NUR 513 Research and Evidence- Based Practice Summer 2013

Problem Description: Amenable to Nursing Intervention The battles and wars of the world are creating a patient population challenging nurses with Evidence-Based Practice (EBP) concerns for veterans with combat-related post- traumatic stress disorder (PTSD). Best practice guidelines for PTSD are established for veteran centric use and addressing means for improving outcomes. Nurses are identified for assisting with the demands of this challenge to provide patient centered care. A recent effort within integrated health clinical services positioned nurses to perform an energy medicine modality, specifically Healing Touch (HT), as adjunctive intervention for veterans with PTSD. This change presents EBP inquiry to address the question : Does implementation of HT as an adjunctive intervention improve the outcomes for veterans suffering from PTSD? The purpose of this paper is to address EBP implementation of Healing Touch (HT) as an adjunctive patient -centered intervention to improve the outcomes for veterans suffering from PTSD.
The target population includes staff and case management nurses of Veteran Administration/Department of Defense (VA/DoD) in all health care settings to include outpatient clinic, domiciliary, acute care hospitals and long term care providing services for veterans with PTSD. The significance of this problem for VA/DoD nurses relates to specialization beyond education offered in core nursing practice. It involves nursing practice advancement for transforming initial PSTD screening and care coordination duties to include providing HT as an adjunctive intervention. The implementation of this practice is an organization process and also serves as an individual EBP change for nurses.
Clinical Guideline
The Department of Veterans Affairs / Department of Defense (VA/DoD) most recent Clinical Practice Guidelines for Stress Disorders (2010) is posted on the National Guideline Clearinghouse. It is written for professionals providing services for veterans in all health care settings. This EBP addresses one of the specific goals identified in VA/DoD (2010) clinical practice guideline to improve patient outcomes with targeted efforts of symptom reduction, increased functional status, decrease co-morbidity and quality of life enhancement ( p. 2).
The clinical guideline identifies energy medicine interventions as an adjunctive option for treatment especially when veterans refuse traditional treatment or by veteran preference but the resources were not integrated or available in the clinical settings. VA/DoD recently declared the significance of its importance with grant funding for education and implementation of HT as an adjunctive intervention. This intervention is becoming a part of nursing practice in clinics and hospital settings across the nation. This quantum shift is described by Curtin (2013) as “the breaking down of our old healthcare system and the breaking through of the new” (p. 56) and warrants transformational processes.
Nurses are the targeted providers and will specifically use HT. Dorothea Hoover-Kramer ((2010) defines HT as “an non-invasive energy therapy in which practitioners consciously use their hands in a heart-centered and intentional way to support and facilitate physical, emotional, mental and spiritual health by addressing imbalances or blockages in the biofield ” (pp. 295-296). HT is an approved continuing education program for nurses through the American Nurses Credentialing Center and endorsed over 20 years ago through the American Holistic Nursing Association . Certification for this energy medicine specialized practice through Healing Touch Program™ (http://www.healingtouchprogram.com/ )