Nursing Evidence Based Practice Guideline Discussion Paper

Introduction

In nursing evidence, based Practice Guideline is very crucial in maintaining the quality of treatment and care. Developing clinical knowledge and professional expertise in care standards can be achieved through evidence-based practice guidelines. The application of practical studies and clinical knowledge maximizes health outcomes. Clinical knowledge based on evidence and the development of professional skills helps in the enhancement of experiential learning. Evidence-based practice and professional decisions that can help in providing the best standards of treatment and care require valid clinical knowledge, externally established evidence, and patient preferences (Melnyk and Fineout Overholt, 2015).  The importance of research in the development of clinical knowledge and professional standards through evidence-based practice needs to be recognized. The fundamental methods, ideas, and methodologies that are involved in the research of evidence-based studies and the effective implementation in practical care of patients need to be investigated. Defining legal, ethical, and cultural factors in evidence-based practice application and knowledge involving various circumstances and individual patient cases, it is important to focus on the development of research-based clinical nursing. Nursing Evidence Based Practice Guideline Discussion Paper

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Discussion
The Type of Evidence-Based Practice Guideline

Various practice guidelines can be utilized to provide patient-centric care and treatment to the patients. In this Report, the database search and focus shall be “Guidelines for Administration of Drugs”, Rules and strategies based on this evidence-based practice shall be discussed.

Guideline Developers

The NACDA has elaborated the guideline regarding the evidence-based practice based on “Administration of Drugs”. The Institute for Blue Cross Blue Shield (BCBS) of California supported the guideline. (drugabuse.gov, 2021)

Were the developers of the guideline representative of key stakeholders in this specialty (inter-disciplinary)?

The National Advisory Council on Drug Abuse, NACDA was involved in the creation of the guidelines for this field. The use of NACDA and creating the guideline were undertaken by the stakeholder organization including main developers and publishers. The specialists in relation to CIBHS and BCBS sectors belonging from universities and colleges are members of NACDA. The interrelationship between the stakeholders and interdisciplinary participation with regard to clinical guidelines involving pain management and the use of drugs can be seen. Various aspects of guideline creation like intervention and therapy, statistics, care of fall aversion are all handled by various specialists belonging from interdisciplinary professionals in the NACDA. (blueshieldca.com, 2021)

Who Funded the Guideline Development?

The development of the guidelines was upheld and bolstered by the CIBHS, the California Institute for Behavioral Health Solutions. The non-benefit organization supports associations, funders, and supports care with evaluation, guide, and examination for individuals with challenges involving substance abuse, physical and mental ailments, and emotional well-being. NIDA, CSAT, and NIAA are some other funders. BCBS offers insurance coverage in the US to 110 million individuals, which is a medical insurance undertaking.

Were any of the Guideline Developers Funded Researchers of the Reviewed Studies?

The Guideline Developers, involved with the institutions also funded research and studies, which were developed in the California Institute for Behavioral Health Solutions (CIBHS), US Preventive Services Task Force (USPSTF), Blue Cross Blue Shield (BCBS), and NGC. The CIBHS was involved in the data meta investigation in the State of California. The researchers David Scott and Hillary McClure were from CIBHS.

Did the Team have a valid Development Strategy?

The fundamental stage of the implementation of a strategic plan involves the determination of the objectives and the intention of the research involving any modification involved in the evidence-based practice and the guidelines. The Development Strategy developed by NACDA had three goals involving reviewing the pattern, using prior directives, and ensuring rules for pain management in teenagers are included in developing the guideline. The NACDA is involved in analyzing the various states in the US and monitors the maintenance of the instructions and processes. The characteristics of the task, goal, and vision are all developed within the guide are of great importance.

Was an explicit (how decisions were made), Sensible, and Impartial Process used to Identify, Select, and Combine Evidence?

NACDA highlights the contribution and assistance of the stakeholders, funders, and guidance in terms of technical support, monetary funding, information, etc. However, it takes solo responsibility for the choices as a lone organization is presented. The final guideline is made without putting liability on the funders and other study organizations. The proof in the guidelines was meant for the experts of the NACDA and takes absolute responsibility for the data. The funders are not put up for government persecution or liability of the law. However, it acknowledges the contribution of the subsidizing members and stakeholders but the unprejudiced strategy is highlighted in terms of the use to distinguish, select and combine evidence (Kerr, & Oglesby, 2017).

Were all Important Options and Outcomes Considered?

All options and Outcomes were considered in the guideline in relation to Pain control and Drug administration. The guideline included cognitive problems, financial issues, and social aspects aligned with cognitive problems. It also considered the legal problems in relation to the guidelines (Kerr, & Oglesby, 2017). The Federal Research Regulations also needs to apply the fundamentals and guidelines in terms of informed consent of participants, concerning kids, options to withdraw, consent of parent’s confidentiality, undue incitement, consultations with the Community, etc.

Is each Recommendation in the Guideline tagged by the level/strength of Evidence upon which it is based and Linked to the Scientific Evidence?

Each recommendation in the guideline is backed by solid evidence and presented with research through the link to an external website and an URL address. The link to the scientific research is established with clinical and scientific evidence involving the educated assent segment of the guide (p 5-7). All suggestions and key information are presented and backed by qualitative evidence or quantitive numerical figures (Calderon, Hunt, & Klein, 2018). The strong clinical representation and evidence also pave the way to, make modifications o consider new suggestions. Furthermore, the recommended suggestions and room for improvisation are also linked to scientific evidence with marked level/ strength. It is sequentially numbered to make the format more comprehensible (Webb, Striley, & Cottler, 2015) Nursing Evidence Based Practice Guideline Discussion Paper

Do the Guidelines make explicit Recommendations (Reflecting value Judgments about the Outcomes)?

The Recommendations are patient-centric and should be assessed separately as per the case involved. The guideline also involves results that should be assessed separately. In the line of the suggestions regarding substance abuse in adolescents, the suggestion involves the recognization of the issue as soon as possible and stresses the need for reduction up to 67% in the duration of six months starting the follow-up. The suggestion for different case scenarios is different and the results and recommendations should be explicitly and separately assessed and considered (Darcy, 2018).

Has the Guideline been subjected to peer review and Testing?

Yes, the Guidelines have been subjected to review and testing as is highlighted by the Wiley Home Library. The reactions of important researchers and stakeholders have been documented. The partners, involved stakeholders, and researchers are acknowledged by the Editor In Chief – EIC through a note of gratitude in examining and validating the direction of research in a scientific way and evidence-based creation of the guideline before it was officially released in 2012,8th March. The Disclosure and Recognization Section enlists the examinations and reviews of the guidelines made by the NACD, Appraisal papers are presented through an external site in relation to the direction of the guideline and are included by the EIC. The rules and research were being evaluated and tested. (The National Institute of Drug Abuse’s, 2012)

Is the Intent of use provided (i.e. National, Regional, or Local)?

The intent of the use is clearly provided through the link to the external site in relation to the guideline assessment that has been involved in the purpose of the creation of the framework. The guideline and kits implementation is recommended at the domestic level including all the states in the US (Dillon, et al., 2017).

Are the Recommendations Clinically Relevant?

The recommendations involving Drug administration and prevention of drug dependency and misuse involve three approaches in treating patients with pain disorders. The treatment for addiction, family approaches, and conduct are the three main steps. The suggestion involving the practice guidelines includes different kinds of alternative therapies and several interventions as well as preventative strategies to be implemented through cognitive leadership abilities. The national center for Nursing Research uses these suggestions and recommendations and the various researches and studies that prove its effectiveness and practicality make it clinically relevant (Hammoudi, Ismaile & Abu Yahya, 2018).

Will the Recommendations help me in Caring for my Patients?

The recommendations and evidence-based practice guidelines in the case of patients with pain disorders shall help in the modification and improvement of treatment and care strategies. The evaluation and implementation of the guidelines can promote the use of alternative therapies in patients who are prone to drug abuse or have a chance of developing such addiction through motivational improvement treatment, twelve-step facilitation treatment, cognitive-behavioral therapy, and use of youth group improvement strategy. Additionally, care and special approach can be taken in prescribing pain medications and including youth in such research involving the effects of drug abuse. Multisystemic treatment, community behavioral therapy, familial functional treatment, short child strategic therapy, and dimensional family therapy approaches are also used. This shall help in preventing such abuse of drugs, help nursing professionals guide such patients in the appropriate manner, and involve therapies in their care program (Boswell,  & Cannon, 2018).

Are the Recommendations Practical/ Feasible? Are Resources (People and Equipment) Available?

The suggestions are greatly useful in guiding nursing practices ad treatment of pain management and drug administration. It is practical and feasible. The formation of end study requirements, follow-up, competency and reference, the adverse clinical findings in relation to youth and drug abuse research, neuroimaging, and genetic analysis are involved in the approach of recommendations. This evidence-based scientific approach in the recommendations of the guidelines shows that they are practical and reliable. There are also involved research and review of the research involved in the recommendations with a practical outline of the guideline and proof of evidence, ingenuity, effectiveness, and practicality. (hhs.gov , 2021).

Are the Recommendations a Major Variation from Current Practice? Can the Outcomes be measured through Standard Care?

There are no drastic changes and significant differences in the current practices and the recommendations of NACDA involving Drug Administration and prevention of drug dependencies. The three main approaches involving pain management, drug administration, and prevention of drug dependencies are being used in practice. All non-drug promotion centers and recovery institutions have the three guidelines as guiding principles for treatment approaches and courses. There are various suggestions for improvements but it does not have stark variation from the present pones and only needs some assistance.

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Conclusion

The review of the evidence-based guideline and research-backed in the study and creation of such guidelines is essential in forming the base of effective care and patient-centric approaches in the nursing profession. Implementation and knowledge of the evidence-based guidelines help in making an informed decision, minimizing error, and increasing the health benefit for the patients involved. It backs all the professional practices through a conjunction of research-based studies. This NACDA guideline with respect to pain management, drug administration, and drug abuse also involves the review and recommendations of peers and researchers with the approval of the Editor In chief for adoption and application in practical settings. The application of these guidelines can help make an informed decision, adopt alternative therapies for the patients through genetic and behavioral research evidence in terms of drug dependency, and abuse tendencies. This shall help in minimizing the drug issue and also avoid legal liabilities and maintain the clinical protocols of upholding the beneficence of the patients Nursing Evidence Based Practice Guideline Discussion Paper.

References

Bates, G. (2017). The drugs situation in Ireland: an overview of trends from 2005 to 2015. Liverpool: Centre for Public Health at Liverpool John Moores University.

Boswell, C., & Cannon, S. (2018). Introduction to nursing research. Jones & Bartlett Learning.

Calderon, S. N., Hunt, J., & Klein, M. (2018). A regulatory perspective on the evaluation of hallucinogen drugs for human use. Neuropharmacology, 142, 135-142.

Darcy, C. (2018). The Precarious Position of Drug Education Workers in Ireland. The Economic and Social Review, 49(3, Autumn), 361-372.

Dillon, L., Galvin, B., Guiney, C., Lyons, S., & Millar, S. Focal Point Ireland: national report for 2017–Drugs Ireland.

drugabuse.gov, 2021. National Advisory Council on Drug Abuse (NACDA) Approved Concepts | National Institute on Drug Abuse. (2021). Retrieved 15 January 2022, from https://www.drugabuse.gov/about-nida/advisory-boards-groups/national-advisory-council-drug-abuse-nacda/national-advisory-council-drug-abuse-nacda-approved-concepts

Hammoudi, B. M., Ismaile, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian journal of caring sciences, 32(3), 1038-1046.

hhs.gov, 2021. NACDA Guidelines for Administration of Drugs to Human Subjects | Guidance Portal. (2019). Retrieved 15 January 2022, from https://www.hhs.gov/guidance/document/nacda-guidelines-administration-drugs-human-subjects

Kerr, D. L., & Oglesby, W. H. (2017). Conducting research on adolescent substance abuse. In Research Methods in the Study of Substance Abuse (pp. 317-340). Springer, Cham.

Melnyk, B. M. & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd Ed.) Philadelphia, PA: Walters Kluwer Health.

The National Institute of Drug Abuse’s, (March 8, 2012), “NACDA Guidelines for Substance Abuse Research Involving Children and Adolescents.” Retrieved 15 January 2022, from https://www.drugabuse.gov/funding/clinical-research/nacdaguidelines-substance-abuse-research-involving-children-adolescents

Webb, F. J., Striley, C. W., & Cottler, L. B. (2015). Marijuana use and its association with participation, navigation, and enrollment in health research among African Americans. Journal of ethnicity in substance abuse, 14(4), 325-339 Nursing Evidence Based Practice Guideline Discussion Paper