Literature Search
Literature Search
- Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
- Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
- Identify and select 5 peer-reviewed articles from your research.
The Assignment: (4-5 pages)
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:
- Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
- Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
SAMPLE ANSWER
Literature Search
The health care sector across the world requires the establishment of targeted clinical systems to help improve patient outcomes. The development and application of evidence-based practices as best clinical systems approach can lead to delivery of health care. Best outcomes refer to the absence of the sign and symptoms of a disease, which can be achieved through quality improvement. This paper addresses the application of The Dietary Approaches to Stop Hypertension (DASH), its outcomes and efficiencies, and lessons learned from its application.
Summary One
Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015). Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: A randomized controlled trial–3. The American journal of clinical nutrition, 103(2), 341-347. https://www.ncbi.nlm.nih.gov/pubmed/26718414
The study by Chiu, et al. (2015) examines the effects of substitution of full-fat with low-fat dairy food products in the DASH diet with a corresponding increase in fat and a decrease in the intake of sugar on plasma lipids, lipoproteins and blood pressure. The Dash diet enhances low-density lipoprotein, lowering of high blood pressure and cholesterol that is high-density lipoprotein. The researchers used a sample size of three health persons to conduct a randomised crossover trial based on three periods. The individuals consumed a standard Dash diet, a control diet, a lower carbohydrate modification of DASH diet, and a high-fat diet for three weeks each which was separated by two weeks’ periods for washouts. The researchers then conducted laboratory measurements that included the concentration of lipoprotein particles determined by the mobility of ions, which was established at the end of each experimental diet.
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The study results showed that the HF-DASH and DASH diets profoundly reduced blood pressure compared to the control diet. There was a reduction in the concentration of medium and large very-low-density lipoprotein particles and triglycerides. The HF-DASH diet also increased the peak particle diameter of LDL and decreased the HDL cholesterol, LDL cholesterol, apolipoprotein A-I, large LDL particles Intermediate density lipoprotein and the width of LDL peak compared with the control diet.
Literature Search
The DAS diet significantly lowered blood pressure to the same extent as the HF- DASH diet and also reduced the concentration of VLDL and plasma triglyceride without increasing the cholesterol. The findings of the study can help improve nursing practice in managing hypertension. Nurses should create awareness among patients and the community at large about the DASH and HF-DASH diet to help reduce the mortality rates and the costs of treatments.
Summary Two
Akita, S., Sacks, F. M., Svetkey, L. P., Conlin, P. R., & Kimura, G. (2003). Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship. Hypertension, 42(1), 8-13. https://www.ncbi.nlm.nih.gov/pubmed/12756219
Akita et al. (2003) assess the effects of the DASH diet on the pressure-natriuresis relationship to identify its mechanisms of lowering blood pressure. The Dietary Approaches to Stop Hypertension can act as primary mechanism for lowering blood pressure through consumption of a diet with vegetables, fruits, and low-fat dairy foods. The article uses a controlled trial method where DASH sodium trial and randomised feeding trial were used. The participants were not healthy individuals as they had systolic blood pressure (SBP) ranging between 120 and 159 and Diastolic blood pressure ranging between 80 and 95 without blood pressure-lowering medication. Statistical analysis was conducted by comparing the x-intercept and the steepness of the curve of the pressure-natriuresis between DASH diets and the control diet as well as the subgroups and testing them by the use of Student t-test for the non-paired samples.
Literature Search
The results of the study showed that the DASH diet effectively lowered blood pressure groups though a diuretic action with high sensitivity of sodium. This means that the article provides proof on whether the DASH diet lowers blood pressure within the first five months if intervention by testing its effects on pressure-natriuresis. Nurses should consider Dietary Approaches to Stop Hypertension as one of the primary nonpharmacological approaches to stop high blood pressure.
From the study, it is critical to note that the DASH diet should be used as a primary nonpharmacological treatment of blood pressure. DASH diet is a significant intervention in lowering the levels of high blood pressure among urban African Americans. It also helps nurses understand the mechanism of the DASH diet in lowering BP, which makes it possible for them to speculate on patients and those situations it can be beneficial.
Summary Three
Kim, H., & Andrade, F. C. (2016). The diagnostic status of hypertension on adherence to the
Dietary Approaches to Stop Hypertension (DASH) diet. Preventive medicine reports, 4, 525-531. https://doi.org/10.1016/j.pmedr.2016.09.009
Kim and Andrade (2016) address the status of hypertension after adhering to the DASH diet. DASH diet is primarily used for patients with hypertension. However, it is unknown if the diagnosis of hypertension can help patients adhere to the DASH diet and nutrient intake. The authors use linear regression analysis to analyse the relationship between DASH diet and diagnosis of hypertension. The study used a sample of patients with hypertension and a DASH score of between 0 and 10 to help measure the intake of nutrients.
Literature Search
The study results indicated that the increased consumption of protein, fat, and sodium was linked to the diagnostic status of hypertension. The patients who followed the DASH diet showed reduced effect of stroke and hypertension. However, patients who did not engage in health nutritional behaviour showed no effect after using the DASH diet. Therefore, most patients did not adhere to the DASH guidelines regardless of their health condition.
I have learned that although the DASH diet is critical in reducing hypertension among patients, most do not adhere to the guidelines which continue putting their health at risk. Nurses need to create awareness on management of hypertension through the use of DASH diet by stressing the importance of diet in managing hypertension and the effect nutrition has when under medication.
Summary Four
Seangpraw, Auttama, Tonchoy, and Panta, (2019) analyses the effect of Dietary Approach to Stop Hypertension (DASH) diet on hypertension among elderly patients. The study employed quasi-experimental research by enrolling the elderly patients with hypertension as selected groups were then assigned to receive the DASH randomly. The sample size was 85, which was obtained after a full 90 days follow up intervention.
Literature Search
The study demonstrated considerable improvements in hypertension in intervention and control groups. The diastolic blood pressure and systolic blood pressure of the patients in the intervention group reduced. Nurses should consider the intervention as the primary prevention strategy for high blood pressure among seniors in various minority ethnic or racial groups in the United States. The findings of the study suggest that nursing education should highly consider training the nurses about DASH diet intervention to improve patient outcome.
I have learned that high blood pressure is reduced using DASH diet intervention among elderly patients. Nursing practice should emphasise increased use of DASH diet among the minority groups, especially elderly patients with hypertension, to reduce the risks of stroke and high blood pressure. It is the responsibility of the nurses to create awareness on the benefits of DASH diet in minimising the stroke cases, which can, in turn, reduce the treatment costs and reduce the mortality rates.
Summary Five
Kawamura, A., Kajiya, K., Kishi, H., Inagaki, J., Mitarai, M., Oda, H., … & Kobayashi, S.
(2016). Effects of the DASH-JUMP dietary intervention in Japanese participants with high-normal blood pressure and stage 1 hypertension: an open-label single-arm trial. Hypertension Research, 39(11), 777. https://www.nature.com/articles/hr201676
Kawamura et al. (2016) address the impact of the DASH-Japan Ube Modified diet Program (DASH-JUMP) dietary patients with stage 1 hypertension and high-normal blood pressure. The DASH-JUMP diet emphasises the consumption of vegetables, fruits, whole grains, and low-fat dairy foods to reduce blood pressure and the risks of cardiovascular diseases. It is essential to include a variation in the composition of the macronutrients in the DASH diet while still enhancing the preservation of the benefits of lipid and blood pressure risk factors.
Literature Search
The study used fifty-eight participants who consumed a standard DASH-JUMP four weeks. After the intervention, it was found that the DASH-JUMP significantly reduced the BMI, fasting serum glucose level and fasting insulin level. The extent of adherence to diet determines the effectiveness of the intervention of the DASH diet. This means that the DASH-JUMP diet was an effective nutritional strategy for reducing high blood pressure among patients.
Most people with the problem of following prescribed diets have difficulty if adhering to DASH-JUMP diet. It is the responsibility of the nurses to create awareness and advice patients to follow prescribed diets to increase the effectiveness of DASH-JUMP intervention. This would help effectively implement the use of the DASH-JUMP diet as a nonpharmacological treatment of blood pressure because it is effective in controlling the level s of high blood pressure within five years of intervention.
References
Akita, S., Sacks, F. M., Svetkey, L. P., Conlin, P. R., & Kimura, G. (2003). Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship. Hypertension, 42(1), 8-13. https://www.ncbi.nlm.nih.gov/pubmed/12756219
Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015). Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: A randomized controlled trial–3. The American journal of clinical nutrition, 103(2), 341-347. https://www.ncbi.nlm.nih.gov/pubmed/26718414
Kawamura, A., Kajiya, K., Kishi, H., Inagaki, J., Mitarai, M., Oda, H., … & Kobayashi, S.
(2016). Effects of the DASH-JUMP dietary intervention in Japanese participants with high-normal blood pressure and stage 1 hypertension: an open-label single-arm trial. Hypertension Research, 39(11), 777. https://www.nature.com/articles/hr201676
Kim, H., & Andrade, F. C. (2016). The diagnostic status of hypertension on adherence to the
Dietary Approaches to Stop Hypertension (DASH) diet. Preventive medicine reports, 4, 525-531. https://doi.org/10.1016/j.pmedr.2016.09.009
Seangpraw, K., Auttama, N., Tonchoy, P., & Panta, P. (2019). The effect of the behaviour
modification program Dietary Approaches to Stop Hypertension (DASH) on reducing the risk of hypertension among elderly patients in the rural community of Phayao, Thailand. Journal of multidisciplinary healthcare, 12, 109. DOI: 10.2147/JMDH.S185569
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