Writing Homework Help

first discussion 

After reading the Read: Nursing Management of the Patient with Multiple Sclerosis and Read: What are the Levels of Evidence? in the Learn section, answer the following questions:

1. Are the guidelines based on evidence?
2. Using the Levels of Evidence Pyramid what is the evidence rating?
3. Would you use the guideline based on the evidence provided? Is there a better approach?
4. How does the evidence you select for your literature review paper fit into this evidence rating?

second discussion 

Discuss when you would use qualitative research in your work practice and why.

Discuss when you would use quantitative research in your work practice and why.

Post 1

first discussion replies

Clinical Guidelines

Are the guidelines based on evidence?

Evidence-based guidelines are intended to recap both the evidence and address a certain question concerning a medical ailment. It is crucial to note that clinical practice guidelines refer to recommendations that guide nursing practice meant for the safety of patients as well as improving patient outcomes. The Association of Rehabilitation Nurses (ARN), the American Association of Neuroscience Nurses (AANN) and the International Organization of Multiple Sclerosis Nurses (IOMSN) are clinical guidelines for the delivery of medical care to patients with multiple sclerosis. The key to providing the finest healthcare, guaranteeing patient safety, and assuring the best patient results is to use evidence-based practice. Levels of evidence are used to categorize the AANN and ARN clinical guidelines, with the initial level being the toughest. Clinical practice guidelines are the foundation upon which clinical choices are made. It is crucial to note that, as high-quality evidence, researchers rely on meta-analysis and randomized controlled trials (Van den Noort & Holland, 1999). Both the ARN and the AANN have experienced lower levels of evidence as well.

Nevertheless, whilst randomized control trials hinder medical practice, decreased levels of evidence must not bear as much pressure on clinical practice. After reviewing the given articles, it is therefore right to conclude that a lot of deliberation as well as research has been carried out to answer the question, “Are the guidelines based on evidence?”. Hence, it is true that the AANN, ARN and the IOMSN are evidence-based, offering present data on how to manage patients with multiple sclerosis. On page six, the article talks about the search strategy and the levels of evidence (Bader & Littlejohns, 2010). Methodological flaws, observational studies such as cohort, qualitative studies, case study and evidence gathered from reports of professional committee and standards are some of the options that were chosen when coming up with the articles.

Using the Levels of Evidence Pyramid what is the evidence rating?

The levels of Evidence Pyramid offer a method to visualize the quality of proof as well as the amount of evidence presented. For instance, systematic reviews in the given article are at the top of the pyramid, implying that both are the greatest level of evidence as well as the least common. With the help of Quality system and the Agency for Health Care Research grading system, I would rate this article level II. This is because from my point of view, both the references and the length this article used offered accurate data for the guideline. Another reason for giving level II rating is because the authors used a medium level of evidence in applying randomized control trials. It is crucial to note that, consistency rating depends on looking at other researches to establish if they have common effect to what one is studying. Notably, it is evident that consistency was not highly applicable since this is not a study but a guideline. This guideline can be subject to change following extra research (Melnyk, 2004).

Would you use the guideline based on the evidence provided? Is there a better approach?

As medical practitioner, I would use this guideline based on the evidence provided because it was established using a higher level of evidence with the help of randomized control attempts. Notably, this guideline in question is backed up by both present and applicable proof to support a change in line of duty. Additionally, the guidelines provided by AANN, ARN and IOMSN will be of great help to me throughout my care for patients ailing from sclerosis. From my point of view, I do not think there is a better approach to this matter because this guideline is fully oriented and extensively explained definitions of nursing management of the Patient with Multiple Sclerosis, classification of MS, Immunogenetics and Pathogenesis as well as nursing responsibilities (Miller, 2001).

How does the evidence you select for your literature review paper fit into this evidence rating?

Excellent health outcomes will remain to be supported by the capacity to apply prevailing evidence to patient care through practice and provide the best degree of care in partnership with the patient’s preferences, requirements as well as concerns. Moreover, the high level of precision and quality associated with formulating practice guidelines is critical to clinical decision-making and patient care delivery. Practicing these recommendations to our daily life as medical practitioners encourages positive client outcomes and is ultimately the defining drive of evidence-based practice.

References

Van den Noort, S., & Holland, N. (1999). Multiple sclerosis in clinical practice. New York: Demos Medical Publishing.

Miller, C. M. (2001). Recognizing and treating cognitive impairment. In J. Halper (Ed.), Advanced concepts in multiple sclerosis nursing care (pp. 109–116). New York: Demos Medical Publishing

Bader, M. K., & Littlejohns, L. L. (Eds.). (2010). AANN Core Curriculum for Neuroscience Nursing. Glenview, IL: American Association of Neuroscience Nurses.

Melnyk, B. M. (2004). Evidence digest: Levels of evidence. Worldviews on Evidence-Based Nursing, 1, 142–145. 

Post 2

For this week’s discussion board we were asked to read two articles and then answer four questions. The two articles were “Nursing Management of the Patient with Multiple Sclerosis” and “What are the Levels of Evidence?” “In evidence-based practice, the term ‘evidence’ is used deliberately instead of ‘proof’” (CEBMa, 2019). The first question we were asked was are the guidelines based on evidence. While reading Nursing Management of the Patient with Multiple Sclerosis (MS) it stated that their “Clinical Practice

Guidelines for practice are established on the basis of the evaluation of the available evidence” (Thompson & Mauk, 2011). “The underlying cause of MS and mechanisms behind this increase remain opaque, although complex gene–environment interactions almost certainly play a significant role (Dobson & Giovannoni, 2018). The study was conducted by using a panel of nursing students to find out the level of evidence for each study that is in the guidelines. For example level 1 recommendations are supported by Class 1 evidence, level 2 recommendations are supported by Class 2 evidence, and level 3 recommendations are supported by Class 3 and Class 4 evidence. The study states that “data from several Class II studies support the association of EBV with MS. There is evidence that the presence of EBV in plasma is associated with increased risk of MS (Wagner, Munger, & Ascherio, 2004)” (Thompson & Mauk, 2011). “The goal of this guideline is to offer evidence-based recommendations on nursing activities that have the potential to maximize outcomes for adults with MS” (Thompson & Mauk, 2011). The next question is using the Levels of Evidence Pyramid what is the evidence rating? From reading the content I believe that the evidence rating is Randomized Controlled Trails also known as RCTs because of the use of guidelines. “The randomized controlled trial (RCT) is considered to provide the most reliable evidence on the effectiveness of interventions because the processes used during the conduct of an RCT minimize the risk of confounding factors influencing the results” (Akobeng, 2021). “A Randomized Controlled Trail is the best research design for providing information about cause-and-effect relationships” (Melnyk & Fineout-Overholt, 2019). The cause-and-effect in this study would be on the recommendations on nursing activities that have the potential to maximize outcomes for adults that have MS (Thompson & Mauk, 2011). I personally would use the guidelines based on the evidence provided. These guidelines can help nurses make appropriate choices when taking care of a patient with MS. Since MS is the most common nontraumatic cause of neurologic disability in young adults, it is important to have guidelines suggesting ways for nurses to provide optimal care for patients or persons with MS. For the fourth and final question about how my evidence that I selected for my literature review paper fits into this evidence rating. The evidence for my literature review paper fits into this evidence by rating the same level on the evidence pyramid. The evidence for my literature review and this evidence rating are both Randomized Controlled Trails.

Matthew 25:37-40 “Then the righteous will answer him, saying, ‘Lord, when did we see you hungry and feed you, or thirsty and give you drink? And when did we see you a stranger and welcome you, or naked and clothe you? And when did we see you sick or in prison and visit you?’ And the King will answer them, ‘Truly, I say to you, as you did it to one of the least of these my brothers, you did it to me.”

Reference:

100 Bible verses about health care. What Does the Bible Say About Health Care? (n.d.). https://www.openbible.info/topics/health_care.

Akobeng, A. K. (2021). Understanding randomised controlled trials. Archives of Disease in Childhood. https://adc.bmj.com/content/90/8/840.

CEBMa. (2019). What are the levels of evidence? Centers for Evidence-Based Management. https://canvas.liberty.edu/courses/122185/modules/items/12190819.

Dobson, R., & Giovannoni, G. (2018, November 18). Multiple sclerosis – A Review. Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1111/ene.13819.

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in Nursing & Healthcare: A guide to best practice. Wolters Kluwer.

Thompson, H., & Mauk, K. (2011). Nursing Management of the Patient with Multiple Sclerosis. TEVA Neuroscience. https://rehabnurse.org/uploads/about/cpgms.pdf.