Please write the following paragraph based on paper provided:
Next Steps: Implementation and Evaluation of Recommended Practice Change to Influence Patient and Population Health Outcomes
After identifying the recommended practice change based on the analysis of the literature, the next step is to develop a plan of action for implementation and evaluation. To ensure the successful adoption of the recommended practice change, it is important to use an evidence-based practice (EBP) model that is suitable for the clinical setting. The plan of action should consider effective organizational and systems leadership, available resources, organizational issues, barriers and facilitators, cost considerations, and monitoring. Additionally, socio-cultural factors and social determinants of health should be integrated into the plan to address potential disparities in access and outcomes.
During the implementation process, it is important to evaluate the effectiveness of the practice change in achieving patient and population health outcomes. This can be achieved through a combination of qualitative and quantitative methods, such as surveys, interviews, chart audits, and clinical data analysis. Evaluation should also include a synthesized appraisal of EBP safety and quality initiatives to ensure that patient safety is maintained and that the practice change does not compromise the quality of care.
Based on the results of the evaluation, adjustments can be made to the practice change to improve its effectiveness and sustainability. Additionally, the dissemination of the findings and outcomes of the practice change can be shared with other healthcare providers to promote best practices and improve patient care on a broader scale. Implementing and evaluating the recommended practice change is essential to ensure that patient and population health outcomes are improved and that healthcare practices are evidence-based and of high quality.
Running head: ANALYSIS OF A CLINICAL PROBLEM
Alternative Medicine and Opioid Narcotics in Pain Management: Which is More
Effective and Efficient
Jessica Mock, RN-BSN
College of Staten Island: CUNY
ANALYSIS OF A CLINICAL PROBLEM
2
Abstract
Up to 31% of the adult population in the United States is afflicted by chronic pain.
Despite the immense advancement in medical technology and therapies directed at pain
management, patients continue to deal with chronic symptoms that are never fully
addressed. Adults between the age of thirty years and above often seek other therapies
outside of conventional medical prescriptions to address chronic pain. Due to an increase
in demand for alternatives to medical therapy in pain management, holistic alternative
medicine is becoming a common healthcare practice. Groups in academic and
governmental settings are now incorporating holistic alternative medicine as a
recommendation for managing chronic pain among patients. As such, the body of
literature on the contribution of alternative medicine in pain management is also growing.
If alternative medicine shows positive and safe efficacy in pain management,
conventional options, such as opioid narcotics in the pharmacological management of
chronic pain symptoms, may be undermined. This paper will analyze the effectiveness of
holistic alternate medicine in managing chronic pain for patients aged between thirty and
seventy years, compared to the effectiveness of opioid narcotics in three months.
Introduction
Holistic alternative medicine is currently not part of the conventional medical
process system. However, the global demand and the market for alternative medicine
options are growing across all age groups, mainly among adults (Jahromi et al., 2021).
Moreover, the widened demand and need for alternative medicine has informed the
development of such effects as clinical trials and scientific research, which have informed
ANALYSIS OF A CLINICAL PROBLEM
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the re-classification of medicine to include specific treatments such as herbal medicine.
The use of alternative medicine has been adopted for numerous conditions, from
managing nausea to reducing somatic body fat. However, the condition for which holistic
alternative medicine has been sought most is pain (Santaguida et al., 2009; Bauer et al.,
2016). Compared to opioid narcotics, Holistic alternative medicine has been associated
with minimal side effects with long-lasting impacts on the user’s body. For instance,
while pharmacological therapies such as opioid narcotics could inform addiction,
wholesome alternatives such as acupuncture and massages do not. As such, there is a
great pool of scientific literature today, supporting more the use of alternative medicine
compared to opioid narcotics. The primary aim of this project is to answer the question:
In adult patients aged 30 to 70 years reporting chronic pain (P), what is the effect of
Holistic Alternative Medicine (I) on pain control (O) compared with use of opioid
narcotics (C) within a 3-month period (T)?
Chronic pain simply means any pain that has persisted for an extended period,
usually over three months, independently or due to another health condition (Bauer et al.,
2016). If pain is not managed, it can inform adverse psychological and physical outcomes
in any patient. If pain management is poorly done or gaps exist, the managing
professionals risk being engaged in long legal repercussions. As a result, pain
management must be employed in timely, cost-effective, and efficient ways to benefit the
patients and the health professional team. The primary clinical problem this research will
address is chronic pain, as it is one of the most dynamic health conditions that
professionals deal with in their daily practice.
ANALYSIS OF A CLINICAL PROBLEM
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In practice, I have encountered numerous patients suffering from chronic pain.
While chronic pain in some patients occurs after a surgical procedure or medical
condition, others develop independent pain points in their bodies without provocation.
One patient in my care Mr. T started suffering chronic pain after a motor vehicle accident
that affected his knee joints. Even with a total knee replacement and several injections to
the area, Mr. T still continues to experience pain. He has been placed on different opioid
narcotic painkillers to manage his symptoms. Yet, these efforts have proven ineffective,
as even the most potent painkillers do not give him sufficient pain relief. For such a
patient, it is essential to find alternative management options, to accord the patient total
and sustainable relief from the pain.
EBP Model
The Ace Star Model of Knowledge Transformation best fits this project. The
project’s primary objective is to translate the role of holistic alternative medicine from a
complementary treatment to an independent management approach for pain. This model
includes four steps: knowledge discovery, a summary of the evidence, translation into
practice recommendations, integration into practice, and evaluation. As with any
treatment options, alternative medicine in pain management is also associated with some
gaps and problems, including health concerns about consuming herbal remedies. As such,
discovering the concerns with this medical option and reviewing existing evidence on its
effectiveness in pain management is critical. With a background of knowledge and
evidential support, the use of holistic alternative medicine can be recommended for
patients experiencing chronic pain in the place of opioid narcotics. This is the translation
into practice recommendations. The integration into practice of this treatment option
ANALYSIS OF A CLINICAL PROBLEM
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would come in through the provision of alternative options for pain management, such as
chiropractic sessions and massages as prescriptions to manage pain, as opposed to
recommending opioid drugs. As with any intervention, any new mode of treatment must
be evaluated to determine effectiveness. Evaluating this treatment option would answer
the project’s PICOT question by establishing if the use of holistic alternative medicine is
better than opioid narcotics in managing chronic pain in adults aged between thirty and
seventy years.
Critical Appraisal of the Evidence
The evidence search included several databases, such as PubMed, CINAHL, and
Cochrane Library, using search terms such as “holistic alternative medicine,” “chronic
pain,” “opioid narcotics,” and “pain control.” The search resulted in a total of 42 articles,
and after screening for relevance, 15 articles were selected for inclusion in this paper. The
Synthesis Table Appendix outlines the evidence used in this paper, including study
design, sample size, intervention, comparison, and outcomes.
The evidence suggests that holistic alternative medicine can be effective in
managing chronic pain in adult patients aged between 30 and 70 years. Specifically,
acupuncture, massage therapy, and mindfulness meditation have been found to be
effective in reducing pain symptoms and improving quality of life for patients with
chronic pain. These interventions have been associated with minimal side effects and
reduced risk of addiction compared to opioid narcotics. However, there is still a need for
high-quality randomized controlled trials to establish the effectiveness of holistic
alternative medicine in pain management fully.
ANALYSIS OF A CLINICAL PROBLEM
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The limitations of the current knowledge-base related to the clinical problem
include the lack of standardized interventions and outcome measures, making it
challenging to compare and generalize findings across studies. The small sample sizes
and short follow-up periods of some studies limit the generalizability of their findings.
There is also a lack of research on the long-term effects of holistic alternative medicine in
pain management, making it challenging to determine the sustainability of its effects over
time. Despite these limitations, the evidence suggests that holistic alternative medicine
has a place in the management of chronic pain and can be used as a complementary or
alternative therapy to opioid narcotics.
Analysis of the Problem for Clinical Decision Making
Chronic pain is a complex and dynamic health condition that affects a significant
proportion of the adult population in the United States. Despite the advances in medical
technology and pain management therapies, many patients continue to experience pain
symptoms that are not fully addressed. Holistic alternative medicine is increasingly
becoming a common healthcare practice for managing chronic pain among patients aged
between 30 and 70 years. This paper aims to analyze the effectiveness of holistic
alternative medicine in managing chronic pain in comparison to the effectiveness of
opioid narcotics within a three-month period.
The evidence synthesis shows that compared to opioid narcotics, holistic
alternative medicine has been associated with minimal side effects with long-lasting
impacts on the user’s body. While pharmacological therapies such as opioid narcotics
could inform addiction, wholesome alternatives such as acupuncture and massages do
not. The body of literature on the contribution of alternative medicine in pain
ANALYSIS OF A CLINICAL PROBLEM
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management is growing. The critical appraisal of the evidence indicates that there is
enough evidence to support the use of holistic alternative medicine in the management of
chronic pain. However, there are gaps and problems, including health concerns about
consuming herbal remedies, which must be taken into consideration when integrating
holistic alternative medicine into clinical practice.
Next Steps: Implementation and Evaluation of Recommended Practice Change to
Influence Patient and Population Health Outcomes
After identifying the recommended practice change based on the analysis of the
literature, the next step is to develop a plan of action for implementation and evaluation.
To ensure the successful adoption of the recommended practice change, it is important to
use an evidence-based practice (EBP) model that is suitable for the clinical setting. The
plan of action should consider effective organizational and systems leadership, available
resources, organizational issues, barriers and facilitators, cost considerations, and
monitoring. Additionally, socio-cultural factors and social determinants of health should
be integrated into the plan to address potential disparities in access and outcomes.
During the implementation process, it is important to evaluate the effectiveness of
the practice change in achieving patient and population health outcomes. This can be
achieved through a combination of qualitative and quantitative methods, such as surveys,
interviews, chart audits, and clinical data analysis. Evaluation should also include a
synthesized appraisal of EBP safety and quality initiatives to ensure that patient safety is
maintained and that the practice change does not compromise the quality of care.
Based on the results of the evaluation, adjustments can be made to the practice
change to improve its effectiveness and sustainability. Additionally, the dissemination of
ANALYSIS OF A CLINICAL PROBLEM
8
the findings and outcomes of the practice change can be shared with other healthcare
providers to promote best practices and improve patient care on a broader scale.
Implementing and evaluating the recommended practice change is essential to ensure that
patient and population health outcomes are improved and that healthcare practices are
evidence-based and of high quality.
Summary
Based on the review of current research on wholesome alternative medicine, there
is efficient evidence that this approach may be more effective in managing pain for some
patients than traditional opioid interventions. As such, the PICOT question developed is
“in adult patients aged 30 to 70 years reporting chronic pain (P), is the use of Holistic
Alternative Medicine more efficient and effective (I) on pain control (O) compared with
the use of opioid narcotics (C) within three months (T)?
References
Bauer, B. A., Tilburt, J. C., Sood, A., Li, G. X., & Wang, S. H. (2016). Complementary
and alternative medicine therapies for chronic pain. Chinese Journal of
Integrative Medicine, 22, 403-411. https://doi.org/10.1007/s11655-016-2258-y
Finnerup, N. B. (2019). Nonnarcotic methods of pain management. New England Journal
of Medicine, 380(25), 2440-2448. https://doi.org/10.1056/NEJMra1807061
ANALYSIS OF A CLINICAL PROBLEM
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Jahromi, B., Pirvulescu, I., Candido, K. D., & Knezevic, N. N. (2021). Herbal medicine
for pain management: efficacy and drug interactions. Pharmaceutics, 13(2), 251.
https://doi.org/10.3390/pharmaceutics13020251
Santaguida, P. L., Gross, A., Busse, J., Gagnier, J., Walker, K., Bhandari, M., & Raina, P.
(2009). Complementary and alternative medicine in back pain utilization
report. Evidence Report/Technology Assessment, (177), 1-221.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781194/
ANALYSIS OF A CLINICAL PROBLEM
Appendix A (Synthesis Table)
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