Paediatric Infectious Disease - Essay Example

Evidence-Based Practice & Applied Nursing Research of Learning Section A Review the sources of evidence In ifying the type of each source of evidence, one realizes that they could be as either a general information resource, a filtered resource, or an unfiltered resource, which contain useful information on matter relating to the medical intervention for the children suffering from acute diseases. For instance, the article by the American Academy of Pediatrics and American Academy of Family Physicians, “Clinical practice guideline: Diagnosis and management of acute otitis media,” published in 2004 can be classified as a filtered resource (AAP &AAFP, 2004). Notably, the information is based on research, about the disease, its diagnosis and possible management interventions. The second article by Block, S. L., is the journal published in 1997. “Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media, Pediatric Infectious Disease”, can be classified as an unfiltered resource, because the information it illustrates a wide range of preventive and curative measures for pediatric diseases (Block, 1997). The third article by Kelley, P. E., Friedman, N., & Johnson, C. (2007), “Ear, nose, and throat” can also be classified as a general resource (Kelley, Friedman, & Johnson, 2007). In the edition written by W. W. Hay, M. J. Levin, J. M. Sondheimer, & R. R. Deterding (Eds.), “Current pediatric diagnosis and treatment”, it can also be classified under the general resource because of its elaborate approach in managing pediatric diseases (Hay et al., 2007). The fourth article is written by G. H. McCracken, “Treatment of acute otitis media in an era of increasing microbial resistance. Pediatric Infectious Disease”, can be classified as an unfiltered resource, because the information is specific to the treatment of the disease (McCracken, 1989). Appropriateness of Each Source In essence, each source of evidence is appropriate for this nursing practice situation, because they contain research evidences of the causes, signs, management, and treatment of the acute Otitis media, which is an infectious disease (AAP &AAFP, 2004). In addition, since the parents also play a significant role in monitoring the patient’s progress, parental interviews would be appropriate sources of evidence. The parents would provide adequate information on the signs that they are able to observe from their children’s health. Block article of evidence can be classified as primary research evidence, because it contains first-hand information, which has been documented after conducting actual field study. Parental interviews are also classified as primary resource because the information is received first-hand. American Academy of Pediatrics and American Academy of Family Physicians article is classified as an evidence-based guideline. Kelly’s article could also be classified as an evidence-based guideline. McCracken’s article is classified as an evidence summary. Notably, the findings are useful for taking future intervention in eliminating acute otitis, which is an infectious disease (McCracken, 1989). Concerning implementation, the specific ways in which the findings can be implemented in clinical nursing practice is through involving the nurses, the parents and physicians. Section B Review of the article Watchful Waiting In evidence-based nursing practice, watchful waiting is an appropriate approach for treating children with acute otitis media (Kelley, Friedman, & Johnson, 2007). This is because there are signs, which the child’s guardian has to monitor as the patient recovers. Based on the evidence presented in the article, it is apparent that the use of homeopathy, acupuncture, herbal remedies, chiropractic treatments, and nutritional supplement.130, among others should be closely monitored if the desirable outcome is achieved, or not (Kelley, Friedman, & Johnson, 2007). Apparently, the practice of watchful waiting is an appropriate approach according to the American Academy of Pediatrics article. Though most guardians are skeptical and do not share the sick children’s information with the physicians attending to their children, the article indicates that disclosing such information is very important to the doctors attending to the children. The reason is that the information could influence the doctor’s decision of the kind of treatment to administer to the patients, and if there could be need to alter the medication based on the patient’s progress. Through watchful waiting, the parents could be able to note significant improvements on the patient’s health or persistence of the disease, thus enabling the doctor to stop or change the type of medication appropriate to the patient. According to Kelley, Friedman, & Johnson, 2007, the authors argued that the care giver could as well monitor the patient’s progress and share it with the responsible physicians for immediate action (Kelley, Friedman, & Johnson, 2007). It is also imperative to note that through watchful waiting, it might be easy to make future prescription, depending on the evidenced outcome of the current medical intervention. This improves the skills of the physicians handling such cases (Jewell, 2010). Notably, the guideline development for medical intervention, especially for cases of acute otitis media requires the approach, which would incline towards evidence-based recommendations from the physicians. In fact, the physicians are considered as knowledgeable and experienced in the field, therefore it makes the process of intervention easy and workable (Kelley, Friedman, & Johnson, 2007). Research outcome has proved reliable in making progress on issues relating to evidence-based approaches to nursing. In this regard, the patients are viewed as the best option for monitoring the suitability of the medical intervention for acute otitis media, since it is based on the use of practical information from the recovering patient (Melnyk & Fineout-Overholt, 2010). Section C Application of the Findings In applying the research findings to improve nursing practice in the clinic, it is important to develop the policy framework that would identify, appraise and summarize the evidences (Jewell, 2010). Indeed, this makes it easy to define the evidences and recommendations of the evidenced-based practice in nursing. The findings could also help in giving diagnosis to acute otitis media. B. M. Melnyk & H. Fineout-Overholt noted that in doing so, the clinicians and nurses would evaluate the patient’s condition from the origin of the disease, the signs and symptoms of both middle-ear effusion, and middle-ear inflammation (Melnyk & Fineout-Overholt, 2010). Notably, high quality evidence that the nurses realize from the intervention is likely to attract strong recommendations for the practitioners and the patient’s caregiver(s) so that both of them achieve the intended desires (Melnyk & Fineout-Overholt, 2010). The findings also create the compelling and clear reasons for the best alternative approaches in solving the medical problems of the patients. Concerning the ethical issues that could arise in researching and changing clinical practice guidelines, based on the evidence-based research, the clinicians have to choose the appropriate antibacterial and other preventive measures for acute otitis media (Melnyk & Fineout-Overholt, 2010). In addition, they have to review and adhere to the comprehensive guidelines, relating to the management of children suffering from acute otitis media (Jewell, 2010). Section D Ethical Issues It is within the ethical framework and requirement that the clinical officers treating cases of acute otitis media have to force a good relationship with the patients and their care givers so that they can achieve mutual relationship (Kelley, Friedman & Johnson, 2007). It also requires the clinicians to follow the recommendations strictly to be able to minimize cases where the clinicians use undue approaches in treating the medical condition. Therefore, Ethics should be upheld at all level of the medical intervention for the diseases. Taking into an account the fact that the evidenced-based approach deals with the people, the ethical concerns takes the center stage, because the people view the process in different directions. The staff should therefore make sure that the clients are attended to, in a manner that does not delude them of self-respect and worthiness. The issues of vulnerable populations, confidentiality, and informed consent have to be considered especially when research involves children. According to the research that Block conducted, the parents have to give consent on the kind of medication that the patients have to undergo. For instance, when the research involves children, they might be young to give consent on the kind of medication administered to them. Kelley, Friedman, & Johnson also noted that the parents’ informed consent and preferences play an integral role in decision making about the treatment option that the clinicians should take. Secondly, the treatment of the vulnerable persons has to be highly confidential to maintain his/her integrity and that of the guardians. It is only through confidentiality that the patients would feel comfortable with the treatment that they receive (Melnyk & Fineout-Overholt, 2010). In addition, they might feel free to share the unseen medical sings of the diseases with their doctors, for the latter to find more appropriate ways of prescribing medication for the patients. In this regard, the physicians provide nose, ear and throat treatment to the infected people according to the prescription and guidelines. This, according to Kelley, P. E., Friedman, N., & Johnson, C., improves the effectiveness of the treatment services, thus catering the needs of vulnerable people (2007). References American Academy of Pediatrics & American Academy of Family Physicians, (AAP &AAFP). (2004). Clinical Practice Guideline: Diagnosis and Management of Acute Otitis Media. Retrieved Jan 30, 2012, from Block, S. L. (1997). “Causative Pathogens, Antibiotic Resistance and Therapeutic Considerations in Acute Otitis Media.” Pediatric Infectious Disease Journal, 16, 449– 456. Hay, W. W., et al. (2007). Current Pediatric Diagnosis and Treatment. (18th Ed.). New York: Lange Medical Books/McGraw-Hill. Jewell, D. V. (2010). Guide to Evidenced-Based Physical Therapist Practice, (Second Edition). New York, NY: Jones & Bartlett Learning. Kelley, P. E., Friedman, N., & Johnson, C. (2007). Ear, Nose, and Throat. New York, NY: Ediciones Universitarias Press. McCracken, G. H. (1998). “Treatment of acute otitis media in an era of increasing microbial resistance.” Pediatric Infectious Disease Journal, 17, 576–579. Melnyk, B. M & Fineout-Overholt, H. (2010). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. New York, NY: Lippincott Williams & Wilkins. Read More