NURS 601 Assignment 3.1 Critique a Clinical Practice Guideline

• NURS 601 Assignment 3.1: Critique of a Clinical Practice Guideline

AGREE II Score Sheet: Scope and Purpose

Dementia is a progressive brain disorder characterized by cognitive decline that affects a patient’s ability to perform daily activities independently. Depending on the stage of the disease, this deterioration impacts physical, psychological, and behavioural states. These challenges underscore the need for clear, evidence-based clinical practice guidelines to manage the condition effectively.

The American Psychiatric Association (APA) has developed detailed dementia care guidelines to assist healthcare providers. These guidelines offer a comprehensive framework for managing dementia symptoms, prescribing medications, and tailoring care plans to meet each patient’s unique needs (Gale et al., 2021). By adhering to these guidelines, providers can deliver evidence-based care that enhances the quality of life, reduces symptom progression, and improves patient functionality. This analysis focuses on critiquing the guideline in the context of NURS 601 Assignment 3.1.

Stakeholder Involvement

Multidisciplinary Contributions

These guidelines were developed withutions from diverse experts, including physicians, psychologists, and researchers. Notable contributors include Dr. Aaron Gale, Dr. Kirsten Stoesser, and Dr. Katherine Fortenberry, among others from the University of Utah. These clinicians tailored the guidelines to address the use of antipsychotics in dementia patients experiencing agitation or psychosis (Gale et al., 2021). The involvement of such an interdisciplinary team ensures a well-rounded perspective that considers both patient care and caregiver needs.

Rigor of Development

Methodological Approach

The guideline development process emphasized transparency and rigour. The contributors declared potential conflicts of interest at various stages—before, during, and after publication. The American Psychiatric Association’s interdisciplinary workgroup conducted thorough reviews to ensure high-quality, evidence-based recommendations (Mühlbauer et al., 2021).

The guidelines were developed following best practices outlined by the Institute of Medicine (IOM), the Council of Medical Specialty Societies, and the Agency for Healthcare Research and Quality. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework allowed for systematic evaluation of the recommendations. This framework balances the benefits and risks of interventions to ensure their applicability in real-world settings.

Evidence-Based Recommendations

Each guideline section includes an implementation plan, evidence levels supporting each recommendation, and a detailed summary of potential benefits and limitations. Subsections like “Rating the Strength of Research Evidence” and “Rating the Strength of Recommendations ” describe these elements and offer a clear rationale for each proposed intervention. This approach enables clinicians to make informed decisions while using the guidelines in clinical practice.

The meticulous methodology outlined in this document reflects the principles discussed in NURS 601 Assignment 3.1, highlighting the importance of evidence-based clinical practice guidelines in improving dementia management.

Applicability

Real-World Implementation

The guideline emphasizes patient-centred care, tailoring treatment plans to individual needs and symptoms. Given dementia’s variability in presentation and progression, this approach is particularly vital for managing it. The guideline offers a holistic framework for enhancing patient outcomes by including medical and non-medical management strategies.

The APA underscores that these guidelines are not rigid standards but educational tools to guide practice. This distinction helps healthcare providers adapt the recommendations to diverse clinical settings. The APA also addresses practical barriers, such as organizational control and resource limitations, offering actionable strategies to overcome these challenges (Keepers et al., 2023).

Conclusion

Evaluation and Recommendations

After analyzing the guideline using the AGREE II Score Sheet, I rate its overall quality at 6 out of 7, indicating high reliability and applicability. The guideline meets most criteria for high-quality, evidence-based practice, from its comprehensive development process to its inclusion of diverse expert perspectives.

In the context of NURS 601 Assignment 3.1, this guideline demonstrates its value in improving dementia care by providing structured recommendations supported by robust evidence. Its application in clinical settings is likely to enhance the management of antipsychotics for dementia patients, improving both patient outcomes and caregiver satisfaction. With no suggested changes, this guideline is a valuable resource for addressing the complexities of dementia care.

References

Gale, A., Stoesser, K., Fortenberry, K., Ose, D., & Migdalski, A. (2021). Pharmacologic Management of Agitation in Patients with Dementia. American Family Physician, 104(1), 91–92. https://www.aafp.org/pubs/afp/issues/2021/0700/p91.html

Keepers, G., Fochtmann, L., Anzia, J., Sheldon Benjamin, Jeffrey, M., Lyness, Ramin, M., Servis, Lois Choi-Kain, Nelson, K., Oldham, J., Sharp, C., Degenhardt, A., Seung-Hee, H., Anzia, D., Benson, R., Catherine, Posada, M., Michael, J., & Vergare. (2023). THE AMERICAN PSYCHIATRIC ASSOCIATION PRACTICE GUIDELINE FOR THE TREATMENT OF PATIENTS WITH BORDERLINE PERSONALITY DISORDER Guideline Writing Group Systematic Review Group Committee on Practice Guidelines APA Assembly Liaisons.

https://www.psychiatry.org/getmedia/3ac9a443-4590-47e6-ad9b-0b2d1cff4d53/APA-Borderline-Personality-Disorder-Practice-Guideline-Under-Copyediting.pdf

Mühlbauer, V., Möhler, R., Dichter, M. N., Zuidema, S. U., Köpke, S., & Luijendijk, H. J. (2021). Antipsychotics for agitation and psychosis in people with Alzheimer’s disease and vascular dementia. Cochrane Database of Systematic Reviews, 2022(1).
https://doi.org/10.1002/14651858.cd013304.pub2

psychiatryonline. (2023). Introduction. American Psychiatric Association Publishing EBooks. https://doi.org/10.1176/appi.books.9780890424865.eatingdisorder01