Clinical Practice Guideline Policy
Question
Research and
Statistical Analysis
Appraising a Clinical
Guideline
At the completion of this assignment, the learner
will:
- Demonstrate
the ability to concisely summarize a clinical practice guideline.
- Develop
an appropriate appraisal.
- Analyze
the evidentiary strength and quality of guideline recommendations.
- Make
recommendations for policy or practice change based on the analysis.
The following are links to two guidelines. You may choose
one (1) of these to analyze.
https://www.guidelines.gov/summaries/summary/49491
Read the guideline and do the following:
1. Briefly summarize the guideline and
include the nursing issue or health issue the guideline addresses, specific interventions
considered for inclusion in the guideline, the major expected outcomes from
using the guideline and the targeted population for which the guideline is
intended. (This must be in narrative form, not a list. (40 points)
2. Describe in detail and in your own
words the methodology, or process, that was used to develop the guideline. (15
points). This should include the following:
- Search method
used to find articles
- What
inclusion/exclusion criteria were used to limit article numbers
- Final number
of articles used
- Method used
to analyze the articles (e.g., systematic review)
- Method used
to form the recommendations
- Statement of
external peer/public review for validity
3. List each recommendation contained in
the guideline (If there are more than 3 recommendations, limit the number to 3).
Describe the level(s) of evidence (quality) and strength of evidence that
support each recommendation (Because different organizations view levels of
evidence in different ways, use the levels of evidence as described in the
specific guideline). Recommendations should lead to outcomes that are
measureable (10 points)
4. Looking at the criteria for appraising
a guideline, appraise the guideline using the AGREE Grid for Guideline
Appraisal (attached) (25 points)
6. Think about how you could use the guideline to recommend changes in your practice area based on the evidence you have obtained (10 points).
Appraising
a Clinical Guideline
The following are criteria by which one evaluates the
quality of a clinical guideline. As you
read the guideline, use the modified AGREE format to appraise its strengths and
weaknesses. If you rate anything lower than “Completely Meets Criteria”, you
need to provide a brief rationale for your rating. (modified from: Hanson, Hoss, & Wesorick,
2008)
Scoring
Each section of a guideline is rated according to the following:
Completely
Meets Criteria |
Partially
Meets Criteria |
Insufficiently
Meets Criteria |
Score as Insufficiently Meets Criteria if there is no information
that is relevant to the item or if the criteria are very poorly reported. Give
rationale why you chose this category.
Score as Completely Meets Criteria if the quality of reporting is
exceptional and easily understood.
Score for Partially Meets Criteria is assigned when the reporting
of the item does not address the item fully. A score is assigned depending on
the completeness and quality of reporting. Give rationale why you chose this
category.
1. Quality and Purpose: The overall objective,
clinical question, and patient population are specifically described.
Completely
Meets Criteria |
Partially
Meets Criteria |
Insufficiently
Meets Criteria |
|
|
|
2. Stakeholders:
Development group has appropriate credentials, users of the guideline are
identified appropriately, users of the guideline have provided a peer review.
Completely
Meets Criteria |
Partially
Meets Criteria |
Insufficiently
Meets Criteria |
|
|
|
3. Rigor of
Development: The method used to search for evidence is clearly described,
including key terms and databases used, inclusion and exclusion criteria,
process for selecting articles, and final number of articles considered.
Completely
Meets Criteria |
Partially
Meets Criteria |
Insufficiently
Meets Criteria |
|
|
|
4. Rigor of
Development: Method for formulating recommendations is clearly described,
recommendations are specific and clearly linked to the evidence, each
recommendation is supported by an appropriate rating scheme, recommendations
have undergone external review.
Completely
Meets Criteria |
Partially
Meets Criteria |
Insufficiently
Meets Criteria |
|
|
|
5. Implementation: Barriers to implementation
and/or cost implications are clearly considered.
Completely
Meets Criteria |
Partially
Meets Criteria |
Insufficiently
Meets Criteria |
|
|
|
6. Editorial independence: Guideline developers
are independent from the funding organization and any conflicts of interest of
developers clearly described
Completely
Meets Criteria |
Partially
Meets Criteria |
Insufficiently
Meets Criteria |
|
|
|


Solution
linical
Practice Guideline Policy
1.
Guideline Summary
Best
evidence statement (BEST) aims at assessing nurses providing care or education
in healthcare facilities. The directive examines if the participation in the mentoring program as well as team building enhances satisfaction and retention of nurses.
The target population of the BEST guideline is the registered nurses providing
care or education in care settings (NGC, 2013).
The guideline was obtained from the electronic database and was reviewed by two
independent reviewers to determine its validity.
BEST examines primary points of care and does not preclude care modalities of
studies published after the current revision of the guideline. The document is
applicable in management and staff collaboration to facilitate the
establishment of the criteria that allows one to become a mentor and the
process of formulating a mentorship program. Conflicts of interests, as well as
financial disclosures, are also presented
in the guideline whereby dispute of
interest forms are filed with no
financial conflicts of interest (NGC, 2013).
The direction offers multiple sessions that are crucial for the nurses to support
the sustainability of the mentoring program.
2.
Methodology Used to Develop BEST Guideline
The electronic
databases that include Medline, CINAHL, Google Scholar and OhioLink were used
to obtain credible information sources to develop the guideline. The search keywords were used such as nurse relationships,
team building, nurse retention, and healthy
work environment. The results were filtered
in the English language with no date
limit. The inclusion and exclusion criteria were
based on the table of evidence levels that indicated the strength of the
evidence presented in each source. The guideline does not specify the number of
the source documents obtained after the search. However, 13 references were selected to support the
recommendation. Review of published
meta-analysis and systematic review approaches were used to analyze the
articles, while expert consensus strategy was used to formulate a proposal (NGC, 2013).
The statement for external review for validity indicates that two independent reviewers have reviewed the BEST
against quality from CCHMC Evidence Collaboration.
3.
Recommendations
Strength |
Recommendation |
It
is strongly recommended that |
When
applying the strength of the evidence for the judging dimensions, there is
the high support that benefits and
outweighs risks as well as burdens. |
It
is recommended that |
When
applying the strength of the evidence for the judging dimensions, there is a
presence of moderate support that benefits and are carefully balanced with the burdens and risks. |
4.
Appraising BEST Guideline
1.
Quality and Purpose: The overall objective, clinical question, and patient
population are accurately described.
Completely Meets
Criteria |
Partially Meets
Criteria |
Insufficiently
Meets Criteria |
|
AGREE The guideline
gives objective and clinical question but lacks patient population on the
applicability of the approach. Instead,
it describes its use by the nurses. |
|
2. Stakeholders: Development group has
appropriate credentials, users of the guideline are
identified appropriately, and users of the guideline have provided a peer review.
Completely Meets
Criteria |
Partially Meets
Criteria |
Insufficiently
Meets Criteria |
AGREE |
|
|
3. The rigor
of Development: The method used to search for evidence is clearly described, including key terms and databases used, inclusion and
exclusion criteria, the process for
selecting articles, and a final number of
articles considered.
Completely Meets
Criteria |
Partially Meets
Criteria |
Insufficiently
Meets Criteria |
|
AGREE The guideline
provides the key terms, databases and inclusion and exclusion criteria, but
fails to give the final number of articles selected. It only lists 13 sources
supporting recommendations. |
|
4. The rigor
of Development: Method for formulating recommendations is clearly described, recommendations are specific and clearly linked to the evidence, each recommendation is supported by an appropriate
rating scheme, and proposals have
undergone external review.
Completely Meets
Criteria |
Partially Meets
Criteria |
Insufficiently
Meets Criteria |
AGREE |
|
|
5. Implementation: Barriers to implementation and
cost implications are explicitly considered.
Completely Meets
Criteria |
Partially Meets
Criteria |
Insufficiently
Meets Criteria |
|
AGREE The guideline
presents the cost implications but fails to clearly identify challenges or
barriers faced during the implementation process |
|
6. Editorial independence: Guideline developers
are independent of the funding
organization and any conflicts of interest of developers clearly described.
Completely Meets
Criteria |
Partially Meets
Criteria |
Insufficiently
Meets Criteria |
|
|
AGREE The guideline
does not clear regulations governing developer’s
independence. Instead, it only presents the copyright policy that controls instructions posted on the National Guideline
Clearinghouse (NGC) |
5.
How to use the Guideline to Recommend for Changes Nursing
The BEST guideline
is essential in nursing collaboration and
management through the establishment of
the criteria followed by a nurse to become a mentor as well as formulating the
framework of the mentorship program (NGC, 2013).
The guideline may also be used to match new nurses with a mentor and to specify
duration within which the new nurses should work under a mentor. The directive
is also helpful in designing team building sessions. As articulated by Pipe et al. (2012), the process incorporates
identifying the appropriate location and schedule for the sessions as well as the convenient nurses to
attend. The BEST guideline can also be used to change the current mentoring
program for the new nurses by utilizing hospital human resource department to
oversee the mentorship and team building
interventions. The use of BEST strategy will ensure that nurses receive
directions from their respective mentors to carry out their day to day care activities.
References
National Guideline Clearinghouse (NGC). (2013, Mar.
25). Best evidence statement (BESt). Team building and mentoring for increased
satisfaction and retention. Retrieved from
https://www.guidelines.gov/summaries/summary/44353/best-evidence-statement-best-team-building-and-mentoring-for-increased-satisfaction-and-retention?q=guidelines+for+nurse+educators
Pipe, T. B., Buchda, V.
L., Launder, S., Hudak, B., Hulvey, L., Karns, K. E., & Pendergast, D.
(2012). Building personal and professional resources of resilience and agility
in the healthcare workplace. Stress and Health, 28(1),
11-22.



About Author
Tough Essay Due? Hire Tough Essay Writers!
We have subject matter experts ready 24/7 to tackle your specific tasks and deliver them ON TIME, ready to hand in. Our writers have advanced degrees, and they know exactly what’s required to get you the best possible grade.
Find the right expert among 500+
We hire Gradewriters writers from different fields, thoroughly check their credentials, and put them through trials.
View all writers