NURS 716 Assignment: Evaluating Professional Practice Standards

NURS 716 Assignment: Evaluating Professional Practice Standards

NURS 716 Assignment: Evaluating Professional Practice Standards

EVALUATING PROFESSIONAL PRACTICE STANDARDS ASSIGNMENT INSTRUCTIONS
OVERVIEW
There are a variety of ways of securing evidence to support a change in practice. One significant
way is the review of current literature. Clinician experience and patient preferences are other
ways of securing evidence. Another way to secure input is through professional practice
guidelines which are also evidence-based. This is the perspective when you are doing the
evaluation of the professional practice model using the assigned evaluation tool (AGREE).

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INSTRUCTIONS
In this assignment, you will have the opportunity to review a reliable and valid process for
reviewing and evaluating professional practice standards, the framework is the Appraisal of
Guidelines for Research and Evaluation (AGREE Tool II).
1. Access the links provided for the AGREE process for evaluating professional practice
guidelines. You can find these links on the Evaluating Professional Practice Standards
Assignment page under Evaluating Professional Practice Standards Assignment
Resources. Explore the websites provided.
2. Review the assessment tool. You can find this link on the Evaluating Professional
Practice Standards Assignment page under Evaluating Professional Practice
Standards Assignment Resources.
Note: The tool you will use to evaluate the required guideline is the AGREE II Tool.
Once you access the document in the link, the tool is all the way at the bottom of the
document Entitled: AGREE Tool II. You may need to reproduce the tool in a MS Word
document or you may develop each domain in a narrative format but be sure to score
each domain per the tool.
3. Access the assessment form via the 2013 ACCF/AHA Guideline for the Management of
Heart Failure link provided. Use the tool to evaluate the practice guideline selected. You
can find the link on the Evaluating Professional Practice Standards Assignment page
under Evaluating Professional Practice Standards Assignment Resources.
4. As the AGREE tool is used, it is evident that the guidelines are evidence-based and the
evidence to support the guideline is leveled using letters to identify strength of evidence.
You can find the link on the Evaluating Professional Practice Standards Assignment
page under Evaluating Professional Practice Standards Assignment Resources.
Just review this document for your information. It is important to know
professional guidelines are to be based on current evidence.
5. Complete each portion of the assessment thoroughly, providing a score on the Likert
scale and providing details in the comments section.
6. Once the AGREE assessment has been completed, develop an introductory paragraph
discussing the purpose of the guidelines and other information you deem relevant,
develop a narrative summary as to the outcomes of the assessment. Integrate the assigned
reading for this week into the narrative, paying special attention to the implications for
NURS 716
Page 2 of 2
the micro, and macro systems levels’ application. Be sure to include information as to
your support of using the tool in the practice setting.
7. Include a title page and a reference list per current APA format.

Evaluating Professional Practice Standards Resources:
1. AGREE II (Links to an external site.)
2. UpToDate Database (Links to an external site.)
3. AGREE Assessment Tool (Links to an external site.)
4. 2013 ACCF/AHA Guideline for the Management of Heart Failure (Links to an external site.)
5. Levels of Evidence (Links to an external site.)

Evaluating Professional Practice Standards Grading Rubric | NURS716_D01_202230

Criteria	Ratings				Points
Using the AGREE Tool, Evaluate the Assigned Practice Guideline	70 to >65.0 pts Advanced It is evident the AGREE Tool is closely followed. The response for each section of the tool is detailed and comprehensive. Full explanations are provided for every question. Examples and additional resources are cited.	65 to >60.0 pts Proficient It is evident the AGREE Tool is closely followed. The response for each section of the tool is detailed and comprehensive.	60 to >0.0 pts Developing It is evident the AGREE Tool is followed but responses are brief and lack detailed and comprehensive responses.	0 pts   Not Present	70 pts
Quality of Work	30 to >27.0 pts	27 to >25.0 pts	25 to >0.0 pts	0 pts	30 pts
	Advanced	Proficient	Developing	Not Present
	Correct use of current APA format, grammar, and structure is followed. The work is thorough and clear. There is evidence of additional resources to provide robust background information on the topic.	Correct use of current APA format, grammar, and structure is evident with few minor errors. The work is thorough and clear but there may be lack of detail in some areas. There is evidence of additional resources, but they don’t strongly support the topic.	Multiple APA format, grammar, and/or structure errors exist. The work is not thorough and/or lacks clarity. There are no additional resources used to support the topic.
Total Points: 100

A Sample Of This Assignment Written By One Of Our Top-rated Writers

Evaluating Professional Practice Standards Assignment

Heart failure is also referred to as congestive heart failure, and it occurs to individuals when their heart muscles fail to pump blood appropriately as it is meant to pump. When such a thing occurs, the blood mainly backs up with the fluid retention building up in an individual’s lungs, leading to shortness of breath (Heckman et al., 2019). Some other heart conditions like coronary artery disease or hypertension also endanger the heart by making it too stiff or weak to carry out blood pumping effectively. The main ways healthcare professionals can improve heart failure is by following effective guidelines and advising the patients on various lifestyle changes like exercising, losing weight, managing stress, and reducing sodium intake Trivedi et al., 2019). Currently, over 23 million individuals globally have heart failure issues; new cases are 2 million annually (Lippi & Sanchis-Gomar, 2020). As a way of managing heart failure, The American Heart Association (AHA) and the American College of Cardiology Foundation (ACCF) have collaborated since 1980 to formulate effective Guidelines for managing heart failure (Giannitsi et al., 2019). Different models help in critical appraisal, but the Appraisal of Guidelines for Research and Evaluation (AGREE) II  is an essential tool that helps assess the Guidelines’ methodological quality (Hoffmann-Eßer et al., 2018). Therefore, the paper critically appraises the 2013 ACCF/AHA Guideline for Managing Heart Failure, the AGREE Tool II.

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2013 ACCF/AHA Guideline for the Management of Heart Failure

Domain 1: Scope and Purpose

1. Guideline’s Overall Objectives

1 Strongly Agree

2

3

4

5

6

7 Strongly Agree

 

Comments The 2013 ACCF/AHA guideline on heart failure describes the project’s overall objectives. The ACCF/AHA guideline aims at helping clinicians make informed decisions by providing evidence-based approaches to diagnosing, managing, and preventing specific heart failure conditions and diseases. Hence, the Guideline’s main aim is to meet most patients’ needs in all circumstances. For instance, on page Yancy et al. (2013, p.e150), it is evident that the writing committee has to engage evidence-based methodologies to support data and provide recommendations to ensure that such recommendations are balanced and offer patient-centric clinical practice guidance on heart failure like consideration of the ejection fraction in adults (Latado, 2022).

2. Guideline’s Health Questions

1 Strongly Agree

2

3

4

5

6

7 Strongly Agree

 

Comments Can easily determine the health questions through the document has not succinctly described them. That is because these questions are broad. Some questions addressed include HF questions on adults and children and specific therapeutic and clinical questions.

 

3. Guideline’s Target Patient Population

1 Strongly Agree

2

3

4

5

6

7 Strongly Agree

 

Comments The Guideline provides a clear definition of its target patient population. On page e150, it is clear that the Guideline is more beneficial to the North America Patient population and clinicians within the region (Yancy et al., 2013). However, the Guideline only provides various management practices for adult patients with heart failure issues. The Guideline also does not address heart failure issues in children and adults’ congenital heart lesions cases. Hence, the Guideline clearly defines what the reader should expect from it.

 

Domain 2. Stakeholder Involvement

4. Involvement of Relevant Professional Groups in Guideline Development

1 Strongly Agree

2

3

4

5

6

7 Strongly Agree

 

Comments The ACCF/AHA task force ensures that all members are notified on time for consensus purposes. Also, every guideline change process must undergo a transparent evaluation by making all writing committee members known to the members.

 

5. Target Populations Views and Preferences

1 Strongly Agree

2

3

4

5

6

7 Strongly Agree

 

Comments The guidelines notify that there is more to patient education since these patients require care information to help them understand their care plans and diagnostic needs  (Yancy et al., 2013, p. e152).

 

6. Clear Definitions of the Guideline’s Target User

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The Guideline is clear in that it provides guidelines that need to be utilized by both clinicians and the target patient population. The Guideline on page e150 indicates that it is essential for North American heart failure patients and clinicians in that case.

 

Domain 3: Rigor of Development

7. Evidence’s Systematic Methods

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The ACCF/AHA guideline uses search databases like PubMed, Institute of Medicine, Cochrane, EMBASE, and Agency for Healthcare Research and Quality Research. Quick searches were mainly done using PubMed with a clear indication of search periods and key terms used for reliability and quality information (Moon, 2019). However, the Guideline does not name all databases that aided the Guideline’s success

 

8. Evidence Selection Criteria

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The evidence selection criteria had to engage studies that supported the guidelines Level of Evidence. Therefore, the researchers ensured that the research evidence was in English while the studies had to be evidence from human subjects, reviews, and studies.   Hence, the main studies in the Guideline include retrospective, observational and randomized studies, thus proving no specific study type (Glasofer & Townsend, 2019).

 

9. Body of Evidence Limitations and Strengths

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The study’s main strength is bound by the guideline publication being approved by AHA/ACCF bodies. Another strength is the endorsement of the Guideline by various heart-related foundations like the Heart Rhythm Society and the American College of Heart Physicians, thus proving its reliability and objectivity. The main limitation is that the writing committee did not provide enough evidence for an appropriate heart failure condition. Another limitation is that the writing committee was more concerned with reducing the Class 1 level of evidence, thus putting minimal effort into other classes’ therapies which may affect the overall research intended outcome(Yancy et al., 2013; Oh &Yun, 2019).

 

10. Recommendation Formulation Criteria

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments  The study recommends using cardiac resynchronization therapy (CRT) criteria to intervene in adults’ heart failure. However, the Guideline also provides a specific group of heart failure patients that cannot benefit from the CRT criteria, thus proving the Guideline’s quality. The patients that cannot benefit from CRT criteria include those with limited survival for heart failure and those with symptoms in the New York Heart Association (NYHA) Class I or II. .

 

11. Consideration of Benefits, Risks, and Side Effects

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments  The Guideline benefits patients, their families, clinicians, and healthcare facilities that address issues concerning heart failure. However, due to the complexity of issues leading to heart failure, the Guideline requires clinicians to be more vigilant to factors like heart failure patients and their caregiver’s socioeconomic, behavioral, and psychosocial factors. That way, it will be easier to address the risks and side effects of heart failure medications and their side effects.

 

12. The link between Recommendation and Supporting Evidence

 

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments Clear links on recommendations and supporting evidence like the effectiveness of care in palliative care interventions on heart failure patients.

 

13. External Review by Experts Prior Publications

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The Guideline involved objective peer review before its publication.

 

14. Guideline’s Updating Procedure

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments Any appropriate review and updates have to undergo the consensus of all members before any update can happen.

 

Domain 4: Presentation Clarity

15. Recommendations are Specific and Unambiguous

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The Guideline provides the specific patient population with children being excluded from the heart failure recommendations.

 

16. Clear Presentation of Different Management Options

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments There is a clear presentation of different heart failure management options like engaging the patients in a healthy lifestyle, exercising, and dieting like reduction of sodium intake.

 

17. Easy Identification of Key Recommendations

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments Readers easily substantiate the Guideline’s key recommendations since they are bolded and highlighted.

 

Domain 5: Applicability

18. Guideline’s Facilitators and Application Barriers

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The main facilitators of the Guideline are the ACCF/AHA. Some indicated barriers include heart failure barriers to care, like patients’ behavioral changes, as provided on page e199.

 

19. Guideline’s Advice on how the Advice or Tools can be Utilized

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The Guideline offers advice on how the patient can transition into heart failure diseases. As indicated on page e199, the guidelines advise the clinicians not to involve beta blockers in patients requiring inotropes during their hospital stay when transitioning to post-discharge cases.

 

20. Resource Implications of Using the Recommended Tools

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The Guideline indicates on page e171 that when patient education on heart failure is carried out, it may prevent hospital overstays and the subsequent costs.

 

21. Guideline’s on Monitoring and Auditing Criteria

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The Guideline requires clinicians to attend follow-up appointments to assess the patient’s condition improves. However, the reader cannot easily locate the auditing criteria unless one engages in extensive reading.

Domain 6: Editorial Independence

22. Funding Body Views Not Influencing the Guideline’s Content

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments No financial-related information disclosed

 

23. Competing interests of guideline development group members have been recorded and addressed.

1 Strongly Disagree

2

3

4

5

6

7 Strongly Agree

 

Comments The Guideline required the peer reviewers and writing committee to disclose any relationship they might have with any healthcare body, especially those that were within 12 months before initiation to the group, as indicated on e151

Overall Guideline Assessments

Overall Guideline Quality

1 Lowest Possible Quality

2

3

4

5

6

7 Highest Possible Quality

I would Recommend the Guideline for Use

Yes
Yes, with Modification	ü
No

Comments The 2013 ACCF/AHA Guideline for the Management of Heart Failure provides effective knowledge on managing heart failure. The reason for rating it at 6-scale concerns its provision of objective research that aims at improving overall well-being for adults with heart failure. However, it needs modification in various areas, like stating its research questions clearly instead of stating them broadly.

Conclusion

The 2013 ACCF/AHA Guideline for the Management of Heart Failure is an effective guideline for clinicians, particularly patients who would like to manage their heart failure problems effectively. In most Domains, the Agree Tool II has enabled critical appraisal of the information provided in the document. Most of the information was viable in real clinical practice, especially on the non-pharmacological interventions for heart failure. Hence, despite the prevailing limitation like the recommendations excluding children with heart failure, the overall information is effective in a clinical environment

References

Giannitsi, S., Bougiakli, M., Bechlioulis, A., Kotsia, A., Michalis, L. K., & Naka, K. K. (2019). 6-minute walking test: a useful tool in the management of heart failure patients. Therapeutic advances in cardiovascular disease, 13, 1753944719870084. https://doi.org/10.1177/1753944719870084

Glasofer, A., & Townsend, A. B. (2019). Determining the level of evidence: experimental research appraisal. Nursing2020 Critical Care, 14(6), 22-25. doi: 10.1097/01.CCN.0000580120.03118.1d

Heckman, G. A., Shamji, A. K., Ladha, R., Stapleton, J., Boscart, V., Boxer, R. S., … & McKelvie, R. S. (2018). Heart failure management in nursing homes: a scoping literature review. Canadian Journal of Cardiology, 34(7), 871-880. https://doi.org/10.1016/j.cjca.2018.04.006

Hoffmann-Eßer, W., Siering, U., Neugebauer, E. A., Brockhaus, A. C., McGauran, N., & Eikermann, M. (2018). Guideline appraisal with AGREE II: online survey of the potential influence of AGREE II items on overall assessment of guideline quality and recommendation for use. BMC health services research, 18(1), 1-9. https://doi.org/10.1186/s12913-018-2954-8

Latado, A. L. (2022). Prognosis of Heart Failure with Mid-Range Ejection Fraction: A Story or a Version?. Arquivos Brasileiros de Cardiologia, 118, 701-702. https://doi.org/10.36660/abc.20220170

Lippi, G., & Sanchis-Gomar, F. (2020). Global epidemiology and future trends of heart failure. AME Med J, 5(15), 1-6. : http://dx.doi.org/10.21037/amj.2020.03.03

Moon, M. D. (2019). Triangulation: A method to increase validity, reliability, and legitimation in clinical research. Journal of Emergency Nursing, 45(1), 103-105. https://doi.org/10.1016/j.jen.2018.11.004

Oh, E. G., & Yang, Y. L. (2019). Evidence-based nursing education for undergraduate students: A preliminary experimental study. Nurse education in practice, 38, 45-51. https://doi.org/10.1016/j.nepr.2019.05.010

Trivedi, R. B., Slightam, C., Nevedal, A., Guetterman, T. C., Fan, V. S., Nelson, K. M., … & Piette, J. D. (2019). Comparing the barriers and facilitators of heart failure management as perceived by patients, caregivers, and clinical providers. Journal of Cardiovascular Nursing, 34(5), 399-409. doi: 10.1097/JCN.0000000000000591

Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey Jr, D. E., Drazner, M. H., … & Wilkoff, B. L. (2013). 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation, 128(16), 1810-1852. https://doi.org/10.1161/CIR.0b013e31829e8807