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:

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.