# data[].attributes.body
Evidence Based Practice

1. Wash hands and encourage the patient to do the same.

This practice can be accomplished by providing face-to-face teaching to the patient. The level of assistance will be minimal, but occasional reminding may be beneficial in case the patient forgets. The accommodations will consist of allowing times between events to wash hands

2. Encourage patient to increase fluid intake if not contraindicated

This practice will require face-to-face teaching, brochures, and cooking classes. The level of assistance will be continuous to ensure the patient sticks to his/her diet. The accommodations will be learning to shop at stores that provide nutritious foods, and also funds to purchase the food. Also, the older adult will need to be informed of social events in the community that will provide others to accompany them during meal times.” Older people need a better quality diet, with a greater density of nutrients than other people” (Coutts, 2001,pg. 605).

3. Encourage adequate rest

This practice can be accomplished by providing face-to-face teaching to the patient. The level of assistance will be minimal, but occasional reminding may be beneficial in case the patient forgets. The accommodations will consist of not scheduling activities so close together in order to allow rest periods. Also, it will call for having more chairs or etc around to allow the patient to sit during times of rest.

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Evidence Based Practice

1. Turn and reposition the patient every 2 hours to prevent skin breakdown and improve breathing.

This practice can be accomplished by teaching this strategy through a video, pamphlet or face-to-face learning session.  The level of assistance will require help from a health care professional in order to effectively complete this strategy. The physical/environmental accommodations will involve eliminating distractions to that patient will be able to concentrate, such as turning TV off and limiting visitors. The environment should be clean, such as free of smoke and etc

2. Maintain a high protein, high calorie diet

This practice will require face-to-face teaching, brochures, and cooking classes. The level of assistance will be continuous to ensure the patient sticks to his/her diet. The accommodations will be learning to shop at stores that provide nutritious foods, and also funds to purchase the food. Also, the older adult will need to be informed of social events in the community that will provide others to accompany them during meal times.” Older people need a better quality diet, with a greater density of nutrients than other people” (Coutts, 2001,pg. 605).

3.. Ensure patient consumes at least 1,300 ml of fluids daily (unless contraindicated) (Eliopoulos, (2014).
This practice will require face-to-face teaching and brochures. The level of assistance will require major family support. Accommodations will consist of giving water continuously during the day

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Evidence Based Practice

1. Assess blood glucose level before meals and at bedtime

This practice can be accomplished by teaching this strategy through a video, pamphlet or face-to-face learning session.  The level of assistance will require help from a health care professional in order to effectively complete this strategy. The physical/environmental accommodations will involve eliminating distractions to that patient will be able to concentrate, such as turning TV off and limiting visitors. The environment should be clean, such as free of smoke

2. Instruct patient to avoid heating pads and always to wear shoes when walking

This practice can be accomplished by teaching this strategy through a video, pamphlet or face-to-face learning session.  The level of assistance will require help from a health care professional in order to effectively complete this strategy. The physical/environmental accommodations will involve eliminating distractions to that patient will be able to concentrate, such as turning TV off and limiting visitors. The environment should be clean, such as free of smoke

3. Teach patient to treat hypoglycemia with crackers, a snack or glucagon injection

This practice can be accomplished by teaching this strategy through a video, pamphlet or face-to-face learning session.  The level of assistance will require help from a health care professional in order to effectively complete this strategy. The physical/environmental accommodations will involve eliminating distractions to that patient will be able to concentrate, such as turning TV off and limiting visitors. The environment should be clean, such as free of smoke

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Evidence Based Practice

1.Encourage the patient to keep bathroom and hallways well lit because vision may be impaired at night or in dimly lit areas

This practice will require face-to-face teaching, and brochures. The level of assistance will require family support to make changes in the home. Accommodations will require night lights to be placed in dark areas and for furniture to be repositioned

2. Instruct the patient to avoid situations that could damage vision by increasing intraocular pressure, such as aggressive coughing, sneezing, straining to have a bowel movement, strenuous exercise, and emotional stress
This practice can be accomplished by teaching this strategy through a video, pamphlet or face-to-face learning session.  The level of assistance will require help from a health care professional in order to effectively complete this strategy. The physical/environmental accommodations will involve eliminating distractions to that patient will be able to concentrate, such as turning TV off and limiting visitors.

3.Advise the patient to avoid activities for several hours following administration of eye drops to accommodate blurred vision that could occur during this time

This practice can be accomplished by teaching this strategy through a video, pamphlet or face-to-face learning session.  The level of assistance will require help from a health care professional in order to effectively complete this strategy. The physical/environmental accommodations will involve eliminating distractions to that patient will be able to concentrate, such as turning TV off and limiting visitors. The environment should be clean, such as free of smoke

# data[].attributes.body
Evidence Based Practice

1. Proper Nutrition (Eliopoulos, (2014).

This practice will require face-to-face teaching, brochures, and cooking classes. The level of assistance will be continuous to ensure the patient sticks to his/her diet. The accommodations will be learning to shop at stores that provide nutritious foods, and also funds to purchase the food. Also, the older adult will need to be informed of social events in the community that will provide others to accompany them during meal times.” Older people need a better quality diet, with a greater density of nutrients than other people” (Coutts, 2001,pg. 605).

2.Adequate Exercise (Eliopoulos, (2014).

This practice will require face-to-face teaching, brochures, and exercise classes. The level of assistance will be continuous. The accommodations will require exercise geared toward their age group and exercise that allow frequent rest periods. “Exercise programs show promise among effect fall prevention strategies”( Yeşilyaprak et al, 2016).

3. Cigarette Smoke Avoidance (Eliopoulos, (2014).

This practice will require face-to-face teaching and brochures. The level of assistance will require major family support. Individuals will need to attend smoking cessation programs, acupuncture

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Evidence Based Practice

1. Perform active or passive ROM exercises to all extremities every 2 to 4 hours to foster muscle strength and tone, maintain joint mobility, and prevent contractures

This practice can be accomplished by teaching this strategy through a video, pamphlet or face-to-face learning session.  The level of assistance will require help from a health care professional in order to effectively complete this strategy. The physical/environmental accommodations will involve eliminating distractions to that patient will be able to concentrate, such as turning TV off and limiting visitors. The environment should be clean, such as free of smoke and etc

2. Maintain proper body alignment at all times to avoid contractures and maintain optimal musculoskeletal balance and physiologic function

This practice can be accomplished by teaching this strategy through a video, pamphlet or face-to-face learning session.  The level of assistance will require help from a health care professional in order to effectively complete this strategy. The physical/environmental accommodations will involve eliminating distractions to that patient will be able to concentrate, such as turning TV off and limiting visitors. The environment should be able to promote healthy living

3.Encourage active exercise. Provide trapeze or other assistive device whenever possible.

This practice will require face-to-face teaching, brochures, and exercise classes. The level of assistance will be continuous. The accommodations will require exercise geared toward their age group and exercise that allow frequent rest periods. “Exercise programs show promise among effect fall prevention strategies”( Yeşilyaprak et al, 2016).

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Evidence Based Practice

1. Instruct patient to perform kegel exercises daily (Eliopoulos, (2014).

This practice will require face-to-face teaching and brochures. Assistance will be minimal. Accommodations will consist of privacy

2. Support verbalization of positive or negative feelings about the actual or perceived loss (Eliopoulos, (2014).

This practice will require an open dialogue between patient and healthcare professional. Accommodations will require a quiet and nonjudgmental environment that will foster dialogue.

3. Listen to patients concerns and provide support (Eliopoulos, (2014).

This practice will require an open dialogue between patient and healthcare professional. Accommodations will require a quiet and nonjudgmental environment that will allow healthcare professional to listen

# data[].attributes.body
Evidence Based Practice

1. Offer at least 1,500 ml of liquids daily unless contraindicated (Eliopoulos, (2014).

This practice will require face-to-face teaching and brochures. The level of assistance will vary upon each individual illness.” The highest level need for assistance with bladder management varied greatly by the patient’s impairment”(Fisher, n.d, pg.18) Accommodations will consist of providing frequent bathroom breaks

2. Ensure the bathroom is easily accessible; provide bedside commode or bedpan if needed (Eliopoulos, (2014).
This practice will require teaching on how to use the bedside commode and bedpan. Assistance will be needed at all times for this strategy. Also, environment will be needed to accommodate incontinence, such as protection for mattress and furniture, provide good ventilation, use room deodorizer, keep bathroom well lighted.

3. Review dietary pattern with patient and educate as needed regarding the inclusion of high-fiber foods in diet; monitor dietary intake (Eliopoulos, (2014).

This practice will require face-to-face teaching, and brochures. “ Increased fiber intake should be gradual to prevent discomfort and bloating and should be accompanied by and increase in fluid intake to prevent dehydration” (Pellet, 2007).The level of assistance will require a dietitian and family support. Accommodations will require meals with more fiber and high in calories

# data[].attributes.body
Evidence Based Practice

1. Ensure patient consumes at least 1,300 ml of fluids daily (unless contraindicated) (Eliopoulos, (2014).
This practice will require face-to-face teaching and brochures. The level of assistance will require major family support. Accommodations will consist of giving water continuously during the day

2. Review dietary pattern with patient and educate as needed regarding the inclusion of high-fiber foods in diet; monitor dietary intake (Eliopoulos, (2014).
This practice will require face-to-face teaching, and brochures. “ Increased fiber intake should be gradual to prevent discomfort and bloating and should be accompanied by and increase in fluid intake to prevent dehydration” (Pellet, 2007).The level of assistance will require a dietitian and family support. Accommodations will require meals with more fiber and high in calories

3. Assist patient in developing a program to increase activity level as appropriate (Eliopoulos, (2014).
This practice can be accomplished by providing face-to-face teaching to the patient. The level of assistance will be minimal, but occasional reminding may be beneficial in case the patient forgets. The accommodations will consist of not scheduling levels of activity 5 times a week for at least 30 minutes. Accommodations will require age appropriate activities and actives aligned with desire level of activity

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Circulatory                                                                                           

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Circulatory                                                                                           

# data[].attributes.body
Evidence Based Practice

1.  Proper Nutrition
This practice will require face-to-face teaching, brochures, and cooking classes. The level of assistance will be continuous to ensure the patient sticks to his/her diet. The accommodations will be learning to shop at stores that provide nutritious foods, and also funds to purchase the food. Also, the older adult will need to be informed of social events in the community that will provide others to accompany them during meal times.” Older people need a better quality diet, with a greater density of nutrients than other people” (Coutts, 2001,pg. 605).

2. Adequate Exercise (Eliopoulos, (2014).

This practice will require face-to-face teaching, brochures, and exercise classes. The level of assistance will be continuous. The accommodations will require exercise geared toward their age group and exercise that allow frequent rest periods. “Exercise programs show promise among effect fall prevention strategies”( Yeşilyaprak et al, 2016).

3.Cigarette Smoke Avoidance (Eliopoulos, (2014).

This practice will require face-to-face teaching and brochures. The level of assistance will require major family support. Individuals will need to attend smoking cessation programs, acupuncture.

# data[].attributes.body
Evidence Based Practice:

1. Teach breathing exercises to increase inspiratory to expiratory ratio using the following guidelines: Slowly inhale to the count of 5,Lean forward (30-40) and slowly exhale to the count of 10; use pursed lip breathing for expiration, Repeat several times, breathing slowly and why rhythmically. (Eliopoulos, (2014).

This practice can be accomplished by teaching this strategy through a video, pamphlet or face-to-face learning session.  The level of assistance will require help from a health care professional in order to effectively complete this strategy. The physical/environmental accommodations will involve eliminating distractions to that patient will be able to concentrate, such as turning TV off and limiting visitors. The environment should be clean, such as free of smoke and etc.

2. Instruct patient to cough and deep breathe deeply at least once every 8 hours. (Eliopoulos, (2014).

This practice can be accomplished by teaching this strategy through a video, pamphlet or face-to-face learning session. The level of assistance will require help from a health care professional in order to effectively complete this strategy. The accommodations will cause for limited distractions in order to execute the strategy and will require the patient to sit upright.

3. Schedule rest periods between activities (Eliopoulos, (2014).

This practice can be accomplished by providing face-to-face teaching to the patient. The level of assistance will be minimal, but occasional reminding may be beneficial in case the patient forgets. The accommodations will consist of not scheduling activities so close together in order to allow rest periods. Also, it will call for having more chairs or etc around to allow the patient to sit during times of rest.