Evidence based nursing
Competency 724.8.3: Research Integration - The graduate recognizes the significance of applying research in evidence-based practice, recognizes sources of evidence, and applies ethical principles to evidence-based practice research.
Objectives: 724.8.3-01: Recognize appropriate sources of evidence for nursing practice. 724.8.3-02: Describe ethical principles applicable to a given research task in evidence- based practice. 724.8.3-03: Classify specified clinical knowledge elements as primary research evidence, evidence summary, or evidence-based guideline. 724.8.3-04: Apply specified evidence-based clinical practice guidelines to determine appropriate care in a given situation. 724.8.3-05: Apply specified research findings to improve nursing practice in a given situation.
Introduction:
Recent clinical guidelines suggest that watchful waiting is better than immediately beginning treatment with antibiotics when a child presents with otitis media. A group of nurses in the outpatient clinic decide to use evidence-based research for this practice to help them understand whether this is the appropriate care for the children they see. If they find it is grounded in the research, they will suggest a change in the clinical policy guidelines. They are aware that this policy may be a concern for parents who are used to getting antibiotics immediately when they bring their children to the clinics.
The nurses brought the following sources of evidence to their first meeting:
Note on retrieving articles for this assessment:
§ AAP/AAFP (2004) is retrieved from the web address provided within the citation below.
§ Block (1997), Kelly et al., (in Hay 2007), and McCracken (1998) are all loaded in the undergraduate Nursing EReserves of the WGU library ready for you to download.
§ ‘Interviews’ are fictitious evidence that can represent evidence brought by a nurse in any format that you want to apply for this assignment, such as anecdotal evidence/clinical experiences shared by the nurse.
Task:
A. Review the sources of evidence listed above and do the following: 1. Classify the type of each source of evidence as either a general information resource,
a filtered resource, or an unfiltered resource. 2. Discuss whether each source of evidence is appropriate for this nursing practice
situation. 3. Classify each source of evidence as primary research evidence, evidence summary,
evidence-based guideline, or none of these.
B. Review the article (see “Clinical Practice Guideline” attached below) and do the following:
1. Discuss whether watchful waiting is an appropriate approach for treating children with acute otitis media, based on the evidence presented in the article.
C. Discuss how you would apply the findings in the attached article to improve nursing practice in the clinic.
D. Discuss ethical issues that could arise in researching and changing clinical practice guidelines, based on the evidence-based research. 1. Include issues of vulnerable populations, confidentiality, and informed consent when
research involves children. E. When you use sources, include all in-text citations and references in APA format.
ESSAY KEY POINTS TO INCLUDE:
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If the candidate uses sources, the candidate provides appropriate in-text citations and/or references with no readily detectable deviations from APA style, OR the candidate does not use sources. |
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American Academy of Pediatrics and American Academy of Family Physicians. (2004.) Clinical practice guideline: Diagnosis and management of acute otitis media. Retrieved May 17, 2008, from http://aappolicy(dot)aappublications(dot)org/cgi/content/full/pediatrics;113/5/1451
• Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic
considerations in acute otitis media. Pediatric Infectious Disease Journal, 16, 449–456. • Kelley, P. E., Friedman, N., Johnson, C. (2007). Ear, nose, and throat. In W. W. Hay, M.
J. Levin, J. M. Sondheimer, & R. R. Deterding (Eds.), Current pediatric diagnosis and
treatment (18th ed., pp. 459–492). New York: Lange Medical Books/McGraw-Hill. • McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing
microbial resistance. Pediatric Infectious Disease Journal, 17, 576–579.
• Results from interviews with parents who have brought their children into the clinic for
acute otitis media.
Student:
Professor:
Course title:
Date:
Evidence based nursing
Part A
Source 1: American Academy of Pediatrics and American Academy of Family Physicians. (2004). Clinical practice guideline: Diagnosis and management of acute otitis media.
Filtered source: this article represents evidence that is based upon views on Acute Otitis Media (AOM). As such, informed and sound decisions could be made regarding the care required in treating Acute Otitis Media, for instance the use of antibiotics or the wait and see method. This filtered source is appropriate for this nursing practice situation since it discusses various studies carried out suggesting that watchful waiting is apt whenever treating cases of otitis media that are not complicated. Nurses could utilize this resource in providing education to parents and carers of children with otitis media. This particular source is classified as evidence-based guideline given that it contains a number of research articles and reviews them systematically to provide appropriate recommendations to clinicians.
Source 2: Block, S. L. (1997). Causative pathogens, antibiotic resistance, and therapeutic considerations in acute otitis media. Pediatric Infectious Disease Journal, 16, 449–456.
Unfiltered source: this article was obtained from the biomedical database. This second source is appropriate since it provides a discussion on pathogens which have become resistant to antibiotics. In essence, becoming resistant to antibiotic continues to be more prevalent within the pediatric population, hence education to parents in regards to needless usage of antibiotics is imperative in order to avoid this problem (Block, 1997). It is an Evidence Summary source primarily because it has a summary of resources and references utilized to make up this article.
Source 3: Kelley, P. E., Friedman, N., Johnson, C. (2007). Ear, nose, and throat. In W. W. Hay, M. J. Levin, J. M. Sondheimer, & R. R. Deterding (Eds.), Current pediatric diagnosis and treatment (18th ed., pp. 459–492). New York: Lange Medical Books/McGraw-Hill.
General Information: the article was derived from a text book. This source is also appropriate; nurses could utilize this source in finding background information associated with AOM for instance symptoms and signs, causes, as well as treatment (Kelley, Friedman & Johnson, 2007). It is not appropriate for this nursing practice situation since the information contained therein is not up-to-date or current which could be relevant to the diagnosis of acute otitis media by doctors. The article is classified as Summary of Evidence.
Source 4: McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. Pediatric Infectious Disease Journal, 17, 576–579.
Filtered source: this is because it was filtered for addition in a journal that is peer-reviewed. It is appropriate for this nursing practice situation given that the author of this article aimed at establishing the most effectual techniques toward the treatment of AOM. The author also sought to establish the chief reasons regarding why the causative agents for AOM are becoming more and more antibiotic resistant (McCracken, 1998). This article is classified as primary research evidence, and this is underpinned by features of the article including primary data collection.
Source 5: Results from interviews with parents who have brought their children into the clinic for acute otitis media.
General information resource: this source of evidence does nothing more besides classifying the views of parents concerning the condit...