Critical Appraisal of EBP Guideline
Project instructions:
Assignment: Critical Appraisal
This assignment allows you to critically appraise an Evidence Based Guideline (EBG) associated with a topic in nursing that is related to your population, focus area, personal interest, or problem that you have seen in practice that you think needs to change. Ideally, you could focus on a similar topic area that you have already been researching through your prior searches this semester (qualitative and quantitative papers).
To assist you in thinking about a guideline topic to search consider the following questions:
1. Who is my population?
2. Are there any specific problems that I have identified (or administration, educators, and/or other clinicians have identified) as an issue in the unit I work in and no current policy exists to solve the problem?
In this assignment, you will be asked to critically appraise the guideline selected using the AGREE Tool. You will also evaluate process and outcome measures related to the guideline. While both are equally important, the process measure typically leads to the outcome measures. Thoroughly looking at the process is key to determining if those processes leading to the outcomes are both effective and efficient. Therefore, the process should be measured by determining if the overall objective was met or unmet. Looking at the process is a fundamental step to understanding whether a problem exists with the underlying structure already in place. Process measures can help distinguish measures of quality care.
In comparison, measuring outcomes and connecting them to the nursing action is an important component of evidence based practice and thereby establishing quality improvement. Outcome measures will reveal how the process worked or did not work. An outcome may be short or long term, physical or physiologic (Heart rate, blood pressure). Essentially, outcomes serve as the end result to a particular change initiated to a patient, population, community, or facility. Outcome measures provide information about whether improvements are needed to enable a practice to be more effective.
When you think of an outcome measure you are specifically referring to the dependent variable which will measure the outcome of the intervention. These outcomes may be desirable or undesirable changes and can occur specifically in a single patient, group of patients/population. The outcomes occur as a result of the health care itself and may include a change in behavior, improving health promotion activities, patient satisfaction or even family satisfaction. However, when looking at the outcome measures, one must be careful that the quality is not overlooked. For example, if one was looking at whether providing an incentive spirometer on all patients immediately upon transfer from the recovery room to the floor helped reduce the number of pneumonia incidences, only the result of pneumonia diagnoses would be needed. However, despite the intervention possibly creating a reduction in pneumonia cases diagnosed in post-operative patients, the quality of that care would not be seen in the outcome measure. Data would only represent the number of associated pneumonia cases in post-operative patients. The process of when it was initiated, who initiated (respiratory therapy or the nurse), how often it was performed, etc. would not be determined unless you looked at the process measures of this intervention. Therefore, when reviewing your guideline, you must look at both how the process and outcomes will influence the intended change you desire.
Searching for an Evidence Based Practice Guideline:
Try searching for a guideline by searching topics of interest at the following sites:
www.guideline.gov
https://www.rnao.org/Page.asp?PageID=861&SiteNodeID=133
After you have found a guideline that is current (within 3 years) and applicable to your practice area, use the AGREE tool to complete the appraisal.
Go to: AGREE Tool:
https://www.agreetrust.org/wpcontent/uploads/2013/06/AGREE_II_Users_Manual_and_23-item_Instrument_ENGLISH.pdf
You will need to complete the AGREE tool which you will attach to your paper as an appendix. Then you will need to discuss how to apply the guideline to practice, why or why not, define the process and outcome measures.
The total length of this assignment should not be more than 8 pages (excluding title page, appendix and references). Please submit your title page, paper, appendix, turnitin report, and copies of the EBP guideline as a merged copy to the Assignment Section of the course by the due dates listed in the course schedule.