1. Ferris State University NURS 450 Tracy Stark

2. Identify types of complementary and alternative medicine. Declare why it is important to nursing. Discuss relevant evidence-based theories. Explore policies, resources, quality & safety surrounding the use of complementary and alternative medicine in practice. Reflection on assessment of health care environment. Explore recommendations for improvement on quality & safety.

3. Complementary & Alternative Medicine abbreviated as CAM Focuses on the person as a whole. It is not based on the patient’s physical symptoms but also on the individual’s lifestyle, environment, diet, mental, emotional and sometimes even spiritual health. This is why complementary and alternative medicine is often referred to as holistic medicine.

4. Traditional Alternative Medicine: Acupuncture Ayurveda Homeopathy Naturopathy Chinese or Oriental Medicine Body Chiropractic or Osteopathic Medicine Aromatherapy Massage Tai Chi Yoga Diet and Herbs Dietary Supplements Herbal Medicine External Energy Electromagnetic Therapy Kinesiology Reiki Qigong Mind Meditation Biofeedback Hypnosis Senses Art, Dance, and Music Visualization and Guided Imagery (Marcellin, L., Nelson, G. A.,2015)

5. Acupuncture: scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation. University of Maryland completed one of the largest studies on validity of acupuncture. Randomized Controlled Trail followed 570 participants Concluded that Chinese Acupuncture significantly reduces pain and improves function for patients with osteoarthritis of the knee (University of Maryland Medical Center, 2013)

6. Aromatherapy: Aromatherapy, also referred to as Essential Oil therapy, can be defined as the art and science of utilizing naturally extracted aromatic essences from plants to balance, harmonize and promote the health of body, mind and spirit. It seeks to unify physiological, psychological and spiritual processes to enhance an individual’s innate healing process. (National Association for Holistic Aromatherapy, 2015)

7. Dietary or Herbal Supplements: Usually taken by mouth in the form of tablets, capsules, powder, or liquid and contain one or more of the following: vitamins, minerals amino acids or other botanicals.

8. In 2007, U.S. adults spend $33.9 billion out of pocket on visits to CAM practitioners and purchases of CAM products, classes and materials! In 2010, ONLY 43% of U.S. medical schools offered courses or electives in complementary & alternative medicine (CAM). In 2013, 58 of the 120 members stated that a lack of education and training opportunities for traditional and complementary medicine providers was among their key concerns Medical Tourism (Academy of Integrative Health & Medicine, 2015) https://www.youtube.com/watch?v=i1SlTGBpB2A

9. Betty Neuman’s Systems Model Comprehensive holistic and system-based approach to nursing that contains an element of flexibility. “The condition in which all parts and subparts, or variables, are in harmony with the whole of the client." (Nursing Theory, 2013)

10. Betty Neuman’s Systems Model (Nursing Theory, 2013)

11. Health Belief Model (HBM) The HBM derives from psychological and behavioral theory with the foundation that individuals have The desire to avoid illness, or conversely get well if already ill; The belief that a specific health action will prevent, or cure, illness. Six Major Concepts (Behavioral Change Models, 2013)

12. Current Practice Within Hospitals Hospice Lack of Education Placebo Effect Mind Over Medicine by Lissa Rankin “Our minds can make us sick and our minds can make us well” (Rankin, 2013)

13. Resources Evidence-Based Research! The American Holistic Nurses Association http://www.ahna.org/ The National Association for Holistic Aromatherapy http://www.naha.org/explore-aromatherapy/resources/ The National Center for Complementary & Integrative Health https://nccih.nih.gov/

14. Lack of Knowledge Lack of Education Lack of Evidence Lack of Interest Lack of Training Lack of Marketing Other Causes?

15. Without proper education we will fall short of caring for our patients in a holistic way. Florence Nightingale Be Resourceful! Choose to educate yourself: Get those CEUs!

16. .{.Acupuncture.}. Encourage patients to discuss use of acupuncture with their PCP. Educate Yourself! Educate Your Patients! Find a licensed acupuncturist to discuss treatment opportunities with! American Academy of Medical Acupuncture Visit http://www.medicalacupuncture.org/ National Center for Complementary & Integrative Health: Acupuncture Visit https://nccih.nih.gov/health/acupuncture (American Academy of Medical Acupuncture, 2015) (National Association for Holistic Aromatherapy, 2015) (National Center for Complementary and Integrative Health, 2015a)

17. .{.Aromatherapy.}. Encourage patients to discuss use of aromatherapy with their PCP. Educate Yourself! Visit http://www.naha.org for information, safety guidelines and research. Important factors that influence the safety of essential oils include: Quality of essential oil being utilized Chemical composition of the oil Method of application Dosage/dilution to be applied Integrity of skin Age of client (National Association for Holistic Aromatherapy, 2015)

18. .{.Herbal & Dietary Supplements.}. How Do I Educate My Patients: Recommend they speak with their health care provider AND suggest they visit: National Institutes of Health: Office Of Dietary Supplements http://www.ods.od.nih.gov https://www.youtube.com/watch?v=bj8FK63nFio Educate Yourself! Visit the American Holistic Nurses Association website to complete your CEUs! (Continuing Education Credits) http://www.ahna.org/About-Us/What-is-Holistic-Nursing

23. Which of these over-the-counter drugs may interact with herbal supplements?

24. Drug-Supplement Interactions Are Especially Important When…

25. QSEN COMPETENCIES Patient-Centered Care: Knowledge about complementary and alternative medicines is caring for the whole person Teamwork & Collaboration: Crucial conversations can take place with patient, nurse and doctor to discuss alternative therapies to create higher patient satisfaction Evidence Based Practice: Quality research used to educate Quality Improvement: Improve the quality in care of patients can be utilized when exploring all health practices. Safety: Educate yourself and properly educate your patients Informatics: The use of information in health care by clinicians.

26. Standard 5A. Coordination Of Care. “The registered nurse coordinates care delivery” Standard 5B. Health Teaching and Health Promotion “The registered nurse employs strategies to promote health and a safe environment” Standard 8. Education “The registered nurse attains knowledge and competence that reflects current nursing practice” Standard 9. Evidence-Based Practice and Research “The registered nurse intgrates evidence and research findings into practice” Standard 15. Resource Utilization “The registered nurse utilizes appropriate resources to plan and provide nursing services that are safe, effective, and financially responsible” (ANA, 2010)

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28. National Association for Holistic Aromatherapy. (2015). Exploring aromatherapy. National Association for Holistic Aromatherapy. Retrieved from https://www.naha.org/explore-aromatherapy/about- aromatherapy/what-is-aromatherapy National Center for Complementary and Integrative Health (March 2015a). Acupuncture. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https://nccih.nih.gov/health/ acupuncture National Center for Complementary and Integrative Health. (Aug 2013). Ayurvedic medicine: An introduction. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https://nccih.nih.gov/health/ayurveda/introduction.htm National Center for Complementary and Integrative Health (June 2011). Botanical dietary supplements. U.S. Department of Health & Human Services: National Institutes of Health: Office of Dietary Supplements. Retrieved from http://ods.od.nih.gov/factsheets/BotanicalBackground- HealthProfessional/ National Center for Complementary and Integrative Health. (Feb 2012). Chiropractic: An introduction. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https:// nccih.nih.gov/health/chiropractic/introduction.htm?lang=en National Center for Complementary and Integrative Health. (May 2013). Homeopathy: An introduction. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https:// nccih.nih.gov/health/homeopathy National Center for Complementary and Integrative Health. (March 2012). Naturopathy: An introduction. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https:// nccih.nih.gov/health/naturopathy/naturopathyintro.htm

29. National Center for Complementary and Integrative Health. (Nov 2014). Meditation: What you need to know. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https:// nccih.nih.gov/health/meditation/overview.htm National Center for Complementary and Integrative Health. (Sept 2014). Reiki: What you need to know. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https:// nccih.nih.gov/health/reiki/introduction.htm National Center for Complementary and Integrative Health. (Aug 2010). Tai chi: An introduction. U.S. D epartment of Health & Human Services: National Institutes of Health. Retrieved from https:// nccih.nih.gov/health/taichi/introduction.htm National Center for Complementary and Integrative Health. (March 2015a). Traditional chinese medicine. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https:// nccih.nih.gov/health/chinesemed National Center for Complementary and Integrative Health. (March 2015b). Understanding Drug Supplement Interactions. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https://nccih.nih.gov/health/herbs/understanding-interactions National Center for Complementary and Integrative Health. (June 2014). Using dietary supplements wisely. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https:// nccih.nih.gov/health/supplements/wiseuse.htm National Center for Complementary and Integrative Health. (June 2013). Yoga for health. U.S. Department of Health & Human Services: National Institutes of Health. Retrieved from https://nccih.nih.gov/health/ yoga/introduction.htm Nursing Theory. (2013). Systems theory. Nursing Theory. Retrieved from http://www.nursing-theory.org/ theories-and-models/neuman-systems-model.php

30. Tabish, S.A., (2008). Complementary and alternative healthcare: Is it evidence-based? International Journal of Health Sciences Qassim University. 2 (1). University of Maryland Medical Center. (2013). Acupuncture provides added benefits for people with osteoarthritis of the knee. University of Maryland Medical Center. Retrieved from http://umm.edu/ news-and-events/news-releases/2004/acupuncture-provides-added-benefit-for-people-with- osteoarthritis-of-the-knee