Synthesis of Literature Multiple steps were utilized in critically appraising research articles for this project in order to decipher if enough valid and reliable evidence was collected from the evidence search to make recommendations for an innovative project at LakeWood Health Center. These steps included searching for and analyzing articles for validity, reliability, and applicability utilizing a rapid critical appraisal checklist presented in Evidence Based Practice in Nursing & Healthcare: A Guide to Best Practice by Mazurek Melnyk & Fineout-Overholt (2015). The following synthesis of literature will present evidence presented from research and evidence-based practice guidelines broken down into themes to include: screening for childhood
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Savinon et al. (2012) also found a clear increase in recording frequency of BMI, completing BMI growth charts, and scoring questionnaires when utilizing an EMR versus a written or paper medical record. Customization of the EMR during the study included templates, tools, and management strategies within the EMR to document assessment, diagnosis, counseling, and management consistent with guidelines by means of prompts. Additionally, resources for patient education handouts and guideline recommendations for patients were implemented at point of care. Providers and staff were trained and involved in customizing the EMR allowing for input and feedback which generated a commitment to the innovation within the facility. Overall, Savinon et al. (2012) appreciated improvements in screening, diagnosis, and management of childhood overweight and obesity by customizing the EMR at the study facility.
Jacobson & Gance-Cleveland (2011) identified in their systematic review that the inclusion of office-based assessment and counselling tools within the EMR were “successful visible reminder on the patients’ medical record, which improved performance and adherence …show more content…
(2016). This review also noted that many of these drugs are not licensed for use in pediatric patients. Poor trial quality, report bias, and high dropout and discontinuation rates lead to a lack of support for pharmacological interventions in pediatric patients. Only modest weight reduction was noted for short term periods in trials and it is unknown if these results are sustainable over longer time frames. Additionally there was a high rate of adverse effects reports by participants. (Mead et al., 2016).
Orlistat and sibutramine combined with behavioral interventions were noted to have small to moderate improvement in very obese adolescents with a BMI reduction of 2.6 kr/m2 more than behavioral interventions alone in those taking sibutramine and 0.85 kg/m2 for those taking orlistat. Orlistat remains the only recommended medication for use in adolescents age 12 and older by the FDA. No studies followed up on maintenance of this weight loss and side effects were more commonly in comparison to behavioral interventions alone with varying degrees of severity. (Whitlock, O’Conner, Williams, Beil, & Lutz,
Savinon et al. (2012) also found a clear increase in recording frequency of BMI, completing BMI growth charts, and scoring questionnaires when utilizing an EMR versus a written or paper medical record. Customization of the EMR during the study included templates, tools, and management strategies within the EMR to document assessment, diagnosis, counseling, and management consistent with guidelines by means of prompts. Additionally, resources for patient education handouts and guideline recommendations for patients were implemented at point of care. Providers and staff were trained and involved in customizing the EMR allowing for input and feedback which generated a commitment to the innovation within the facility. Overall, Savinon et al. (2012) appreciated improvements in screening, diagnosis, and management of childhood overweight and obesity by customizing the EMR at the study facility.
Jacobson & Gance-Cleveland (2011) identified in their systematic review that the inclusion of office-based assessment and counselling tools within the EMR were “successful visible reminder on the patients’ medical record, which improved performance and adherence …show more content…
(2016). This review also noted that many of these drugs are not licensed for use in pediatric patients. Poor trial quality, report bias, and high dropout and discontinuation rates lead to a lack of support for pharmacological interventions in pediatric patients. Only modest weight reduction was noted for short term periods in trials and it is unknown if these results are sustainable over longer time frames. Additionally there was a high rate of adverse effects reports by participants. (Mead et al., 2016).
Orlistat and sibutramine combined with behavioral interventions were noted to have small to moderate improvement in very obese adolescents with a BMI reduction of 2.6 kr/m2 more than behavioral interventions alone in those taking sibutramine and 0.85 kg/m2 for those taking orlistat. Orlistat remains the only recommended medication for use in adolescents age 12 and older by the FDA. No studies followed up on maintenance of this weight loss and side effects were more commonly in comparison to behavioral interventions alone with varying degrees of severity. (Whitlock, O’Conner, Williams, Beil, & Lutz,