Free

Clinical practice guideline: Diagnosis and management of acute otitis media - Research Paper Example

Comments (0) Cite this document
Summary
The first article (excerpt) ‘Ear nose and throat’ is a filtered source of evidence. The reason it qualifies as a filtered source is that there is pre-decided aspect involved in the study…
Download full paperFile format: .doc, available for editing
GRAB THE BEST PAPER93.2% of users find it useful
Clinical practice guideline: Diagnosis and management of acute otitis media
Read TextPreview

Extract of sample "Clinical practice guideline: Diagnosis and management of acute otitis media"

Acute Otitis Media A. Review the sources of evidence listed above and do the following: A1. Type of source of evidence The first article (excerpt) ‘Ear nose and throat’ is a filtered source of evidence. The reason it qualifies as a filtered source is that there is pre-decided aspect involved in the study. Using keywords to search it makes the evidence unfiltered, however this is a chapter with a title ‘Ear nose and throat’ from the book Current Pediatric Diagnosis and Treatment. The source is a database (published book), which pre-decides what the reader will see. As far as the question of filtering the evidence is concerned, the excerpt does offer filtered evidence. Based on the same principle of keyword and content vagueness, the other two articles, ‘Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media’, and ‘Treatment of acute otitis media in an era of increasing microbial resistance’, both published in Pediatric Infectious Disease Journal are unfiltered. The article ‘Diagnosis and Management of Acute Otitis Media’ published in the American Academy of Pediatrics And American Academy of Family Physicians and the article Diagnosis and Management of Acute Otitis Media, published in Pediatrics is filtered. Lastly the ‘parents’ interview’ is a primary source. A2. Appropriate for this nursing practice situation The article ‘Diagnosis and Management of Acute Otitis Media’ published in the American Academy of Pediatrics and American Academy of Family Physicians qualifies as appropriate for the nursing practice situation. The abstract of the article clearly states that it is an “evidence-based” clinical practice guideline that gives recommendations to primary care clinicians regarding the treatment of AOM children between the ages of 2months to 12 year olds for the managing (which is what the nursing discussion is about). The diagnosis, treatment and precautions offered are appropriate for nursing practice. For instance, the first excerpt ‘Ear nose and throat’, mentions Otitis Externa, and tells the patient if in the condition is in the acute phase; they should avoid swimming, moreover, a cotton ear plug won’t be sufficient and may spread the infection further (Kelly, Freedman & Johnson, 2007). The second article ‘Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media’ offers information on ‘isolated pathogens’ (Block, 1997) in patients, which is helpful in understanding AOM however probably not appropriate under the situation. The third ‘Treatment of acute otitis media in an era of increasing microbial resistance’ discusses more advanced treatment (Streptococcus pneumoniae) for children with AOM (McCracken, 1998), again not appropriate under current situation. Parent interviews showed that parents were comfortable if there was enough evidence to change the policy. Majority of them said that they wanted the best for their children and nurses and doctors know best what to do. A few of them did object, especially those that had some previous ‘accidents’ with antibiotics. Parent interviews are appropriate in the discussion of changing the clinic policy for it is with the consent of the parents their children will be treated. A3. Classification of each source of evidence The first article (excerpt) ‘Ear nose and throat’ from the book Current Pediatric Diagnosis and Treatment is classified as filtered, an evidence summary because it is an excerpt from a book. Sources of the knowledge in that chapter are other books (it is not explicitly written that it was a primary research). The second article ‘Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media’ from the medical journal The Pediatric Infectious Disease Journal, is an unfiltered source of evidence. The reason for this conclusion is that nothing is pre-decided here, it is proceeding from a symposium and is an ‘evidence summary’. There are key words vividly given at the start of the journal article. The third article (a journal article) is also an unfiltered source. The article titled ‘Treatment of acute otitis media in an era of increasing microbial resistance’ is also published in the journal The Pediatric Infectious Disease Journal. This article is a supplement to Current Assessment of Diagnosis and Management of Otitis Media, therefore an evidence summary. The fourth article, ‘Diagnosis and Management of Acute Otitis Media’, published in the journal Pediatrics is a published article, also available from website. It qualifies as a filtered source database. The abstract makes it quite clear what the reader should expect from this. This article is an “evidence-based” clinical practice guideline. The fifth source is ‘parent interviews’, which is a primary research evidence. B. Appropriateness of Clinical Practice Guideline Review The clinical practice guideline from the American Academy of Pediatrics And American Academy of Family Physicians journal proposes well researched recommendations. For instance, in order to diagnose AOM, the first thing a clinician should do is to confirm the history of acute onset. Next, identifying the signs of MEE, and evaluation for testing the presence of symptoms of middle-ear inflammation would be very safe and a tested procedure. This procedure is appropriate as it includes 136 references in concluding the recommendations. For instance, besides diagnosing AOM, the management of AOM must comprise a pain assessment procedure. The procedure is appropriate because ignoring pain can be very damaging for the patient as well as the condition he/she is in. If pain exists, the clinician can work toward alleviating or reducing pain. Instead of delving into the applications of the findings, it would be more helpful to understand the construction of this guideline, this way it will be much easier to categories it as appropriate or inappropriate. The American Academy of Pediatrics and American Academy of Family Physicians summoned a board of primary care physicians and talented specialists in the fields of infectious disease, otolaryngology and epidemiology. The subcommittee worked with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center for reviewing the evidence-based AOM literature. The article addresses the association of age less than 2 years with increased risk of watchful waiting fails and the fear of grave infection in children less than 6 months of age. These aspects tremendously influence “immediate antibacterial therapy” decision. Despite being a broad ranged report, the evidence is more focused toward the appropriate diagnosis and initial treatment of a child suffering from AOM. The “observation option” (watchful waiting) for AOM refers to delaying antibacterial treatment in selected children for a time period of 48 to 72 hours and restraining treatment to only management, for a symptomatic relief. The decision to watchful waiting or treating with antibiotics depends on the child’s age, diagnostic certainty, and the severity of illness. C. Application of findings The application findings boil down to three categories; A) children less than 6 months with certain/uncertain AOM diagnosis need antibacterial treatment. B) Children between the ages of 6months-2 year olds need antibacterial therapy in certain diagnosis. In uncertain diagnosis and illness is non-severe, observation option can be opted for. If illness is severe, antibacterial treatment is a must. C) For children over 2 years old, with an uncertain diagnosis, observation option can be exercised. In case there is a certain diagnosis and the illness is non-severe, observation option (watch and wait) can be exercised. However if the illness is severe, anti-bacterial therapy should be opted (please refer to page 1454 of the article ‘Diagnosis and Management of Acute Otitis Media’ for a complete discussion regarding temperature changes for watchful waiting). There are certain options while treating in a preliminary care, observation without using antibacterial agents in a child with simple case of AOM is a choice for ‘some’ children. These children must be selected based on; age, diagnostic certainty, illness severity, and guarantee of a follow-up. In case a judgment is made to treat the child with an antibacterial agent, the clinician should recommend amoxicillin. This is the general case and works effectively on most children (based on evidence). When amoxicillin is prescribed, the dose should not exceed 80-90mg/kg per day. D. Ethical issues in research For the purpose of this evidence based research, the children tested were not from a random sample, they were carefully selected. These children did not have any severe AOM illnesses. This raises no ethical issues whatsoever. Otherwise ethical issue of ‘experimenting’ with severely sick patients could arise. D1. (Ethical) Issues for vulnerable populations Voluntary participation, informed consent, risk of harm, confidentiality and anonymity are some of the major issues for vulnerable populations. All of these matters were kept in focus for the research. The research is an extraction, discussion and analysis of many previous research studies, for instance, the placebo-controlled trials of AOM over the past 30 years have been used, and they show that majority of the children do well without anti-bacterial therapy, thus raising no ethical issues. Works Cited American Academy of Pediatrics and American Academy of Family Physicians. (2004).   Clinical practice guideline: Diagnosis and management of acute otitis media. Retrieved August 27, 2012, from http://aappolicy.aappublications.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. Trochim, W. M. K. (2006, October 20). Research methods knowledge base. Retrieved from http://www.socialresearchmethods.net/kb/ethics.php Read More
Cite this document
  • APA
  • MLA
  • CHICAGO
(“Clinical practice guideline: Diagnosis and management of acute otitis Research Paper”, n.d.)
Clinical practice guideline: Diagnosis and management of acute otitis Research Paper. Retrieved from https://studentshare.org/nursing/1456315-otitis-media-clinical-practice-guidelines
(Clinical Practice Guideline: Diagnosis and Management of Acute Otitis Research Paper)
Clinical Practice Guideline: Diagnosis and Management of Acute Otitis Research Paper. https://studentshare.org/nursing/1456315-otitis-media-clinical-practice-guidelines.
“Clinical Practice Guideline: Diagnosis and Management of Acute Otitis Research Paper”, n.d. https://studentshare.org/nursing/1456315-otitis-media-clinical-practice-guidelines.
  • Cited: 0 times
Comments (0)
Click to create a comment or rate a document

CHECK THESE SAMPLES OF Clinical practice guideline: Diagnosis and management of acute otitis media

Teaching in clinical practice

.... According to Brandon and All (2010), many nurse educators continue teaching the way they have been doing, despite the need for reforms. However, pedogogical research has indicated the need for change in nursing curricula. The emphasis is to shift from traditional courses to concept-based courses which com across across clinical settings. In order to accomplish such a useful change, it is very important for the nurse teacher to understand the role of "the rapidly advancing profession" (Hamner and Wilder, 2001; cited in (Brandon and All, 2010). In using reflection as a tool for the development of the professional nursing practice, a plan can be designed to meet the goals of the reflective activity by...
10 Pages(2500 words)Essay

Otitis Media

...?Otitis Media Otitis media Inflammation of the middle ear is called Otitis media. Media means middle and otitis refers to the inflammation in the ear. The inflammation in the ear usually starts with infections that give rise to cold, sore throat or any other respiratory problems which in turn spreads to the middle of the ear. The infections can be caused by bacteria or viruses and the severity can be either chronic or acute. Otitis media that sets a rapid onset and that lasts for a short duration is called Acute Otitis media. This type of infection is usually caused by the accumulation of fluid in the middle of the ear together with symptoms and signs of ear infection. The symptom includes a perforated eardrum with drainage of pus... ...
2 Pages(500 words)Research Paper

Critical Appraisal of a Clinical Guideline

...there exist different types of research design, all research works should be focused towards achieving a set target and bringing about change. According to him, when this is achieved, we can conclude that a piece of research work has been of value. To this end, it can be said that the research has been very valuable. This is so because the researchers were able to achieve their research aim. More to this, the value of the research can be measured in terms of how relevant the research was to clinical practice. According to the researchers, “Understanding the Hong Kong Chinese participants’ perceptions of CHD is vital in developing illness prevention and health promotion strategies to increase their levels...
6 Pages(1500 words)Essay

Guideline

...Guideline In sociology, there are three important perspectives used by sociologist when analyzing the behavior of individuals in the society. The conceptualization of behavior in society is subject to interpretation of social perspectives. The perspectives are conflict theory, symbolic interactionism and structural functionalism. The following three scholars and theorists have been associated with the development of social perspectives Karl Max, Emile Durkheim and Max Weber. The three categories of social perspectives fall under two social patterns or also known as levels, which are either a micro or a macro. This paper will provide a discussion of the three sociological perspectives. Generally, the discussion will...
5 Pages(1250 words)Essay

Otitis media

...? Application of Research in Evidence Based Practice: Its merits and Drawbacks Application of Research in Evidence Based Practice: Its merits and Drawbacks 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.aappublications.org/cgi/content/full/pediatrics;113/5/1451 This source of evidence is a thoroughly evaluated resource document because it provides guidelines and recommendations for clinicians to use...
7 Pages(1750 words)Essay

The Clinical Practice Council

...? Observation Paper Sur Educational Observation Paper Introduction According to the observation of both groups, it has been identified that each of the groups are involved and associated with certain number of members in order to acquire an effective study of providing healthcare services. The Clinical Practice Council is one of those groups involved; it provides professional nursing practices through maintaining effectiveness and safety environment which is mutually beneficial both for the patients and the healthcare organization. The second group is represented by A.A which is a worldwide fellowship of men and women focusing on helping and supporting each other in order to provide an...
4 Pages(1000 words)Essay

Guideline

...?Other (s) Guideline for making sidewalks more walkable First Street is a long major street in the city of San Fernando. The Street has several intersections with major roads and highways in the city and is therefore always busy with all types of users including pedestrians. To make the street more walkable, there is an urgent need to improve the pedestrian infrastructure protection, provide more safety from traffic, reduce the complexity of intersection as well as improve the overall surface quality of the sidewalks and cross walks on both sides of the First Street An analysis of the side analysis questionnaire reveals that most of the users as well as those living within the street neighborhood have a number of concerns...
3 Pages(750 words)Essay

Categorization of Symptoms of Acute Clinical Depression

...sleep Weight loss Lack of appetite Diagnosis A possible diagnosis for Terry is of an episode of Acute Clinical Depression. This diagnosis may be confirmed through formal testing. This diagnosis was made on the basis of the symptoms presented. Although Terry seems to have always been a recluse and given to being by himself; he has been considered a friendly person. His behavior when interacting with instructors shows that he has been experiencing some sort of negative mood. Depression is often manifested as irritation and ‘moodiness’. Not everyone with depression experiences sadness. The physical symptoms exhibited are also consistent...
4 Pages(1000 words)Essay

Research study on treatment for acute otitis media

... of the study from their influence by contracting an independent party to implement the study, and initiative that managed researcher bias at the data collection process towards validity. use of an experimental design, application of a double blind approach, randomization, and using an independent party to implement the study are therefore measures that the authors undertook to address validity and reliability issues (Tahtinen et al., 2011). Reference Tahtinen, P. et al. (2011). A placebo-controlled trial of antimicrobial treatment for acute otitis media. The New England Journal of Medicine 364(2).... Research study on treatment for acute otitis media Tahtinen et al ed the article, ‘A...
1 Pages(250 words)Assignment

Otitis media, analyeses and evaluation the care delivered to a patient with otitis media

... are children and may be suffering from other diseases with similar symptoms. Treatments should be administered with the help of a specialist. Finally, research will enhance studies of otitis media and come up with faster and efficient treatments. Works Cited Alper, Cuneyt T. Advanced Therapy in Otitis Media. Hamilton, Ont.: BC Decker, 2004. Print. Block, Stan L., and Christopher J. Harrison. Diagnosis and Management of Acute Otitis Media. 3rd ed. Caddo, OK: Professional Communications, 2005. Print. Bluestone, Charles D., and Jerome O. Klein. Otitis Media in Infants and Children. 4th ed. Hamilton: BC Decker;, 2007. Print. Rosenfeld, Richard M. Evidence Based Otitis Media. 2nd ed. Hamilton, Ont.: BC Decker, 2003. Print.... to the impacts...
8 Pages(2000 words)Essay
sponsored ads
We use cookies to create the best experience for you. Keep on browsing if you are OK with that, or find out how to manage cookies.

Let us find you another Research Paper on topic Clinical practice guideline: Diagnosis and management of acute otitis media for FREE!

Contact Us