Using_Knowledge_and_Evidence_to_Support_Study

What is the role of a nurse in obesity management and prevention' The aim of this assignment is to outline the role of nurses in obesity management and prevention. The question, ‘what is the role of a nurse in obesity management and prevention'’ arose from the case study written by Sara Kirk in 2003 which talks about diet and weight management. The question will be investigated by conducting a literature search to identify relevant information. The importance of using evidence that has been thoroughly researched when finding ways of preventing and managing obesity will also be explained. For nurses and other health professionals to be able to help the public to manage and prevent obesity effectively they have to use evidence- based practice (EBP). EBP combines scientific research, patient preferences, clinical expertise and expert opinions and this allows healthcare professionals to decide on the best care to provide to patients based on the best available evidence (Dearholt and Dang, 2012). EBP saves time, reduces cost, produces more positive results (Dearholt and Dang 2012) and it also gives the patients a better experience of illness and good quality care (Craig and Smyth, 2007). Providing care based on evidence that has been thoroughly researched where this is available give nurses confidence because they know that they provide quality care based on evidence rather than tradition (Craig and Smyth 2007). Patients might want to know why nurses have chosen a particular way to care for them and they expect them to know. Using evidence based practice will enable nurses to explain clearly to the patients why a particular procedure has to be followed or performed (Aveyard and Sharp, 2009). Nurses will have confidence to explain because they know they have evidence to support their actions. While it is important to give a clear reason for the care you provide, it is also important to provide practice based on the best available up to date evidence. Up-to-date practices will help health professionals to deliver best possible and cost effective care rather than using out-of-date practice. The question will be addressed using journals, books and databases from SHU library search, Internurse and CINAHL. Books are a good source of information but they can contain out of date information if they are too old and so only books published up to a decade will be used. The results retained from the literature search were evaluated to see if they were reliable by using the Evaluation check list on UKESSP Module site (SHU, 2012). Peer reviewed journals were used as they give articles that have been checked by people that are experts in the area and they can give material that has been recently researched. The tables below show the search strategy and the resources accessed from the search strategy. |Table 1. Search strategy | |Database |keywords |rationale |Search limits |No. of results | |SHU Library Search |Nurs* |Word nurse/nurses and |Books |18 | | |AND |either |2003 to 2012 | | | |role* |role/roles and the phrase |Peer reviewed journal | | | |AND |“obesity management and |articles |79 | | |“obesity management” |prevention” |2010 to 2012 | | | |AND | |English language | | | |prevention | | | | |Internurse |Nurs* |Word nurse/nurses and | Journal articles |17 | | |AND |either |2008 to 2012 | | | |Role* |role/roles and the phrases|Peer reviewed | | | |AND |“weight management and |Journal articles. | | | |“weight management” OR |“obesity management” |English language. | | | |“obesity management” | | | | |CINAHL PLUS |“Nurs* role*” in “weight |Nurse/nurses and either |Journal articles |45 | | |management” OR “obesity |role/roles and the phrases|2010-2012 | | | |management” |“weight management” OR |Peer review journal | | | | |“obesity management” |articles. | | | | | |English language. | | |Table 2. Resources accessed in the literature search described in table 1 | |Author(S) |Year |Type |Title | |ANDERSEN, Ross E (ed) |2003 |Book |Obesity: Etiology, Assessment, | | | | |Treatment and Prevention | |BARNETT, Anthony H and KUMAR, |2009 |Book |Obesity and diabetes | |Sudhesh (eds) | | | | | | | | | |LAZAROU, Chrystalleni |2011 |Journal article |Preventing and managing obesity | | | | | | | | | | | |SHEPHERD, Alison |2010 |Journal article |Current management strategies in | | | | |the treatment of obesity. | |BROWN Jenny and WIMPENNY, P |2011 |Journal article |Developing a holistic approach to| | | | |obesity management. | Obesity is considered to be one of the main causes of cardiovascular diseases in the UK and it is estimated that it will cost the government about £19.5 billion per year in 2015 (Lazarou, 2011). Research shows that about 6.8 per cent of all deaths in England are linked to obesity. The number of people suffering from obesity is set to increase if no action is taken (Shepherd, 2010). The general public and the healthcare professionals are confused with the advice given to them on how to deal with obesity even though there are various management strategies and treatments available to deal with crisis (Shepherd, 2010). It is not clear what nutritional factors are linked to obesity, but research has shown eating food high in calories as the main cause (Lazarou and Kouta, 2010). A successful treatment will need to include nutritional advice, physical exercise program, drug therapy or bariatric surgery and psychosocial support (Shepherd, 2010). The UK government has launched some programmes such as the Healthy Weight Healthy Lives (Shepherd, 2010) where nurses can help individuals by giving them advice on healthy eating, exercise and overall wellbeing. This help individuals change to healthier lifestyles, lose weight and engage in more physical activities if they follow the advice. There is also a society-wide initiative programme which was launched in 2009 with the intention of preventing children becoming overweight by encouraging them to do more physical activity and to eat a healthy diet. Many overweight individuals do not seek help early because of fear of disapproval from healthcare professionals and they also fear being blamed for eating unhealthy food and not exercising (Shepherd, 2010). Many people also find it difficult to talk about body weight. Therefore it is very important for nurses to provide a positive and well-managed first consultation (Shepherd, 2010). This will improve self-confidence and encourage individuals to be successful in their weight loss program. It is also important for nurses to use open –ended questions when talking about weight loss issues as this gives patients confidence to respond in a positive way. An example of an open minded question is asking a patient if they are worried about their weight (Shepherd, 2010). Nurses are expected to encourage and advice people to adapt to living healthy lifestyles (Shepherd, 2010). Examples of healthy life styles were nurses can help include supporting people to engage in physical activities, eat regular meals, breast feed to prevent risks of being overweight in babies and to provide advice on nutrition (Lazarou, 2011). Advice can be given to individuals in clinics or in group- based nutrition education sessions. It can take some time for some people to change as they may never have eaten a healthy diet before; some do not eat on a regular basis because of the demands of life. So, for these programmes to be successful, it is important for nurses to be trained and supported in obesity management (Shepherd, 2010). Epidemiologists have suggested lack of exercise and eating a high calorie diet as some of the causes of obesity (Andersen, 2003). Therefore, eating a low calorie and low fat diet can help reduce weight. For example, changing diet by eating food containing 50 calories less daily and exercising for about 15-20 minutes may reduce weight by 5kg a year (Lazarou, 2011). For very –low-calorie diets less than 800kcal/day, individuals have to eat adequate amount of proteins to reduce the loss of lean muscle mass (Barnett and Kumar, 2009). Those individuals who do not eat on a regular basis they can spread their energy intake throughout the day by eating small amounts of food regularly (Shepherd, 2010). Dieting alone is not effective enough to achieve good results in weight loss especially after child birth (Shepherd, 2010). Therefore, the most effective way to lose more weight is to eat healthy and do physical activities as well (Barnett and Kumar, 2009). Most people do not see the need for physical activities because they believe that spending the whole day standing at work or being kept busy by small children is enough for exercise (Shepherd, 2010). In this case, it may be necessary for nurses to use tools that can encourage patients to do more physical activities. An example, is giving them a pedometer to record the number of their steps. Nurses can also use nutritional assessment tools which allow them to detect obesity early and therefore take necessary steps to prevent it developing further (Lazarou and Kouta, 2010). Regardless of the cause of patient’s obesity, it is important for nurses to consider the patient’s multiple needs when dealing with overweight people. This allows them to deal with the person as a whole not just weight as they will also be looking at the psychological and social factors as they are some of the factors that contribute to obesity (Brown and Wimpenny, 2011). Dealing with a patient as whole promotes a holistic approach will allow nurses to treat overweight patients as individuals with different needs and this could produce positive results. Preventing and managing obesity can reduce the number of people who die from cardiovascular diseases in the UK. Obesity is accountable for about 6.8 per cent of all deaths in England and the number is set to increase if no action is taken. Nurses have an important role to play in the management of weight loss, but they cannot do this alone. They need to be trained and given support to achieve more positive results. It is vital for nurses to make clinical decisions based on evidence rather tradition when treating patients. They need to identify key words from the question and understand the search process to conduct a literature search. They also need to know which sources are reliable to search from and be able to identify information relevant to their question. The assignment has shown how important to use evidence based practice when making clinical decisions as it likely to produce more positive results, saves time and money. It is a requirement for all nurses by the Nursing and Midwifery Council ( NMC code of Conduct, 2008) for nurses to use evidence-based practice. The assignment has also demonstrated how it is important for nurses to have the skill that will allow them to conduct a literature search and retrieve reliable information that will assist them in making clinical decisions. . References ANDERSEN, Ross E., (ed) (2003). Obesity: Etiology, Assessment, Treatment and Prevention. United States, Human Kinetics Publishers. AVEYARD, Helen and SHARP, Pam (2009). A beginner’s Guide to Evidence Based Practice in Health and Second care Professions. Berkshire, Open University Press. BARNETT, Anthony H and KUMAR, Sudhesh (eds) (2009). Obesity and Diabetes. 2nd ed., Wiltshire, Wiley-BlacKwell. BROWN, Jenny and WIMPENNY, Peter (2011). Developing a holistic approach to obesity management. [online]. International Journal of Nursing Practice. 17, 9-18. Article from CINAHL Plus last accessed 25 November 2012 at: http://web at ebcsohost.com.lcproxy.shu.ac.uk CRAIG, Jean V and SMYTH, Rosalind L (eds.) (2007).THE Evidence- Based Practice Manual For Nurses. 2nd ed., London, Churchill Livingstone Elsevier. DEARHOLT, Sandra L and DANG, Debora (eds.) (2012). JOHN HOPKINS NURSING EVIDENCE BASED PRACTICE: MODELS AND GUIDELINES. [online] 2nd ed.,Indiana, Sigma Theta Tau International. Book from Myilibrary last accessed 27 November 2012 at: http://lib.myilibrary.comlcproxy.shu.ac.uk HOLLAND, Karen and REES, Colin (2010). Nursing: Evidence- Based Practice Skills. Oxford, University Press. LAZAROU, Chrystalleni (2011). Preventing and managing obesity. [Online].Independent Nurse, 8 (22), 1-4. Article from Internurse last accessed 01 November 2012. Nursing and Midwifery Council (2008). The code: standards of conduct, perfomance and ethics for nurses and midwives. Nursing and Midwifery Council, London. Sheffield Hallam University (2012) Evaluation Check List. [online]. Last accessed 25 November 2012. UKESSP Blackboard site. SHEPHERD, Alison (2010). Current management strategies in the treatment of obesity. [Online]. Nursing Standard, 25 (14), 49-56. Article from CINAHL Plus last accessed 31 October 2012.