Discontinuation of Cholinesterase Inhibitors in Dementia Discussion Paper

NUR 39700: General Discussion Guidelines

This course makes extensive use of online discussions. Due dates and times for initial posts and replies are given in the Course Schedule. Points possible for each discussion are given in the Syllabus.

I will post instructions in each forum, including the purpose of the discussion and the questions/topics to be covered, but others may be generated over the course of the discussion. Listed below are some guidelines and requirements for these online discussions:

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1. Your “initial post” is an original idea posted in response to the faculty question(s) and assigned topic(s). Be sure to make your initial post prior to the due date/time. Late initial posts are NOT accepted for grading. Discontinuation of Cholinesterase Inhibitors in Dementia Discussion Paper
2. *Note: For the EBP discussions, failure to attach the complete guideline as instructed will result in loss of points for the initial post.

2. Log in to the course site, checking the forum frequently.
3. Make a minimum of 2 posts as replies to your peers prior to the due date/time. Late reply posts are NOT accepted for grading. Reply with substantive comments. “Substantive” is not “Yes, I agree” or “No, I don’t see that” or “I like what you said,” and so on. These types of comments alone do not add to or advance the conversation. Offer comments that are reflective and demonstrate critical thought. What can you say that would move the conversation forward? Agreeing or disagreeing is fine, but say why. Offer examples. When necessary and appropriate, use scholarly references from the literature to support your thinking and rationales. There are no “right” or “wrong” answers. Consider asking questions of your classmates. You are surrounded by people with varied backgrounds, professionally and personally, as well as varied individual strengths and challenges. Draw on others’ knowledge and expertise; this is your opportunity to learn and grow from each other!
4. I do not require a minimum or maximum number of words per post or per reply. Treat the online discussion forum as you would if you were face-to-face in class; address the question/topic while being succinct and articulate. However, one or two sentences is rarely enough to add to the discussion in a substantive manner.
5. I expect to see citations and references in your posts, demonstrating your ability to draw on scholarly material to support your ideas. Unless directed otherwise in a specific discussion forum, I do not generally require that you use and include a minimum number of references in your posts and replies. While opinions are ok to include, they should be supported by scholarly references when possible. You must be able to properly cite and reference others’ work. Additionally, it is important to understand what a “scholarly” reference/resource is. In general, these are articles written by people who are considered experts in a particular field and published in peer-reviewed sources (i.e., journal articles).
6. Use scholarly and professional presentation (i.e., writing or speaking) at all times. When referencing and citing materials in written form, use correct APA formatting. Write and/or speak in complete sentences with correct grammar. Texting/shorthand-type posts are not considered professional or scholarly. Discontinuation of Cholinesterase Inhibitors in Dementia Discussion Paper

Points will be assigned according to a rubric. In general, points are earned based on quality of responses, adherence to discussion guidelines, and according to the required number of postings as specified in individual forum instructions. As in other online activities, remember to treat one another on the discussion board as you would in person; be respectful and considerate at all times. Please follow the rules of netiquette. Your peers, Academic Coach, and Course Faculty will be viewing the posts. Posts considered disruptive will not be allowed (e.g., off-topic, offensive to individual or group of people, foul/abusive/threatening language, etc.).

In sum, please keep three words in mind: professional, meaningful, and decent. Since this is a baccalaureate-level nursing course, students are expected to write and/or speak in a professional manner, similar to what you would do in any professional setting. When participating in class discussions, it is important to make contributions meaningful. Try to avoid making “I agree” comments or offering up generic platitudes that do not add value to the discussion at hand. Discussions are moved forward by asking intelligent questions and bringing facts, logic, and course material to the table. As always, please keep in mind that there is a real live person on the other end of the conversation. Treat everyone with whom you interact with decency.

A Systematic Review of Practice Guidelines and Recommendations for Discontinuation of Cholinesterase Inhibitors in Dementia

The selected article is “A Systematic Review of Practice Guidelines and Recommendations for Discontinuation of Cholinesterase Inhibitors in Dementia” by Renn et al. (2018). Dementia is a grouping of social and thinking symptoms that disrupts how an individual goes about their daily functioning, which involves at least two brain impairment functions like poor judgment and memory loss (Livingston et al., 2020). In treating dementia, clinicians mainly introduce the patients to Cholinesterase inhibitors as the first-line pharmacological treatment for Alzheimer’s disease. Hence, the main reason for selecting the article is that it provides a clear guideline on discontinuing the use of Cholinesterase inhibitors due to their long-term use risks and effectiveness. Therefore, the article will be essential during practice since it provides the dos and don’ts, especially when dealing with Alzheimer’s patients under cholinesterase inhibitors, to balance its benefits and risks. Discontinuation of Cholinesterase Inhibitors in Dementia Discussion Paper

The article is more effective for Competency 2, which requires nursing students to serve as role models and advocates in providing quality care to the elderly. That is because the article provides effective knowledge and teaching and provides the national nursing practice guidelines on discontinuing Cholinesterase inhibitors using evidence-based research to ensure discontinuation effectiveness. Also, to discontinue Cholinesterase inhibitors effectively, these students need to learn how to engage in collaboration with other healthcare providers. For instance, the article by Renn et al. (2018) provides a systematic review of different books and articles on the most effective approach toward discontinuing Cholinesterase inhibitors. Through all the randomized trials that Renn et al. (2020) involved, the authors found that all guidelines did not offer any consensus on when and under what circumstances the discontinuation of Cholinesterase inhibitors should happen. That is because most textbooks and guidelines failed to respond or show the ineffectiveness of dementia’s progressive condition. Hence, when applying the discontinuation of Cholinesterase inhibitors, it is clear that nurses and other healthcare providers should focus more on an individualized approach when dealing with patients and their families, especially in making treatment decisions.

References

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., … & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413-446. https://doi.org/10.1016/S0140-6736(20)30367-6

Renn, B. N., Asghar-Ali, A. A., Thielke, S., Catic, A., Martini, S. R., Mitchell, B. G., & Kunik, M. E. (2018). A systematic review of practice guidelines and recommendations for discontinuation of cholinesterase inhibitors in dementia. The American Journal of Geriatric Psychiatry, 26(2), 134-147. doi:10.1016/j.jagp.2017.09.027. Discontinuation of Cholinesterase Inhibitors in Dementia Discussion Paper

EBP Guideline Related to Sexuality, Medications, or Psychosocial Aspects of Care
Weekly Objectives 3 and 4 are addressed in this discussion.

Before posting to the discussion board, locate one Clinical Best Practice Guideline or recent research article (within the past five years) related to sexuality, medications, or a psychosocial aspect of aging that aligns with your practice area or an area of interest.

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Then address the following:

Entitle your discussion post with the title of the article/guideline.
Provide a rationale for why you’ve chosen this article/guideline and state how you intend to use it in practice in one paragraph.
Apply one of the Recommended Baccalaureate Competencies and Curricular Guidelines for the Nursing Care of Older Adults that fit the article/guideline and state your rationale for using it. (Located in Appendix 2.A on page 30 of the textbook)
Attach the full research article or EBP guideline as a document in the discussion board so that other students can read it and respond more effectively. Discontinuation of Cholinesterase Inhibitors in Dementia Discussion Paper