition or substance use prior to the first onset of her obsessive–compulsive symptoms. Criteria D
requires that the disturbance not better explained by the symptoms of another medical condition.
Currently there is no evidence

Compare and Contrast the Main Principles in Any Two of the...
Good psychological health is characteristic of a person's ability to complete some key functions and
activities, including: learning ability, ability of feel, expression and management of all kinds of
positive and negative emotions, the ability to form and maintain good human relations and the
ability of deal with and change management and uncertainty. (Mental health foundation) Good
psychological health not only is the lack of may diagnose mental health problems, although a good
mental health may help prevent the development of many of these issues. There are some mental
health problems: strong emotional experience, behavior/motivation to change, physical/physical
symptoms, unrealistic idea and thought prejudice and distress and damage ... Show more content on
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(Source from: 'The practice of behavior therapy' (Third Edition), Copyright 1982, Pergamon Books
Ltd.) As the figure shows, when anxiety evolking potential of A is reduced from 1 to 0, B
automatically is reduced from 2 to 1, and so forth. Aversion therapy is a form of therapy, the use of
behavior principle to eliminate unwanted behavior. In the treatment, unnecessary stimulation is
repeated collocation discomfort. Regulating process goal is to make the individual association
stimulus and unpleasant or uncomfortable feeling. (Kendra Cherry (2)) That means using the pairs
problem stimulus (e.g. alcohol) with aversive outcome (e.g. nausea), to deter engagement. In the
aversion therapy, the client may be asked to want to or participation behavior they enjoy and contact
some unpleasant things such as bad smell, a bad smell or even mild electric shock. Once the
unpleasant feeling become related behavior, hope is unnecessary actions or action will begin to
decrease in the frequency or completely stop. Mainly the aversion therapy can be used in bad habits,
addictions, alcoholism, smoking, gambling etc. The overall effectiveness of aversion therapy can
depend on many factors, including the use of methods, and whether the clients to continue after
practice the prevention and treatment of recurrence. In some cases, the client may return to previous
behavior patterns once their treatment

Examples Of Injustice: Systematic Desensitization
Injustice: Systematic Desensitization to Racism
The history of America has long been viewed by its's occupants as one of perseverance despite great
odds. We take pride in fighting for democracy and promoting freedom around the world. But, at
home these tenants of democracy, equal rights and freedom are all relative; to race, gender and class.
The Bill of rights offers some insight into who we should be as a nation; while reminding us of who
we have not yet become. America's "id" has always been moderated by an "ego" cocktail of social,
scientific and political activists. America is at its best when the differences between right and wrong
are clearly defined by scholars, artists and scientists who can't be ignored because of their expertise
and ability to present evidence that cannot be refuted.
The result of this collective standardization of right and wrong usually leads to change for the
greater American good. However, it seems that our collective "ego" cannot keep our "id" in check
where racism is the primary focus. The resulting effect is pervasive systematic discrimination and
individual desensitization to hate that causes a negative impact on people of color's psychological
and physiological well–being.
The psychiatric profession 's primary index for diagnosing psychiatric symptoms, the Diagnostic
and Statistical Manual of Mental Disorders (DSM), does not include racism, prejudice, or bigotry as
a category or diagnosis in its text or index. Therefore, there is

The Evidence Hierarchy: A Change In Practice
The evidence hierarchy is a ranking that distinguish the types of research evidence based on the
strength of the evidence itself (Polit & Beck, 2012). It is mostly applicable to the research questions
regarding the effects of clinical interventions. The evidence that are ranked based on the evidence
that uses appropriate research methods, rigorously reviewed with minimized biases and has great
clinical implications. The strongest evidence based on the evidence hierarchy is systematic reviews,
which draws conclusions from many randomized controlled trails (Polit & Beck, 2012). A
comprehensive database research was conducted through online library to research for evidence in
relation to the PICOT question. According to a level VII study, beta ... Show more content on
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Especially for those who have underwent percutaneous intervention unless otherwise
contraindicated due to other conditions to reduce all–cause mortality. The advanced practice nurses
play critical roles in ensuring best evidence practice are being utilized, and the guidelines are being
followed. The advanced practice nurses should also prescribe beta blocker therapy based on
individuality of each unique patients. The advanced practice nurses are the advocate for the patients'
overall health, not only prescribing medical therapies but also educate patients on those evidences to
incorporate health promotion model into the

The Effects Of Deep Breathing Exercises On The Prevention...
PICO question: How does the use of incentive spirometers compare to the use of deep breathing
exercises in the prevention of pulmonary complications in post–operative, hospitalized patients?
Background and Rationale: Currently, postoperative pulmonary complications "account for about
25% of deaths occurring within 6 days of surgery," (Yoder, M 2015). Post–operative pulmonary
complications (PPCs) are of major concern due to the increased length of hospital stays and high
rates of occurrence and death as a result. Those at greater risk of developing a pulmonary
complication include preexisting lung disease, medical comorbidities, poor nutritional status, overall
poor health, and in those who smoke. (Yoder, M, 2015.) The type of surgery the patient is having
also affects the risk. Complications include, but are not limited to, pneumonia, bronchospasm,
respiratory failure and prolonged mechanical ventilation. The development of such complications
negatively affects the expected outcomes for patients. "The basic mechanism of PPCs is a lack of
lung inflation that occurs because of a change in breathing to a shallow, monotonous breathing
pattern without periodic sighs, prolonged recumbent positioning and temporary diaphragmatic
dysfunction. Mucociliary clearance along with the decreased cough effectiveness, increases risks
associated with retained pulmonary secretions, " (Overend, T., Anderson, C., Lucy, S., Bhatia, C.,
Jonsson, B., & Timmermans, C., 2001). Currently,

Six Parts Applied To The Ministry (FRICTO)
What is FRICTO? According to Sihler, Crawford and Davis, (2004, p.13), FRICTO is known as
"Flexibility, Risk, Income, Control, Timing, and Other." I found this website and it made it much
easier for me to understand FRICTO. How does each of these six parts apply to the ministry or the
company where you are? I would like to reflect on the six parts that apply to the church ministry
where I am a part. When starting off talking about "flexibility" it would be accommodating growth
and adjusting so growth is not hampered. Subsequently, looking at things that can be changed and
should be changed if it helps the overall mission of our church program here at the Palace of Peace
SDA church programs. As it relates to "risk" for Palace of Peace SDA

Case Study: Jenny With Systematic Desensitization
Fred, You seemed to have thoroughly analyzed this patient's experiences and potential conditions,
and I am very impressed. I think your suggestion to treat Jenny with systematic desensitization may
prove to be very effective, and is one I have not read anyone else suggest thus far. I am wondering
what is it exactly you are planning to desensitize Jenny from? Are you going to desensitize her from
these possessions, such as the boxes and all of the items purchased on websites like Ebay and
Craigslist? Are you desensitizing her from the emotional dependence she has attached these items
with? I am reassured that you would also suggest cognitive therapy and changing her abnormal
behaviors because she would need to fully understand why these behaviors

Evidence-Based Medicine: A Case Study
Evidence–based medicine is designed to increase the quality medical care and increase the value of
medical by cutting costs through the reduction of misuse and/or overuse (Shi and Singh, 2013) EBM
guidelines are represented by "best practices and proven therapies" (Shi and Singh, 2013). The work
to improve these guidelines and protocols is ongoing as it seeks to improve the delivery of
healthcare, into the future. Shi and Singh (2013) lists 6 recommendations for improving practice
guidelines for the future (p. 352). The purpose of this jouornal entry is to offer an analysis of two of
the guidelines. The first recommendation I chose is the following: "Guidelines and protocols must
be revised and kept current to incorporate subsequent scientific ... Show more content on
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However, the overall economic burden falls upon the hospitals, where surgical robotics such as a da
Vinci System, can sot upwards of $1.5 million to be installed in a facility (Medical Innovation,
2013). The hospital then has to evaluate if the robotic surgery results in fewer complications vs. any
long–term risks for using he equipment, and measure any return investment of using the equipment
(Medical Innovation, 2013). One study showed that a facility would spend an average of $12,
943,60 on a more invasive surgical procedure, whereas the robotics procedure cost the facility
significantly lower at $8,212 (Medical Innovation, 2013). Overall, this guideline is important, but an
equally important argument is being sure that a push for efficacy in health care should not slow
down or curtail innovation (Medical Innovation,

Ebp Project On Bedside Handoff
Indeed, "new and validated knowledge that forms the basis j Y for evidence–based practice (EBP)
most commonly is discovered in academic settings. But findings need to be translated into a
protocol or guideline that can be used to guide practice," according to Conner, (2014, p.40).
Evidence–based projects have lead to many improved clinical practice changes at the bedside and
healthcare in general; and they are highly promoted and supported by different healthcare
organizations. At my healthcare organization, especially in women and infant services department, it
is a common theme that topics on EBP research and projects come up. There have been practice
changes that are brought on by EBPs in how nurses practice. Staff members are encouraged ... Show
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They are tasked to encourage and facilitate EBP projects. This is one way of actively supporting,
promoting and continuing to improve patient outcomes with the use of evidence–based practices.
Challenges arise when there are no consistent leadership in this SL group that may be due to
personal reasons, schedule challenges and the different challenges that may come during the steps in
conducting the EBP project itself. In my personal experience on the EBP project on bedside handoff,
the advantages and benefits of changing from nurse–to–nurse handoff at the nurses' station to
bedside handoff were emphasized to all stakeholders, including the increase in patient satisfaction
when patients are involved in their care. However, we faced a high push–back form staff when it
came to the implementation phase. There were concerns that handoff would be longer than usual,
and that breech of patient confidentiality and privacy would ensue if bedside handoff was done.
Despite all that, the bedside handoff EBP was successfully implemented mostly due to the timing
and adequacy of staff education that included role playing, as well as strong support of the
leadership team. According to Adams, Farrington and Cullen (2012), "The final and perhaps most
intimidating step in the evidence–based practice (EBP) process is dissemination." But with proper
preparation, this can be

Wolpe Perform Systematic Desensitization To Eradicate...
A behavioural psychologist by the name of Joseph Wolpe helped clients in getting rid of their
phobias in a process that would be much quicker than the process of psychodynamic which is the
explanation that humans functioning is based on interactions of drives and forces which occur
within the body such as unconsciousness and the various structures of personality. The basis of
psychodynamic was introduced by an Austrian neurologist, Sigmund Freud. The reason Wolpe
conducted this study was to find the most effective way in to perform systematic desensitization to
eradicate people's phobia. The hypothesis which Wolpe used was that to remove people's phobia a
fear should be combined with something that is also relaxing to the body and that eventually

Evidence-Based Practice In Nursing
Evidence–Based Practice in Nursing Anthony Summerford Mississippi University for Women
Scholarly Activity Ms. Hurd 09/10/2014 Evidence–Based Practice in Nursing Evidence–based
practice is relied on by professional nurses in order for them to make informed decisions as well as
apply critical thinking skills directly to the patient care they provide. The research process allows
the nurse to ask and answer questions systematically to ensure the decisions they make are based on
sound science. Research provides the evidence needed for nurses to practice based off scientific
evidence rather than by tradition (Houser, 2013). Nursing research is fundamental to the practice and
is the central principle that defines the nursing profession. ... Show more content on Helpwriting.net
...
It allows the nurse to be better educated with the care that he or she is providing in order to improve
the outcome of the patients health. Evidence–based practice is also important in order for the nurse
to prevent errors in the patients care. This allows more productive time to be geared toward the care
of the patient instead of using past techniques that may prove counterproductive (Houser, 2013).
Using evidence–based practice in daily patient care may seem like a time–consuming process, but in
reality it is not. It should come as a natural process once incorporated into your daily routine. The
process (as cited in Houser, 2013) involves six elements: (1) Ask a relevant clinical question, (2)
search for the best evidence in the literature, (3) critically appraise the evidence, (4) integrate the
evidence with clinical experience and client preferences, (5) evaluate the outcome of the practice
change, and (6) disseminate the

Systematic Desensitization And Systematic Desensitisation
The third technique that I would like to present here is systematic desensitization and how it is
useful in behaviour modification. Systematic desensitization falls under the broad category of
exposure techniques in behaviour psychotherapy or therapy. Exposure technique involves the person
who is a client to come into repeated and prolonged contact with those situations that triggers
anxiety and that the person repeatedly avoids. The specific therapeutic procedure in which the
principle of exposure is present are diverse. For example, exposure can be done in the imagination
or live (that is, confrontation with life situations that trigger states of anxiety). On the other hand
exposure of avoided situations can be done gradually. ("Clinical Practice Guidelines in SNS", n.d.)
... Show more content on Helpwriting.net ...
In this technique, exposure to situations associated with stress and anxiety is done in the
imagination. Exposure in systematic desensitization takes place gradually that is, exposure to least
anxiety producing situation to the more intense anxiety producing responses. This exposure is done
at the same time as inducing a response that is incompatible with the anxiety that is, state of
relaxation. ("Clinical Practice Guidelines in SNS", n.d.) It is understood that systematic
desensitisation falls under the broad technique of exposure technique. It is also important to
understand that this technique follows the reverse side principles of classical conditioning. More
specifically, this technique follows the principles of counter conditioning. Wolpe (1964) successfully
used the method to treat an 18 year old male with a severe handwashing compulsion. The disorder
involved a fear of contaminating others with urine. (as cited in McLeod,

Clinical Epidemiology: Evidence-Based Research
Epidemiology is the foundation of evidence–based medicine. It involves study of distribution and
causes of health events in a given community and application of the study to address the health
issues (Szklo & Nieto, 2014). Clinical epidemiology is a term used to define a methodology for
clinical research. As a tool for research, clinical epidemiology guides the clinicians to seek answers
through evidence based research (Woodward, 2013). Clinical epidemiology acts as the basis for
clinicians as they take care of patients. Before making decisions on treatment for the patients,
clinicians should use facts gained from population–based studies. Clinical epidemiology makes it
possible to use past experiences as a guide to care decisions for the patients (Fletcher, Fletcher &
Fletcher, 2012). ... Show more content on Helpwriting.net ...
Nominal data does not have an inherent order. Dichotomous data is a type of nominal data which
have one or two levels only. Ordinal data is made up of variables categories with undefined intervals
based on an inherent order. Interval data can be continuous or discrete and is made up of an inherent
order with equal intervals. For continuous data, any value in a continuum is used irrespective of the
manner of reporting. Discrete data uses specific values which are expressed as counts (Fletcher et
al., 2012). Measurement performance in clinical epidemiology is described based on accuracy,
reliability, range, responsiveness, and interpretability. The effectiveness of data from a study is
based on performance of measurement. Thus, the data from clinical epidemiology must be accurate
and reliable to achieve its goal. Validity implies that data measured has to correspond to the true
value being measured. On the other hand, reliability ensures that the data recorded can be
reproduced (Fletcher et al., 2012). Effective performance of measurements should not contain data

The Process Of Carrying Out A Search Strategy
In the process of carrying out a search strategy, a number of measures usually taken into
consideration. First and foremost, identification of the question is crucial as it enables one to
translate natural language terms to subject descriptors and MeSH terms. In the process of
conducting the search, it is important to begin the search with the letters P and I, bearing in mind
that the search results should be initially kept abroad. In the database search, there should be
inclusion of cross infection (and other searches related to hospital acquired infection and the use of
antibiotics). The search strategy should also include sites such as CINAHL and Medline/PubMed as
initial article databases used in scoping search for various health ... Show more content on
Helpwriting.net ...
Depending on the research question, the aim of the study can be achieved through adoption of
different population sample, new conceptual frameworks, various techniques, or trying to link
different studies where the outcomes did not provide solutions to the problem. The goal of the
literature review is to determine the kind of search that has been carried out in line with the present
research. In recognition of this approach, the study of various articles to provide evidence of the
health challenge. There are four categories of literature reviews employed in the study. They
include: those that analyze health systems written for the perspective of comprehensive resources;
synopses which mainly allow for the extraction of high–quality information mainly in the form of
abstracts; syntheses which involve systematic reviews and; studies on the actual research question.
Some of the two research evidence sources that were considered for the study include: Bettany–
Saltikov, J. (2012) How to do a systematic literature review in nursing: a step–by–step Guide.
Maidenhead: McGraw–Hill/Open University Press. This article was used in understanding some of
the various categories of literature reviews that can be used expound on the present research
question. The other article is: Rice, H. E., Englum, B. R., Gulack, B. C., Adibe, O. O., Tracy, E. T.,
Kreissman, S. G., & Routh, J. C. (2015). Use

An Insight Into Either Ultrasound ( Us ) Or Magnetic...
Introduction
The aim of this literature review is to gain an insight into either Ultrasound (US) or Magnetic
resonance imaging (MRI) is the more suitable imaging modality into diagnosing and assessing a tear
within the knee Menisci. Both within trauma and non–trauma adult patients.
This section of the review will explain the topic and reasoning into why it was done. The process of
its relevance into radiography in practise will also be outlined. This will provide background into
positive aspects it could bring.
The project targets and hypothesis will be demonstrated within this section.
Background into the Menisus of the knee
Within anatomy the Meniscus is a piece of cartilage located within the joints of the wrist,
acromioclavicular, ... Show more content on Helpwriting.net ...
Blood supply and age factors
"At the time of birth, nearly the whole meniscus is vascularised" (Institute of anatomy 1995, Vol. 66,
No. 4, Pages 308–312).
The menisci of the knee gains its blood supply from blood vessels entering from the joint capsule
accompanied by loose connective tissue.
Within the second year of life this is reduced to a avascular region located within the inner fringe of
the joint capsule. At the age of twelve the blood vessels are reduced again, being confined to the
lateral third. (Institute of anatomy 1995, Vol. 66, No. 4, Pages 308–312).
Finally after the age of fifty, only the lateral quarter of the meniscal base is vascularized (Institute of
anatomy 1995, Vol. 66, No. 4, Pages 308–312). This creates problems in older patients with
meniscus tear injuries, making it vital for having the best imaging modality in place to gain an early
diagnosis which would lead to a faster treatment.
Diagnostic Imaging role
The severity of a tear with the knee Menisci can easily be identified through the use of diagnostic
imaging.
Modalities used are commonly; conventional radiography, ultrasound (US), magnetic resonance
imaging (MRI), computed tomography (CT) and arthroscopy.
Ultrasound and MRI are the most appropriate imaging modalities for meniscus tears, this is due to
their high sensitivity or image quality and statistics.
Ultrasound
Ultrasound uses an oscillating sound pressure

Evidence Based Practice
Evidence based practice is an essential component of nursing practice. It offers nursing the ability to
transition research to the clinical environment. Evidence based practice is rooted in nursing theory
and is able to innovatively transform phenomena by examining person, health, environment and
nursing practice. Keywords: evidence based practice, communication Introduction An evidence
based initiated communication handoff tool can impact health in a positive manner. A
communication tool can decrease the risk for medication errors through effective collaboration. In a
pediatric emergency environment a communication tool incorporates families and children in the
plan to provide patient centered care. Organization Culture and Readiness The ... Show more
The purpose of this proposed project is to examine how to implement a communication handoff
tool. One objectives is to increase education to nursing staff and families by at least 50% for safer
patient outcomes during an emergency visit. A second objective is to use the communication tool to
aid in decreasing of adverse events such as medication errors by at least 30% in the first three
months of implementation. A third objective is to utilize the communication tool to improve nursing
care handoff efficiency and accuracy by at least 45% in the first six months of implementation. The
anticipated outcome from proposed project is to adequately generate nursing research which can
measure the effectiveness of a safe communication handoff. Through qualitative research, decreased
medication errors can be measured using incident reports and the communication tool in the
patient's chart to track the information. The rationale for the importance to nursing is because
current "research findings show that nursing handover is a point of vulnerability and on average, in
nearly one–fifth of any handover, some sort of deviation from 'accurate dosage' of medication
occurred" (Drach–Zahavy, 2015, pg.

Advantages Of Star Model Of Evidence Based Practice
Introduction:
A model is a representation of concepts which are used to help people know, understand or simulate
a subject matter. Moreover, a model is used to create the various hypothesis which can be tested in
the laboratory or utilized for explaining a case study. The goal of this assignment is to explore three
models of evidence–based practice (EBP) that interest the authors and give a summary. Although
several models used in research, this paper will highlight three specific models and provide a
summary, strengths, weaknesses and a model that can be implemented in a particular practice.
ACE Star Model of Evidence–Based Practice:
The ACE Start Model of evidence–based practice developed at the University of Texas Health
Science ... Show more content on Helpwriting.net ...
The John Hopkins Nursing Evidence–Based Practice Model is a powerful problem–solving
approach to clinical decision making and is used in research. The model is designed to meet the
needs of the practicing bedside nurses and used a three step process called a PET, facilitating nurses
in translating evidence to clinical, administrative and education based on evidence. According to
Melnyk and Overholt (2015), there are three steps to the JHNEBP model. The first phrase is practice
questions: Identification of an EBP question and defines its scope. The second phrase is evidence of
internal and external evidence team determine if its feasibility to implement. The final phase is a
translation which includes recommended practice for changes and dissemination of findings.
ARCC Model of Evidence–Based Practice:
Compared and Contrast the three Models Strengths and Weaknesses:
Models are the conceptual framework that helps people to understand specific concepts. In
examining the three types of models, each presents a unique concept of understanding evidence–
based practice. The John Hopkins model integrates cultural values into evidence–based practice.
Furthermore, the main strength of this model is it provides a simple framework for nurses at the
bedside and incorporates internal and external factors that may affect research. On the other hand,

Information Based Medicine ( Ebm )
A Health intervention is an effort that promotes behaviour that optimizes mental and physical health,
or discourages or re frames behaviours considered to be potentially health–threatening. So, Evidence
based medicine(EBM) is not the only but the best approach to health interventions as it emphasizes
the use of evidence from well designed and conducted research in healthcare decision–making.
EBM is regarded as the gold standard of clinical practice. The term "evidence–based medicine", as it
is currently used, has two main tributaries. Chronologically, the first is the insistence on explicit
evaluation of evidence of effectiveness when issuing clinical practice guidelines and other
population–level policies. The second is the introduction of epidemiological methods into medical
education and individual patient–level decision–making.
Evidence–based medicine (EBM) is the process of systematically reviewing, appraising and using
clinical research findings to aid the delivery of optimum clinical care to patients.
EBM is the practice of solving the clinical problems in one 's practice by judicious and systematic
use of the medical literature. This includes framing questions rightly and searching the right kind of
literature. Thereafter, the available evidence needs to be evaluated for the validity, strength and
effect size. Finally, the results are examined for applicability to the current problem which requires a
detailed knowledge of the clinical setting, patient

Social Adety And Social Anxiety Disorder
Social anxiety disorder is a when an individual suffers from fear of being in social situations. This
interferes with their everyday life because they avoid functions like being in social situations,
hanging out in large groups, and going out. People with the disorder also fear being embarrassed and
judged by others. The thought of being in social situation will also cause distress and anxiety. Social
anxiety is a response that is caused by past events or can also be acquired vicariously. Behaviorists
will attempt to treat social anxiety with exposure therapy,
Social anxiety disorder is acquired through classical conditioning of past events. Someone is most
likely to develop social anxiety of the event occurred childhood and adolescence. This is because
children do not have as much exposure to large group setting as an adult would. They have not
experienced making mistakes or being embarrassed. Classical conditioning is when we pair an
unconditioned stimulus that has an unconditioned response to conditioned stimulus that will also
lead to the same unconditioned response. Social anxiety starts with an unconditioned stimulus which
is neutral event that requires no learning and provokes an innate response. The innate response is the
unconditioned response; this is usually a reflex from the autonomic system. The autonomic system
controls heartbeat, digestion, urine, sweat, and salivation. Conditioned stimulus starts off by being
neutral and leads to a conditioned response after

Evidence-Based Practice
Evidence–Based Practice Article Summary The peer reviewed journal article, A Decision Tree
Model for Postoperative pain Management, is an article describing postoperative pain management
regimens using evidence–based practice. This article's author has created a guide for prescribers
who are managing postoperative pain levels for patients. This article is using evidence–based
practice to help future patients have adequate pain relief, but not have the serious ramifications that
can occur from the wrong dose or wrong medication for said patient. According to the CDC, in the
United States there have been 51.4 million inpatient procedures performed. This shows how relevant
surgery is, it is very common for a person in the U.S. to have a procedure ... Show more content on
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A 67 year old patient is having a total hip replacement surgery performed. The patient has no past
surgical history. The patient has chronic back pain and has been on oxycodone 15mg every six hours
for the past five years. Other than chronic back pain, the patient has no other significant medical
history. Using Ward's postoperative pain management model, this patient is over 65 years old and is
advised to start with lower doses of pain medications. The patient should avoid chronic NSAIDs,
but can be started on a gastrointestinal protector such as a proton pump inhibitor. The patient does
not have a history of renal failure, but is opioid tolerant. This shows that the patient should remain at
their current dose of opioids and expect to give more than a patient who is opioid naïve. Therefore,
using this model as a provider, the author would be cautious of the patient's age, but since the patient
is tolerant to opioids the author would expect to give more than they would to a normal patient that
is 67 years

Disadvantages Of Psychotherapy
The basic methods of psychotherapy treatment divide into behavioral and cognitive therapy. The
first teaches the client how to behave and react in situations that trigger his fear. It works effectively
when treating of social phobias and agoraphobias. The most popular kinds are systematic
desensitization, flooding and modeling. Systematic desensitization is founded on classical
conditioning, aims to learn how to overcome the fear in different situations. It is called also counter
conditioning because therapists use an incompatible response (relaxation) with a conditioned
stimulus (something causes fear. The process has three stages: first, the patient forms a hierarchy
containing the cause of fear and ranks them from least horrifying to most horrifying. Then, the
patient trains how to use relaxation technique to control breathing or meditation. Finally, the patient
copes with the fear hierarchy while using these techniques. S/he starts with the least fearing thing
and practices relaxation. When they are no longer afraid, they go to the next step in the hierarchy. ...
Show more content on Helpwriting.net ...
This behavior is reinforced by negative reinforcement based on operant conditioning. Systematic
desensitization tries to overcome this avoidance concept by gradually exposure to this subject until
the patient can handle with it. This form of the treatment called a graduated exposure therapy. For
example, if a man feels fear during communicating with a women. First, he must form a hierarchy
(sitting beside her, talking with her, walking, and finally dating her). The therapist teaches him how
to relax when he is put in an imaginary situation (in vitro), if he succeeds, he would move to the
next step which is a real situation (in

Systematic Desensitization: A Case Study
"Systematic desensitization is a procedure in which the patient is exposed to the phobic object
gradually, so that fear and discomfort are kept to a minimum and extinction is allowed to occur"
(Mazur, 2013, p.69). When applying this to a person with an anxiety disorder the individual would
need to compose a list of things that are upsetting and cause the anxiety listing them from least
upsetting to most upsetting. The next part of the process would be teaching the person relaxation
techniques such as deep breathing and muscle relaxation in order to empower them use these when
they feel they are getting anxious. Now that the initial procedure are in place the process would
begin by introducing the least upsetting and then telling them to relax, then they would repeat this
process ... Show more content on Helpwriting.net ...
For example, a person with an anxiety/phobia might have the fear of being in tight places also
known as claustrophobia. This person might begin their list with feeling uncomfortable when in
small rooms especially with other people. Another item on the list might be fear of small cars or
elevators due to the confined feeling while also being unable to immediately change locations due to
the elevator and cars movement. Higher up on the list might be how the person feels anxious when
in line with people all around especially with multiple lines giving them the feeling that it is closing
in on them. Listed as the most upsetting and worst possible scenario is being buried alive. Once the
list has been made and the relaxation techniques have been learned the treatment is ready to start.
Starting with the first

Evidence Based Practice Essay examples
A critical appraisal of a published piece of research related to practice.
Evidence Based Practice – HEN62029–5
Student number 10039687
Word count 3150
The following ssion of this assignment attempts to critically appraise the venUS III randomised
control trial (RTC) published in the British Medical Journal.
As a student/healthcare worker who is new to critical appraisal I am aware that I do not fully
understand some of the calculations involved in reporting of findings, however Greenhalgh (2006)
argued, 'all you really need to know is what the best test is to apply in given circumstances, what it
does and what might affect its validity/appropriateness'. When caring for patients it is essential that
Healthcare Professionals ... Show more content on Helpwriting.net ...
The nurses providing treatment where not blind to which treatment had been allocated, this may
impact on construct validity as in some cases it is suggested that control subjects are compensated in
some way by healthcare staff or family for not receiving research intervention (Barker 2010). Nurses
who were blinded were employed to trace the ulcers. Participating patients were not blind to the
treatment/s. As one of the measured outcomes was patients perceptions of health, assessed by a
questionnaire (SF–12) it is reasonable to conceive that this assessment may have been influenced by
the patients awareness of the treatment type they were receiving thus creating the possibility for
assessment bias. Construct validity may also be impacted on peoples behaviours as a response to
being observed or to the treatment because they believe it will have a positive effect. (Barker 2010)
Healing date was assessed remotely by independent assessors who where blind to the treatment
allocation this guards against assessment bias.
Overall both treatment groups were equal in size. Both treatment groups had an almost equal
average age of study participants, this is important because inequality in age between the groups
would represent a heterogeneous population (Barker 2010). Venous leg ulceration is more common
in woman than men in those below 85 year of age (Moffat 2004)

Case Study Of Target Behavior In Marla's Case
Target behavior in Marla's case
The target behavior is Marla's case is an extreme fear of social situations which hinders her from
engaging in social situations.
Describe how respondent conditioning and operant conditioning are involved in the development of
an anxiety problem or fear.
According to Anxiety Disorders: Operational Conditioning Skinner made the discovery of operant
conditioning which paved way for the assessment of what influenced behavior through analyzing
the classical conditioning and what acts followed as a result. Skinner assumed that human behavior
could be explained via benefits and punishment (Mathew et al, n.d). A manipulation of the two
elements thus resulted in learning or unlearning a behavior. A behavioral change can be associated
with the experience that follows a response. The behavior is involuntary that was a ... Show more
The aim is to eliminate the phobia through incorporating a relaxation technique, while In Vivo
Desensitization is classified as an aspect of systematic desensitization whereby the situations
causing anxiety to an individual are real rather than imagined. An advantage of systemic
desensitization is that is it often successful to a greater extent. However, its disadvantage is that, an
individual can be cured with psychoanalysis, and drugs can be used as a substitution and are often
quicker. More so it is a lengthy process and its options are limited to phobia treatment. Advantages
of in–vivo desensitization is that it is quite effective as it involves exposing the individual to the
actual stimulus which the particular person fears the disadvantages is that in its inception it might
result to even more psychological damage in the event that the phobia is heightened. The
desensitization may also take a long time to completely take effect while there are more viable
options (McLeod,

Evidence-Based Practice (EBP)
What is EBP means to you? There are many different definitions of Evidence–Based Practice (EBP).
According to EBP book, most EBP definitions contain three components "research–based
information, clinical expertise, and patient preferences" (In Schmidt & In Brown, 2019, p. 4). These
three words explain what is EBP in a simple way for me to understand. It means EBP research
includes collecting information, reviewing, evaluating, and implementing evidence into the practice
to improve patient outcomes. EBP is unique concept because it doesn't only take consideration of
the evidence, but it does give preference to individual patient's values and needs to advocate for
improved patient experiences. EBP is a holistic approach to improve patient care outcomes and
nursing practices. By utilizing EBP into my practice is not an extra task but it helps to cover the
difference in patient care to improve patient ... Show more content on Helpwriting.net ...
Information Databases The databases I used to develop my PICOT are CINHAL and OVID. The
key terms used during the search are catheter–associated urinary tract infections, nurse–driven
protocol, indwelling urinary catheters, quality improvement, and performance improvement. The P
in the PICOT P in the PICOT is patients with Foley catheter inserted at admission causing patients
catheter–associated urinary tract infections (CAUTI). The aim is to build a nurse–driven protocol to
remove Foley catheters early on will help reduce additional days of having the use of an
unnecessary indwelling urinary catheter. For every extra day, a Foley catheter increases the risk to
develop hospital–acquired catheter–associated infections in our patients ("AACN Competencies and
Curricular Expectations for CNL Education & Practice,"

Evidence Based Practice
In this essay, I am going to consider how evidence–based practice can be used to support, justify,
legitimate and/or improve clinical practice. I am also going to explore and discuss primary and
secondary research evidences about how nursing interventions can potentially improve the quality of
life of patients in the community suffering from heart failure. I will gather these evidences using a
literature search which I will include an account of. Using a critiquing framework for support, I will
appraise both primary and secondary evidences that I have chosen. I will also look at potential non–
evidential factors that can influence evidence utilisation in practice. Finally, a conclusion will be
drawn. Evidence–based Practice (EBP) is ... Show more content on Helpwriting.net ...
I did not choose PsychInfo or Social Care Online and several specialist databases as I did not want
to get any articles that focus on other perspective other than nursing. I asked the search engine to
look for heart failure in the title section of articles and also lifestyle as secondary to it. I also used
quotation marks to specifically search for heart failure rather than search each word individually. To
further refine my search, I went onto the chronic heart failure filter. Using these search criteria, I
was able to pick the primary evidence that fits best to my aims. I used the Cochraine Library to
search for my secondary evidence as it is best to look for systematic reviews which is a form of
secondary evidences. I used the advance search feature of the database. I performed the search using
heart failure with quotation marks in the title section of articles. I also used quality of life and
exercise in the abstract of possible articles as keywords. As well as this, I used the search engine's
function to only show results restricted to systematic reviews. Using these search criteria, I
successfully chosen my secondary evidence. The primary evidence that I have chosen is a study
conducted by Brodie et al (2008) about how a physical activity 'lifestyle' intervention based on
motivational interviewing, compared to standard care, can improve quality of life for people with
chronic heart failure. The authors of this article included an account of its

Systematic Desensitization

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