Self-Assessment Quiz Question #8 Which of the following statements about translating evidence into practice is true? a. EBP research questions are determined by the physician. b. Sources of evidence are limited to the literature. c. Research should add to the body of nursing knowledge. d. Using evidence to make practice changes is under the jurisdiction of the IRB. Clinical practice EBP guidelines Evidence-based guidelines —also referred to as clinical practice guidelines—are defined as systematic statements to help the practitioner and patient decide appropriate healthcare for specific clinical circumstances. The National Guideline Clearinghouse (NGC), sponsored by the Agency on Healthcare Research and Quality (AHRQ), has stated, “Guidelines are not fixed protocols that must be followed but are intended to identify generally recommended interventions to be considered by a knowledgeable healthcare provider” (National for Complementary and Integrative Health, 2021). Many professional organizations and associations have developed guidelines for their respective fields. Such guidelines are developed by panels or groups of experts who synthesize and evaluate the evidence before making recommendations for clinical practice. The American Academy of Physical Medicine and Rehabilitation has explained the need for clinical practice guidelines. According to the Academy, guidelines serve to accomplish the following (2021). ● Describe appropriate care based on the best available. scientific evidence and broad consensus. ● Reduce inappropriate variation in practice. ● Provide a more rational basis for referral. ● Provide a focus for continuing education. ● Promote efficient use of resources. ● Act as a focus for quality control, including audit. ● Highlight shortcomings of existing literature and suggest appropriate future research. Nursing consideration: Systematic reviews (SRs) of clinical practice guidelines can be valuable tools when searching for valid and reliable guidelines. They can be used to systematically identify, assess, and summarize the current state of guidance on a specific clinical topic (Johnston et al., 2019). Numerous clinical guidelines are available from a wide variety of healthcare specialties. These guidelines are accessible via the Internet. Healthcare professionals should critique these guidelines. For example, one could ask the following questions ((Johnston, et al., 2019; University of Washington Health Sciences Library, 2019): ● Who were the authors of the guidelines? What are their credentials? Do their credentials indicate expertise in the field the guidelines address? ● Is there an identified professional association that is affiliated with the guidelines? If so, is it a reputable association? ● Is there an identified healthcare system associated with the guidelines? If so, is the healthcare system reputable? ● Are there any conflicts of interest among the authors, associations, or healthcare system and the content of the guidelines? In other words, does one or more of these entities have a monetary or other interest in the content of the guidelines? ● Do the guidelines reflect the application of the most recent scientific evidence? ● What research findings were used to develop these guidelines? Is the research valid and reliable? ● Do the guidelines contradict any valid research findings? ● Are explanations for changes from previous guidelines given? Do these explanations make sense? Are changes based on recent research findings?
Self-Assessment Quiz Question #9 The role of the IRB is: a. To design the research study. b. To determine sample size. c. To determine costs of the study. d. To ensure that ethical standards are met.
● Can the guidelines be implemented into current clinical practice without difficulty? ● Do the guidelines provide resources to help clinicians see how the guidelines were developed? Is contact information available for guideline authors so that clinicians who have questions about the guidelines or who need help with their implantation can contact the authors or other sources of help? Here are some resources that provide valuable information about locating clinical practice guidelines: ● AIDSinfo : This site has all federally approved HIV/AIDS medical practice guidelines. The guidelines are available in multiple formats and contain treatment recommendations and tables: https://aidsinfo.nih.gov/guidelines ● American Academy of Physical Medicine & Rehabilitation : This site provides timely, in-depth information about physical medicine and rehabilitation guidelines: https://www.aapmr. org/home ● American College of Physicians (ACP) Clinical Recommendations : This site contains three different types of clinical recommendations: clinical practice guidelines, clinical guidance statements, and best practice advice. The ACP’s goal is “to provide clinicians with recommendations based on the best available evidence, to inform clinicians of when there is no evidence, and to help clinicians deliver the best healthcare possible: https://www.acponline.org/clinical- information/guidelines ● American Diabetes Association (ADA) : The ADA provides the latest ADA clinical practice recommendations. These guidelines are regularly reviewed and updated: https:// diabetesjournals.org/care/issue/44/Supplement_1 ● The American Heart Association : The American Heart Association and the American Stroke Association publish medical guidelines and scientific statements on various cardiovascular disease and stroke topics: https://professional. heart.org/professional/GuidelinesStatements/UCM_316885_ Guidelines-Statements.jsp ● Best Practice Information Sheets : Joanna Briggs Institute Guidelines are produced specifically for practicing healthcare professionals and are based on the best available international research evidence as reported in systematic reviews: http://joannabriggs.org/ ● FGCU Library Database : This database is a list of practice guidelines for nursing students and licensed nurses: https:// library.fgcu.edu/az.php ● CMA Infobase : This is a Canadian database of Canadian practice guidelines and is maintained by the Canadian Medical Association. The database contains 1,200 guidelines that were developed or endorsed by authoritative medical and healthcare organizations in Canada: https://joulecma.ca/ cpg/homepage ● National Heart, Lung, and Blood Institute : This site has resources for both healthcare consumers and healthcare professionals. It provides resources to keep healthcare professionals informed about the best practices to treat and manage patient care for those persons who are affected by sickle cells, asthma, hypertension, von Willebrand disease, and cardiovascular disease, and risk reduction in youth: https://www.nhlbi.nih.gov/health-topics/publications-and- resources
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