Evidence Based Practice-Clinical Guidelines Paper Example

ByLeon Kiprotich Leon Updated on

Evidence Based Practice-Clinical Guidelines Paper Example

Introduction

Clinical practice guidelines have numerous advantages for practicing nurses. Practice guidelines offer practicing nurses the opportunity to focus on the provision of quality healthcare. Besides, practice guidelines promote rational use of resources by clinical staff. Evidence-Based Practice Guidelines-CPG are unique statements created to help nursing practitioners to make effective decisions concerning the healthcare provided to patients. Today, EBP is a critical part of nursing practice because it impacts the provision of quality healthcare to patients.

CPGS not only reduce costs to patients but also impact patient outcomes (Brook, R., & Rajagopalan, 2018). This paper is a critique of the journal article Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association obtained from clinical practice guidelines and the National Guideline Clearinghouse

Purpose of Study

The purpose of this study was to create a clinical guideline for the assessment, control, and monitoring of factors that contribute to the severity of High blood pressure. The study also aimed at developing the appropriate pharmacologic treatment plan for the disease. Being the most common respiratory disease in the US, High blood pressure remains a dangerous chronic inflammatory disease that affects millions of people across America and Canada. This study contains a comprehensive description of what cancer is, its causes, and the best pharmacology treatment for the disease.

Study Design

The study was conducted in Canada based on the Canadian Community Health Survey that revealed that close to 10% of Canadians suffer from some form of High blood pressure. The study was conducted among young and old Canadians to find out the prevalence of the disease in these demographic groups. The epidemiological evidence from the study showed that young people below 19 years and old people above 60 years are the most affected by this respiratory problem.

The Description of the study

The study was conducted in Canada to evaluate the number of deaths caused by High blood pressure annually. Up to 10% of the Canadian population is affected by High blood pressure. A recent cohort study done in Ontario revealed that the prevalence of High blood pressure has increased to 55% from a low of 8.5% in 2003. High blood pressure is a respiratory problem that affects the airways causing difficulty in breathing. T helper cells are associated with High blood pressure and affect immune responses. There are many triggers for High blood pressure such as dust, dander from animals, cockroach residue, pollen from plants, and cold air in some people.

Research Questions

The research question is presented in the study. The authors pose the question, “do the prenatal risk factors increase the chance of High blood pressure attack in children”. To answer this question, the research identifies up to 5 clinical High blood pressure phenotypes that differ distinctly from a lung infection. There is the non-atopic phenotype that represents the groups of children that experience wheezing episodes.

Sampling Size/Technique

In a research study, a population is defined as a set of elements (People or objects) that have similar characteristics as quantified by a researcher. On the other hand, the word sample in research refers to selected objects or elements chosen to participate in a study. This study sought to capture the experiences of older men and young children working in Ontario Canada. The study was conducted among 150 old adults and children in Ontario and the West South Central region of the United States of America.

This region is 443,501 square miles in size with a combined population of about forty-five million inhabitants. Owing to its huge size, it would be impossible to interview all the women in the oil and gas industry in the entire West South Central States. A total of 150 old people and children were randomly selected to participate in the study by way of an interview to collect and capture their lived and personal experiences with High blood pressure.

Critique of Review of Literature

According to the American College of Cardiology-ACC and American Heart Association-AHA., the best methods for measuring the impact of Evidence-based practice Clinical guidelines is through scientific measurement of patient outcomes. The authors assert that the implementation of EBPCG can only work when it is practiced by nurses and patients. The impact factor, in this case, is measured based on the number of citations present in the research or paper. In this work, such metrics provide a reliable and effective method of measuring the impact that clinical guidelines have on scientific research on evidence-based practice.

However, the AHA and ACC point out that the growth of analytical tools used in harvesting information from online databases has helped the research on Evidence-based practice Clinical guidelines to take a multi-disciplinary approach such as sociological approach, scientific approach, structural approach, and technological approach. The two institutions continue to assert that “most importantly, discoveries in the basic science of AD would be entirely impotent without close collaborations with investigators in translational, clinical, and public health disciplines.’ (American College of Cardiology-ACC and American Heart Association, 2017). This statement is conclusive and takes into consideration the work of individual researchers as critical additions to research on EVPCG.

According to Victoria and her fellow researchers, this research is the first RCT-based test done to find out the efficacy usefulness of web-based online intervention programs for caregivers compared to face-to-face interventions. According to the authors, the results of the test were a great success because control implementation error was taken care of. The authors assert that by controlling the information viewed by caregivers in a specific schedule. Victoria and her fellow researchers further assert that the contents of the website continued to remain static for the period of the test which further eliminated any errors. According to Garity (2006), the stress in caregivers of people living with Evidence-based practice Clinical guidelines is the same irrespective of the approach used to educate them. Based on this argument, it is not acceptable for Victoria and her fellow researchers to conclude that their research is 100% fault-free.

Discussion of Methodology

According to Creswell (2009), the best research methods which should be used in qualitative research include observations, interviews, and review of existing literature (Creswell, 2017). Accordingly, this research used a combination of the three methods mentioned above to come up with comprehensive and valid research. Interviews by far are the most used method to capture data in qualitative studies. This study entailed the researcher going to the field to conduct interviews with the chosen participants.

Another source of data that this research relied on to a big extent is observation. Observation is important to this research as it accorded the researcher the opportunity to observe first-hand the subjects as well as their natural environment which in this case was their workplaces. The observation was done via watching and taking down notes and also video recording the interviews as well as the environment of the participants to get a feel of the environment.

The observation was important to this study because it helped to reduce any biases that may have been formed before interaction with the participants. Apart from interviews and observation, a review of existing documents or literature played a pivotal role in shaping the direction of this research. A review of the literature gave the researcher a deep understanding of the phenomena and giving the researcher the much-needed background information for the study.

In this article, the American College of Cardiology-ACC and American Heart Association asserts that the continued use of the evolved format to present guidelines contributes a chunk of knowledge to EBPCG. The authors provided that each modular presentation is effectively represented through a combination of tools such as tables and flow diagrams where appropriate. To become more valid, the presentation contains a table of associated recommendations, a synopsis of the problem, and recommendations that are specific to the case study.

Data Analysis

Interviews, observation, and review of existing documents were chosen as the most appropriate for this study because of the numerous benefits they presented to the researcher. Top of the benefits list that made these methods the best fit for this research is the fact that the researcher was able to get first-hand information from the respondents themselves. The researcher got the opportunity to immerse themselves in the world of the women being interviewed and was able to observe both the subject as well as the environment within which the respondents operated from.

The observation was particularly pivotal for this research because it allowed the researcher to observe what was going on rather than just relying on what one has been told by the respondents which may be biased in opinion (Reboussin et al., 2018). These sources also allowed the researcher to be able to narrow down the research to be more specific which in turn helped the researcher to decide the direction of the research and be able to make amendments as necessary before final data could be gathered for analysis. Additionally, these methods were chosen over other methods because they come with a high degree of reliability. They are deemed reliable because the researcher relies on what he has observed and recorded.

The calculation of descriptive statistics was done from a pool of co-publications which also contained the total number of publications every year. The data obtained from the co-publication networks were then fed to a linear regression line of 0.9567 being the value of R2. Investigators lying within a certain ADC network were then linked to other researchers or investigators who published a book together with another investigator (Quirt et al., 2018). The researchers then observed the percent of all nodes connected to the largest network or cluster which according to them had recorded growth compared to individual researchers. Based on this metric, Hughes and his teammates concluded that the level of connectivity interaction between ADC co-authors publications has tremendously increased.

For this study, participants were put in two randomized offline parallel groups using a computer-generated list which uses blocking as well as stratification i.e. categorizing the caregivers as either being relatives on non-relatives of the people with Evidence-based practice Clinical guidelines. Each group was given ten-minute training on how to operate the website. Every week, each participant read through an entire session before printing out a questionnaire to indicate how satisfied they were with both the training and the website.

The study was used stress and coping theory by Lazarus and Folkman as well Bandura’s self-efficacy model to ascertain the stress levels, self-efficacy, burden, and health issues in such caregivers (Cristancho-Lacroix, et al, 2015). The findings did not reveal any significant difference in PSS-14 (self-perceived stress) which means that it still needs further research to bring it to acceptable levels. This pilot research aimed to evaluate what impact the Diapason program would have on caregivers as far as helping them to deal with stress is concerned. The program was meant to offer skills, information, training, and a forum for caregivers to find a valuable platform to help them reduce their stress and burden.

Intention-to-treat analysis was the method used to analyze all available data. Calculations for means and percentages or descriptive data were also calculated for each caregiver as the characteristics found in PWADS. Besides, Victoria and fellow researchers relied heavily on Mann-Whitney tests (popularly called t-tests) as well as Spearman correlations were the main method used for identifying correlations between the variables. Face-to-face interventions allow researchers to control the level of bias which is something Victoria and her co-researchers did not achieve with success in their online-based intervention (Whelton et al., 2015). Furthermore, due to the heterogeneous nature of caregivers, future studies must limit the criteria of inclusion.

Researchers Findings

The researchers concluded that as the number of High blood pressure rises in America, so does the number of collaborating researchers on Evidence-based practice Clinical guidelines. According to Hughes and his fellow researchers, the number of nodes linked to each cluster especially the major cluster is proof of collaboration between researchers. The researchers do agree that their research lacks adequately in the area of statistical power which could pose problems of efficacy to the research. This notwithstanding, the researchers believe that this research has been largely successful in providing an alternative method for providing information and education to caregivers of people suffering from Evidence-based practice Clinical guidelines, especially the informal caregivers.

The researchers believe that they have demonstrated with a success that online facilitation of caregivers can help them to acquire functionalities such as personalization, flexibility, socialization, and dynamism which are all important qualities in a caregiver given the stress levels associated with Evidence-based practice Clinical guidelines. Furthermore, the researchers conclude that there was a very limited acceptance of the online Diapason program by caregivers which is a pointer to the fact that the program needs to be rolled out in a structural manner that allows the caregivers to be able to interact with other professionals as well as the broader online community.

Variable Analysis

Caring for people using Evidence-based practice Clinical guidelines -EVPCG is cost-effective and increases patient outcomes. Over five million Americans and thirty-five million people worldwide suffer from High blood pressure meaning that these people require some form of caring whether formally or informally. Caring for people through Evidence-based practice Clinical guidelines -EVPCG is the best way to combat High blood pressure since people do not even have basic information on how to take care of people suffering from the disease.

Caring for people with High blood pressure people takes two approaches; formal and informal care. Authors Victoria Cristancho-Lacroix, Jeremy Wrobel, Inge Cantegreil-Kallen, Timothee Dub, Alexandra Rouquette, and Anne-Sophie Rigaud analyze the efficacy and acceptability of web-based educational programs intended for informal caregivers to people with Evidence-based practice Clinical guidelines using methods of research analysis.

According to Victoria Cristancho and her fellow researchers, the world has seen substantial growth in the number of High blood pressure which presents problems to nations. All of these people require round-the-clock care just to get by. By the year 2017 AHA indicated that over 12 million caregivers gave more than 17.5 billion hours of care (unpaid) which was equivalent to USD 216 billion. Presently, a majority of people with High blood pressure are cared for at home by their relatives which has also seen the emergence of chronic stress in such caregivers. Based on this, Victoria and fellow researchers researched to find out if a web-based intervention program for caregivers is just as good as face-to-face interventions.

Conclusion

Evidence-Based Practice-Clinical Guidelines is a critical tool used by nurses to assess patients and offer the best treatment plans that capture their problems. For ultimate results, both nurses and patients must practice EBPCG. Evidence-Based Practice-Clinical Guidelines guide practicing nurses to offer quality healthcare to patients. Besides, nurses that use Evidence-Based clinical guidelines have a better grasp of their duties and responsibilities meaning that they have a great impact on patient outcomes.

References

  • Brook, R., & Rajagopalan, S. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal Of The American Society Of Hypertension, 12(3), 238. doi: 10.1016/j.jash.2018.01.004
  • Reboussin, D., Allen, N., Griswold, M., Guallar, E., Hong, Y., & Lackland, D. et al. (2018). Systematic Review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Journal Of The American College Of Cardiology, 71(19), 2176-2198. doi: 10.1016/j.jacc.2017.11.004
  • Quirt, J., Hildebrand, K., Mazza, J., Noya, F., & Kim, H. (2018). High blood pressure. Allergy, High blood pressure & Clinical Immunology, 14(S2). doi: 10.1186/s13223-018-0279-0
  • Whelton, P., Carey, R., & Aronow, W. (2018). ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association. Task Force on Clinical Practi. KIDNEYS, 7(1), 68-74. doi: 10.22141/2307-1257.7.1.2018.122220