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Write a fully developed and detailed APA essay addressing each of the following points/questions
Evidence-Based Practice Guideline
Write a fully developed and detailed APA essay addressing each of the following points/questions. There is no required word count; be sure to completely answer all the questions for each question in detail. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper.
Sources are not required; however, if sources are used make sure to cite using the APA writing style for the essay and complete a reference page. The cover page is required. Review the rubric criteria for this assignment.
Utilize the databases identified in the text to locate an Evidence-Based Practice Guideline, related to your topic identified in Module 1. Perform a rapid critical appraisal of the Evidence-Based Guideline by answering the following questions in APA format. All questions should be answered in detail and explanations offered according to guideline content when applicable.
- Who were the guideline developers?
- Were the developers of the guideline representative of key stakeholders in this specialty (inter-disciplinary)?
- Who funded the guideline development?
- Were any of the guideline developers funded researchers of the reviewed studies?
- Did the team have a valid development strategy?
- Was an explicit (how decisions were made), sensible, and impartial process used to identify, select, and combine evidence?
- Did its developers carry out comprehensive, reproducible literature review within the past 12 months of its publication/revision?
- Were all important options and outcomes considered?
- Is each recommendation in the guideline tagged by the level/strength of evidence upon which it is based and linked to the scientific evidence?
- Do the guidelines make explicit recommendations (reflecting value judgments about the outcomes)?
- Has the guideline been subjected to peer review and testing?
- Is the intent of use provided (i.e. national, regional, local)?
- Are the recommendations clinically relevant?
- Will the recommendations help me in caring for my patients?
- Are the recommendations practical/feasible? Are resources (people and equipment) available?
- Are the recommendations a major variation from current practice? Can the outcomes be measured through standard care?
Be sure to include the database from which the guideline was obtained and please submit a copy of the guideline with your paper.
Your APA formatted paper fully answer each question in complete sentences.
Assignment Expectations:
Length: Clearly and fully answer all questions; include database; attach a copy of the guideline
Structure: Include a title page and reference page (if sources were used) in APA format. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. No minimum sources are required for this assignment; if sources are used APA format is required.
Expert Answer and Explanation
Appraisal of Qualitative Research
Type of the Qualitative Research Design
The Blakeston and colleagues (2020) used the grounded theory together with the interview to explore the subjects’ views regarding their experience with the use of short-acting B2 agonists (SABA).
Validity, Trustworthiness and Credibility of the Results
Although the results match the purpose of the research, only 80 participants participated in the study, and the results are therefore questionable. The use of only 80 subjects may lead to larger margin of error because they offer less accurate mean value. It also leaves out the outliers which may compromise the data (Aspers & Corte, 2019).
Selection of the Participants
The patient recruitment process involved working with the healthcare practitioners to identify the right patients who were willing to take part in the study. To be included in the study, the participants were required to show evidence of the treatment they were using. The recruitment protocol used included patient panel, HCP referral, and HCP finders, and specific methods were used to recruit subjects in the five countries where the participants were drawn. For example, patients in France and Japan were selected using the HCP referral.
Assurance of Accuracy and Completeness of the Data
The researcher collected a significant amount of participants’ data with the data showing the number of subjects for each country, their sex, age range, and the status of their asthma condition. The state of the asthma condition ranged from mild to severe. They also provided information on the number of people whose asthma was controlled or uncontrolled. Therefore, the data was accurate and complete.
Whether the Results are Plausible or Believable
It can be difficult for one to accept the results because the researchers did not provide any information to back up the findings they made. Although they describe how the patients responded including their experience, the researchers do not provide details of the number of participants who responded to each of the survey items. From their research, for example, they found that patients had emotional attachment to the medication that relieves symptoms, yet they don’t mention the number of patients.
Whether the Implications of the Research are stated
According to Blakeston et al. (2020), one of the implications of the research is that it will increase emphasis towards considering patient perspective when developing the protocols for delivery of health care services among asthma patients. Additionally, they feel the results will bring focus on patients’ views towards the disease including the methods they use to treat the disease.
Whether New Insights may increase Sensitivity to Others’ Needs
The results provide new insights about factors that drive the use of the SABA and Inhaled Corticosteroids (ICs). When one understands the extent of the problem, they are likely to show concern, and be compassionate in terms of how they treat asthmatic patients (Kaplan et al., 2020).
Whether Understandings enhance Situational Competence
It is possible to achieve situational competence if one understands the factors that may hamper or improve treatment of asthma. If a provider understands that the patient’s misperception can interfere with the treatment of the patient’s asthma, they can advise, counsel or educate the patient regarding the suitable medication for relieving symptoms or for preventing asthmatic attacks.
The Impact on the Reader
The inferences drawn from the study can expand the reader’s views regarding the use of SABA and ICs, and the impact of patients’ misconceptions on their own treatment. Therefore, the reader can recommend an appropriate therapy for a patient with asthma. For example, the reader can talk to the patient not to rely on SABA because prolonged use of this treatment can expose one to more asthma attacks (Busetto, Wick, & Gumbinger, 2020).
Whether the Reader is imaginatively drawn to the Experience
The researchers conduct a study in which they explore the participants’ behaviors when it comes to the use of SABA as well as controllers. Because the reader gets the opportunity to explore the topic in the eyes of the researchers, they imaginatively become drawn to the experience.
Results of the Study
Although patients were emotionally attached to their SABA , they were not aware of the fact that the more frequently one uses SABA, the more they are poorly controlling their asthma. Furthermore, they determined that poor adherence was likely to occur among asthmatic patients because of the misperceptions they had regarding the ICs treatment.
Whether the Research Approach fits the Purpose of the Study
The research approach which involves recruiting and interviewing asthma patients resonates with the purpose of the research which investigates the beliefs and perceptions held by patients concerning two asthma treatments.
How the Researcher identifies the Study Approach
The researcher identifies the approach by developing the research question, coming up with assumptions, and the methodology for gathering relevant information.
Whether the Data Collection and Analysis are appropriate
The methods used to collect and analyze data are appropriate in the sense that they help gather and analyze data in a manner that one is able to see the connection between the subjects’ perceptions and their preference for specific treatment.
Whether the Importance of the Study is Explicit
Those who conducted the research explicitly described the significance of the study by mentioning that clinicians can use the findings to educate patients about the dangers of depending on SABA to relieve symptoms.
Whether the Literature supports the need of the Study
Blakeston et al. (2020) reviews sources related to the subject and these sources lend support to the need of the research. They leverage systematic reviews and other forms of literature to explain how beliefs about treatment related to the adherence to the treatment.
The Study’s Potential Contribution
The study contributes to the knowledge on the correlation between beliefs and treatment outcomes among asthmatic patients. Those conducting study related to the topic can use the findings to further build knowledge on the management of asthma.
Clarity of the Sampling and whether it is guided by the Study Needs
Other than being clear, the sampling technique is guided by the needs of the study which include identifying of the implications of beliefs held by patients on treatment. Blakeston et al. (2020) chose a model in which they recruited participants based on specified inclusion and exclusion criteria.
Whether the Researcher controls selection of the Sample
Based on how Blakeston et al. (2020) performed the study, they didn’t have control over the way the subjects were selected. They only provided a model to help with recruiting the subjects.
Whether the Sample Size and Composition reflects the Study Needs
As much as the sample size is small, the sample still reflects the needs of the research because they produce enough data to help study the relationships across variables.
Whether the Human Experience is identified
The details of the human experience including the behaviors of the respondents are clear, and the researchers link these behaviors to the beliefs people hold concerning asthma interventions.
Clarity of the Data Collection Procedures
The data collection procedures are clearly articulated by the researchers.
Whether the Sources and Means of verifying Data are explicit
Although the data was acquired by interviewing the subjects as stated by Blakeston et al. (2020), their work lacks details related to the verification of the data.
Whether the Researcher Roles and Activities are explained
The researcher’s role during the study involved conducting face-to-face interviews with the participants, and selecting those who met the required criteria (Muneswarao et al., 2019).
Whether Data Analysis Procedures are defined
The researchers defined the procedures they incorporated in analyzing data. For example, they used transcription and translation during the data analysis process.
Whether Data Analysis guides Direction of Sampling when it ends
The data analysis does not guide sampling direction when it finalizes.
Whether the Data Management Processes are clearly described
Blakeston et al. (2020) clearly defines the data attributes including the number of female and subjects used.
Presentation of the Findings
In presenting the findings, Blakeston et al. (2020) included recommendations with focus on putting the issue into context, and recommending changes to help the reader see the benefits of the study.
Whether the Data Meanings derived from the Data are described in the Context
There is lack of clear description of the data meaning derived from the data, and because of this, it can be a challenge for one to make relevant inferences about study outcomes.
Whether the Writing Effectively promotes understanding
The team that conducted the study provided comprehensive information on the subject. The language used is simple but effective, and one can understand what is being investigated.
Whether the Results will help me care for my Patients
Considering the outcomes of the study, I would use a combination of ICs and SABA to optimize the patient care outcome because this is the intervention that Blakeston et al. (2020) support as best treatment for the condition. I will use the results to guide my intervention decisions.
Whether the Results are Relevant to Persons in Similar Situations
The findings can apply in cases where people are in situations similar to the ones the studied patients are in. The findings can be relied upon to support management of health of asthmatic groups in similar conditions. For example, sensitizing members of this group can help them become informed about how they can better manage the disease.
Whether the results are Relevant to Patient Values and Circumstances
Although the outcomes show the effect of the beliefs on the patient’s choice of intervention, there is limited evidence that they can work in specific patient circumstances.
How the Results can be applied to Clinical Practice
A clinician can use the results by including in the assessment the patient’s perceptions about treatment with either SABA or ICs. The goal is to understand the patient’s needs, and administer treatment that also involves educating the patient on the effective method of managing the condition.
References
Aspers, P., & Corte, U. (2019). What is Qualitative in Qualitative Research. Qualitative sociology, 42(2), 139–160. https://doi.org/10.1007/s11133-019-9413-7.
Blakeston, S., Harper, G., &Mancebo, J.Z.(2020). Identifying the Drivers of Patients’ Reliance on Short-acting B2-agonists in Asthma. Journal of Asthma, 58 (8), 1094-1101. Doi: ttps://doi.org/10.1080/02770903.2020.1761382.
Busetto, L., Wick, W., & Gumbinger, C. (2020). How to use and assess Qualitative Research Methods. Neurological research and practice, 2, 14. https://doi.org/10.1186/s42466-020-00059-z.
Kaplan, A., Mitchell, P. D., Cave, A. J., Gagnon, R., Foran, V., & Ellis, A. K. (2020). Effective Asthma Management: Is It Time to Let the AIR out of SABA?. Journal of clinical medicine, 9(4), 921. https://doi.org/10.3390/jcm9040921.
Muneswarao, J., Hassali, M. A., Ibrahim, B., Saini, B., Ali, I., & Verma, A. K. (2019). It is time to change the way we manage mild asthma: an update in GINA 2019. Respiratory research, 20(1), 183. https://doi.org/10.1186/s12931-019-1159-y.
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FAQs
Evidence based practice guidelines nursing
Evidence-based practice (EBP) guidelines in nursing are essential frameworks that integrate the best available evidence from research, clinical expertise, and patient preferences to guide nursing practice. These guidelines ensure that nurses deliver high-quality care that is grounded in scientific evidence and tailored to meet the unique needs of individual patients. Here are some key components and steps involved in developing and implementing evidence-based practice guidelines in nursing:
- Formulating a Clinical Question: The first step in EBP is identifying a clinical question or problem that requires attention. This question should be structured using the PICO framework, which stands for Population, Intervention, Comparison, and Outcome.
- Searching for Evidence: Nurses conduct a comprehensive search for relevant research evidence using databases such as PubMed, CINAHL, and Cochrane Library. They critically appraise the quality of the evidence to ensure its validity and reliability.
- Appraising the Evidence: Nurses critically evaluate the quality and relevance of the identified research studies using tools such as the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework or the Joanna Briggs Institute (JBI) critical appraisal tools.
- Synthesizing the Evidence: The synthesized evidence is then analyzed to identify common themes, trends, and recommendations. Meta-analyses, systematic reviews, and evidence summaries are often used to consolidate the findings from multiple studies.
- Developing Practice Guidelines: Based on the synthesized evidence, nursing experts develop evidence-based practice guidelines that provide recommendations for clinical practice. These guidelines outline specific interventions, assessments, and actions that nurses should take to improve patient outcomes.
- Implementing Guidelines: Nurses work collaboratively with other healthcare professionals to implement the evidence-based practice guidelines into clinical practice. This may involve staff education, workflow modifications, and the integration of guidelines into electronic health records.
- Monitoring and Evaluation: Continuous monitoring and evaluation of the implementation of guidelines are essential to assess their impact on patient outcomes and identify areas for improvement. Nurses collect data, measure adherence to guidelines, and solicit feedback from patients and healthcare providers.
- Updating Guidelines: Evidence-based practice guidelines should be regularly reviewed and updated to incorporate new evidence, emerging best practices, and changes in healthcare policies or guidelines.
Evidence-based practice guidelines examples
- Pressure Ulcer Prevention Guidelines: These guidelines provide recommendations for preventing pressure ulcers in hospitalized patients. They may include strategies such as regular repositioning, the use of pressure-relieving devices, skin assessment protocols, and nutritional interventions based on evidence from randomized controlled trials and systematic reviews.
- Pain Management Guidelines: Evidence-based guidelines for pain management in various clinical settings help nurses to effectively assess and manage pain in patients. These guidelines may incorporate pharmacological and non-pharmacological interventions, patient education, and individualized pain assessment tools based on the latest research evidence.
- Fall Prevention Guidelines: Falls are a common concern in healthcare settings, particularly among elderly patients. Evidence-based fall prevention guidelines outline interventions such as environmental modifications, exercise programs, medication review, and patient education to reduce the risk of falls and minimize fall-related injuries.
- Infection Control Guidelines: Infection control guidelines aim to prevent healthcare-associated infections through evidence-based practices such as hand hygiene protocols, proper use of personal protective equipment, environmental cleaning, and surveillance of healthcare-associated infections. These guidelines are regularly updated to reflect the latest evidence and recommendations from organizations like the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).
- Medication Administration Guidelines: Evidence-based guidelines for medication administration ensure safe and effective medication practices in nursing. These guidelines may include recommendations for medication reconciliation, dosage calculations, administration techniques, and monitoring for adverse drug reactions based on the best available evidence and regulatory standards.
Evidence based practice guidelines for hypertension
Evidence-based practice guidelines for hypertension provide recommendations for the assessment, diagnosis, and management of high blood pressure. Here are some key components typically included in these guidelines:
- Blood Pressure Measurement: Guidelines specify the proper technique for accurately measuring blood pressure, including patient positioning, cuff size selection, and appropriate equipment. They may recommend multiple readings taken at different times to confirm the diagnosis.
- Diagnostic Criteria: Guidelines outline the diagnostic criteria for hypertension, including blood pressure thresholds for defining hypertension and prehypertension, as well as criteria for diagnosing hypertensive emergencies and urgencies.
- Risk Assessment: Evidence-based guidelines assess the patient’s overall cardiovascular risk, considering factors such as age, gender, ethnicity, family history, smoking status, cholesterol levels, and comorbidities. They may include risk assessment tools or calculators to estimate the patient’s 10-year cardiovascular risk.
- Lifestyle Modifications: Guidelines emphasize the importance of lifestyle modifications as the foundation of hypertension management. These may include recommendations for dietary changes (e.g., DASH diet), weight loss, regular exercise, smoking cessation, and moderation of alcohol consumption based on evidence from clinical trials and observational studies.
- Pharmacological Treatment: Evidence-based guidelines provide recommendations for pharmacological therapy based on the patient’s blood pressure level, cardiovascular risk profile, and comorbidities. They may include specific drug classes such as diuretics, ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, beta-blockers, and others, along with dosing recommendations and considerations for special populations (e.g., pregnant women, older adults).
- Monitoring and Follow-up: Guidelines specify the frequency of blood pressure monitoring and follow-up visits based on the patient’s response to treatment and level of cardiovascular risk. They may also recommend additional diagnostic tests (e.g., lipid profile, renal function tests) to monitor for complications and treatment efficacy.
- Treatment Goals: Evidence-based guidelines establish target blood pressure goals for different patient populations, taking into account age, comorbidities, and cardiovascular risk factors. They may recommend more aggressive targets for high-risk individuals (e.g., diabetes, chronic kidney disease) based on evidence from clinical trials and meta-analyses.
- Patient Education and Shared Decision Making: Guidelines emphasize the importance of patient education and shared decision making in hypertension management. They may provide resources and educational materials to help patients understand their condition, treatment options, potential side effects, and the importance of adherence to lifestyle modifications and medication therapy.
