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The three components of evidence-based practice are best research evidence, clinical expertise, and patient needs and values (Figure 1-1 in the textbook). Consider the following patient situation and the possible conflicts among the evidence, clinical expertise, and the patient needs and values.

        Mrs. Greenwood, age 62 years, was diagnosed 5 years ago with hypertension. Her body mass index (BMI) is 33.8 (weight = 185 lb; height = 62 inches). Her blood pressure readings at the physician’s office range from 220/104 to 176/92, despite treatment with valsartan-hydrochlorothiazide (Diovan-HCT 160/25). The RN who works with the physician has taught the patient about modifiable risk factors and set short-term goals with the patient at each clinic visit for the past 6 months, but Mrs. Greenwood has not lost any weight. She acknowledges that she continues to drink a couple of beers a day and smoke a pack of cigarettes each day.

Because of patient autonomy, conflicts can exist between the application of research evidence and a patient’s needs and values.

Answer the following questions and respond to at least one other person’s post to receive full credit.

1. What conflicts exist between the patient’s needs and values and the best available evidence and clinical expertise of the nurse and physician?

2. How can these conflicts be resolved?

3. To use evidence-based guidelines and health promotion strategies, what additional information does the nurse need to have about Mrs. Greenwood and her behaviors? 

SCIENCE
HEALTH SCIENCE
NURSING

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