APNs must determine the strength of the recommendations and guidelines to regulate whether policy changes are warranted
APNs must determine the strength of the recommendations and guidelines to regulate whether policy changes are warranted. Through this process the APN may begin with a clinical question in mind before searching the literature on the proposed changes needed. This question is typically presented in a PICO framework, which shapes how the question is searched, the outcomes intended, and timing of those outcomes (Hall & Roussel, 2017, Ch. 14). PICO stands for Patient or Population; Intervention; Comparison and Outcome.
Approximate lengths of each section outlined below.
Step 1: Introduction
A good introduction should be no more than 1 paragraph grabbing the reader’s attention providing insight to the POI and significance to the APN\\\’s role. End with a strong thesis or purpose statement. Note: the thesis should be condensed to 1 brief purpose statement.
Step 2: POI Significance:
Discuss why this POI is significant to your role as an APN. How will it change practice? Why did you select this topic? Next, discuss all 3 measures: structural, process and outcomes by comparing them to one another or identifying how/what is different. What expected structural, process OR outcome measures are you hoping to see with instituting a change in practice? You must clearly identify the measure you are evaluating in this example and it should relate directly to your POI. To see a more thorough discussion on these measures, review the following information. (2-3 paragraphs)
AHRQ Structural, Process or Outcome Measures-this link provides an overview of process, structural and outcome measures. Be sure to specify the type of measure you would expect with your implementation of EBP into practice. You must show understanding of the measure itself in your discussion.
Step 3 PICO :
You will include a PICO framework AND the clinical question in this section. Follow these directions as specified.
Outline the PICO framework by listing (do not write in a paragraph format) P-population or patients, I-intervention, C-comparison, and O-outcomes as it relates to your POI. Then develop the clinical question by including all parts of the PICO framework in the question. Be as specific as possible in both the PICO framework development and clinical question and avoid phrases such as: \\\”compared to the standard practice\\\” , or \\\”compared to the current practice\\\” because faculty do not know what the normal practice or standard practice is at your facility.
EXAMPLE: Be sure to include a heading for this section i.e. PICO/Clinical Question.
PICO -center this heading p. 48-49 APA book
P: children in the acute care setting that are between 3 and 18 years of age, not including non-verbal children
I: implementation of non-pharmacologic pain interventions i.e. (art therapy, music, dim lights, etc.).
C: pharmacologic interventions (Tylenol, motrin, narcotics)
O: more effective at reducing pain as measured by decreased pain ratings on approved pain scales, stable vital signs, behavior
Clinical Question: In pediatric patients aged 3 years to 18 years (P) is the implementation of non-pharmacologic pain interventions (I) more effective (O) than pharmacologic interventions (C ) in reducing pain as evidence by: decreased pain ratings, stable vital signs, behavior assessments?
Step 4 Tool Completion:
To provide an overview of the guideline OR position statement use the tool below. You will need to address each question or section of the tool as it applies to the required information; missing information may cause you to lose points. You must submit the completed tool with the assignment. Please attach the completed tool separately to the assignment area. Faculty need to see your analysis of the guideline for full credit. Use the link below to complete. You can save the document as a pdf, use the edit function to fill in or handwrite and scan back into the assignment area.
Evaluation Tool for Guideline OR Position Statement Word Document
Example of how to complete the tool-do not use this document for your appraisal but as a guide only
Step 5 Critique of Guideline/Position Statement:
Critique the guideline or position statement bydiscussing ALL of the following and including appropriate support from your guideline/statement selection: (2-3 pages)
(1) purpose/aim of the recommendation/position statement-are they clear, current and relevant to your population?
(2) Recommendations or objectives of the guideline/statement
(3) Who (authors, groups, organizations) developed the guideline/position statement and what biases or funding did they receive? Did the authors, groups or organization have a valued interest in the guideline, why or why not? Remember to consider the author\\\’s role professionally as part of your answer.
(4) Describe if they information is credible and justify your answer. What makes information credible? Is their truth in the data, interventions recommended, or studies used to support recommendations, how do you know?
(5) What levels of evidence were used to support each recommendation statement-look at the studies and resources used to develop the guideline or position statement. What levels of evidence were these resources/studies? Are those individual studies/resources of strong or weak on the evidence hierarchy? How do you know and does it influence the overall recommendation or guideline?
(6) Based on the level of evidence used to support the recommendation statements, is the overall quality of that evidence high/low and how does that influence your decision to implement this recommendation or practice guideline into your practice? Fully support with evidence from the literature.
Step 6 Quality Improvement:
Explain how this guideline or position statement would impact quality improvement by addressing 2 of the bioethical principles: justice, autonomy, beneficence, or non-maleficence. Students must demonstrate full understanding of each principle discussed. (1-2 paragraphs)
Step 7 Conclusion:
Conclude the entire paper by summarizing each section. Do not repeat what you did in the paper, but summarize the findings. Never include new findings in the conclusion. (1 paragraph)
Step 8 Guideline/Position Statement Attachment:
Include a copy of the full guideline or position statement as an attachment or merged to the paper after the resources. Faculty must be able to have full and direct access to your guideline or position statement to determine if you selected and analyzed accordingly on your tool to receive full credit. If you are reviewing a guideline or position statement that has been updated, than you must be sure to provide the full and original guideline/position statement for your faculty. Therefore, you may need to submit more than 1 document for step 8 to satisfy this rubric item.
Requirements: 6 pages
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