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Using reflective writing to transform learning in an international immersion experience
In a 3-week health promotion in Ghana course faculty and students engaged in primary health care in community settings. This presentation describes the findings of a phenomenological analysis of studentsâ' final ...
Screening for second hand smoke exposure in primary care
Participants within this session will learn the importance of screening and educating on secondhand smoke exposure for all patients within healthcare settings. In addition, the proposal of future implications for clinicians, ...
Evidence-based strategies for successful catheter-associated urinary tract infection reduction hospital-wide: Nurse-driven protocol
Catheter-Associated Urinary Tract Infections (CAUTIs) frequently occur in hospitals and are associated with increased length of stay, high costs of care, patient discomfort, and at times, mortality. Implementing evidence-based ...
Evidence-based strategies to promote health promotion/wellness competency and self-efficacy for patients, clinicians, and students
Participants will explore evidence-based strategies to promote healthy lifestyle behaviors for their patients, students, and themselves. Conceptual models of evidence-based teaching and health promotion will be presented. ...
Applying Tai Chi for older adults with high risk for dementia
This study aimed to explore the feasibility of Tai Chi, developed for older adults with high risk for dementia. Tai Chi has been safely applied for 12 weeks without adverse effects and revealed the potential benefits to ...
Advancing students' educational experiences with interdisciplinary service-based learning: Impacting special needs community
Provide education to nurse educators on interdisciplinary service-based learning to meet the needs of both the community and the students. This abstract will showcase an event conducted in Phoenix, Arizona that provided ...
Promoting healthy lifestyle in children: Nursing staff and teachers in partnership at school
It assess a training session with teachers of children's education to use a serial album for children aged from 7 to 10 years addressing the topic of prevention and control of body weight.
Using physical activity trackers in the African American church to increase physical activity
Physical inactivity is a primary contributing cause of chronic disease. Chronic disease affects African Americans at a disproportionately higher rate than their Caucasian counterparts. Faith-based organizations such as ...
Collaboration for Women Wellness in Rural Communities
Breast cancer impacts many women throughout the world. As nurses, health promotion and disease prevention are emphasized to all populations. In an effort to understand rural populations and their belief system, an ...
Harm reduction in nursing practice: Compassionate care for persons with addiction
(2017-06-22)
Substance abuse and overdose deaths are increasing at profound rates in the United States. Nurses and clinicians must evaluate their response to this growing epidemic. Harm Reduction is an alternative therapy for rehabilitation and was traditionally used in tobacco cessation, and to control the spread of HIV and HCV. The concept of harm reduction can be described as accepting the possibility that individuals will abuse harmful substances, and the goal of treatment is to reduce the harm associated with the addictive behavior; ultimately, this treatment nurtures a non-judgmental environment that facilitates a therapeutic nurse-patient relationship. Much of the literature regarding harm reduction in nursing is isolated to Canada and parts of Europe. However, the 6-fold increase in heroin overdose deaths in the United States from 2001-2013, has prompted lawmakers, parents, and clinicians to explore alternatives to standard rehabilitation practices (National Institute on Drug Abuse, 2015).
This integrative literature review sought to explore current uses of harm reduction, evaluate their efficacy, and examine harm reduction for inclusion into nursing practice in the United States. The following nursing databases were utilized for provision of literature: CINAHL complete and PubMed. Databases were searched using the following terms and Boolean phrases: “harm reduction & nurs*,” and “harm reduction & addiction,”. Articles were chosen if the language was in English, published within the last 10 years (2006-2016), published in an academic peer-reviewed journal, and were primary sources. Of the 99 articles retrieved, 10 will be analyzed in the integrative literature review. The remaining 89 articles were excluded due to the following parameters: duplicate article, application of harm reduction to alternate health disparities (fall prevention, smoking cessation, or cardiovascular disease), no clear relationship to nursing practice, or a position piece.
Results of the literature review yielded 6 studies identifying current uses of harm reduction, and 4 studies focusing on clinician perspectives about providing harm reduction therapy. Selected literature was rated using the Melnyk Fineout-Overholt Hierarchy of Evidence (2011) (Appendix A). Analysis of the literature regarding clinician perspectives revealed common themes such as: harm reduction as a bridge to abstinence; harm reduction’s ability to address the patient as a holistic being; and harm reduction as honoring a patient’s autonomy. A research matrix was created to holistically analyze and categorize the body of selected literature. Studies regarding current use of harm reduction found positive results in patients’ self-reported advocacy, self-esteem, and ability to navigate social services. Patients also experienced a decrease in problems associated with drug and alcohol use, as well as a decrease in money spent on drugs or alcohol. In addition to the evidence-based successes, the ethical components of harm reduction align with much of the nursing code of ethics. Patient autonomy, and trust in a patient’s ability to make health related decisions, is one of the key tenants of Pender’s Health Promotion Model; both perceived self-efficacy and perceived barriers to action greatly influence a patient’s commitment to action, and ultimately the adoption of a health promoting behavior (Alligood, 2013). While it is unlikely that stand-alone facilities modeled under harm reduction will be created in the United States, there are elements of harm reduction that can be readily integrated, and may be unknowingly permeating, current nursing practice.
Appendix A.
Melnyk Fineout-Overholt Heirarchy of Evidence Rating
Frequency
Cumulative Percentage
Level 1: Systematic review & meta-analysis of randomized control trials (RCT) or evidence-based clinical practice guidelines
1
10%
Level 4: Case control & cohort studies
3
40%
Level 6: Single descriptive or qualitative study
4
80%
Level 7: Expert opinion
2
100%
Totals
10
100%
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