NURS 360 Health & Illness III

Reflective Journal Instructions

Reflection is an important component of nursing and this course. Ethical dilemmas are embedded in clinical
practice; an obligation of nurses is to notice, interpret, respond and reflect on these dilemmas using ethical principles
and frameworks as a guideline. In addition, reflection and self-analysis encourages self-awareness and self-care;
ongoing reflection, critical examination and evaluation of ones professional and personal life improve nursing
practice. Therefore, a reflective journal entry is required for this course and it is due on the Monday following each
clinical week. Each week you will address a different question as labeled. Journal entries must be typed and double
spaced using #12-font.
There are a number of outcomes that are being measured with this assignment. Below are the students learning
outcomes being measured, followed by the questions you must address related to that competency. You will be
graded based on the reflective journal scoring rubric.

Week 4: Evaluate and apply the facts and principles of biological, psychological,
sociological, cultural and spiritual functioning while providing nursing care to clients with
needs resulting from altered states of wellness throughout the lifespan.
Address the question listed below:

a.

Evidence Based Practice

Select one nursing intervention you implemented for your patient today and
explain the scientific rationale for its use. Use electronic resources to select an
original research article supporting its use. Please provide at least a 10 sentence
synopsis of the article and provide appropriate reference.

One nursing intervention that I implemented for my patient today is I COUGH. The
acronym stands for Incentive spirometer, coughing and deep breathe, oral care, understanding,
getting out of bed, head of bed elevated. I COUGH is acronym to prevent postop pulmonary
complications, such as pneumonia. The scientific rationale for using this IS is to help teach you
how to deep breathe, clear mucus from your longs and increase amount of oxygen that goes into
your lungs. Oral care helps reduce bacteria and any other particles that could go into your lungs
and cause pneumonia. Understanding helps with patient education, if the patient understands
why they are doing this for they will have better compliance with doing it. Getting out of bed
helps with making patients take deeper breaths because of exercise and head of bed elevated
helps with prevention of aspiration. The hospital that was tested had 2.6% of postop pneumonia.
When they implemented this practice they saw their postop pneumonia percentage drop to 1.6%.
unplanned intubation at their hospital was 2.0% before I cough and with I cough it is 1.2%.

Refrence
Cassidy, M. R. (2013, August). I COUGH Reducing Postoperative Pulmonary
Complications With a Multidisciplinary Patient Care Program. Retrieved April 4,
2016, from http://archsurg.jamanetwork.com/article.aspx?articleID=1693122