NURS601 Assignment 3.1: Critique a Clinical Practice Guideline

NURS 601 Assignment 3.1: Critique a Clinical Practice Guideline Student Name Maryville University  NURS601 Professor Aug 2023 AGREE II Score Sheet (Scope and Purpose of the Clinical Practice Guideline) Dementia is brain deterioration and a process of getting worse in cognitive abilities. In this case, this decrease in function impacts the patients’ movements and their resultant self-care since they are unable to perform most of the attendant activities of daily living single-handedly. This disease manifests itselfin many neurological ways and also in the patient’s psychological and behavioral state based on the type of stage the patient is in. These symptoms translate into the need to undertake activities using very specific guidelines for practice.  The goals of the dementia guidelines are described in detail by the American Psychiatric Association (APA) in their clinical practice guidelines. The following guidelines are very well laid down to assist the healthcare providers in identifying and documenting the various manifestations of dementia. They contain specific and complete guidelines for the management of patients on certain drugs and the appropriate dosage of therapies (Gale et al., 2021). In this way, the guidelines propose a specific framework of how to manage patients in order to deliver evidence-based care appropriate to individual patients’ requirements.  This is the position of the American Psychiatric Association, which has pointed out that the primary aim of these guidelines is to enable the development of sound strategies for managing the group of patients with dementia. The guidelines include all possible forms of management for dementia, including medical management as well as non-medical management, because dementia is a diverse condition. This comprehensive approach is intended to increase patients’ quality of life by decreasing symptoms, decreasing rate of disease progression, and increasing functionality.  The guidelines also focus on the need for patient-centered care plans. Every individual’s condition and symptoms are considered, and the medications and therapies given to the patient are suitable and beneficial for the specific condition. Such an approach is vital when treating a disease like dementia that presents such heterogeneity in its manifestations and progression. Stakeholder Involvement  This clinical practice guideline, of course, acknowledges all the disciplines involved in the preparation of this document, such as Aaron Gale, MD; Kirsten Stoesser, MD; Katherine Fortenberry, PhD; and Dominik Ose, DrPH, MPH, University of Utah, Salt Lake City, Utah, in the Systematic Review Group. These clinicians aimed these guidelines particularly at utilizers of antipsychotics in dementia patients’ experiences with agitation or psychosis (Gale et al., 2021).  Rigor of Development  Some of the features that have been considered when developing this document are stated below. The absence of conflict of interest by making the members of the review group declare any conflict of interest before the review, during the review, and when the guideline is published. The guideline writing group, which is a pluralistic group of interdisciplinary specialists, was involved in the review of the draft guideline and provided the perspective of the patients and their families. The APA Council and workgroup provided the experts’ point of view on data collection, systematic review methods, the systematic review in the present work, and the diagnosis of BDS, which is defined by the APA Board of Trustees (Mühlbauer et al., 2021). This guideline has been developed systematically with the help of members of the guideline work group. Thus, to capture the most informed participants, a snowball survey technique was used. This strategy entailed the provision of information to the researchers to help them select and enroll specialists who have been shown to have a good track record in managing dementia patients, especially those with aggression or paranoid symptoms.   These guidelines were developed in compliance with the procedures outlined in the Institute of Medicine (2017)’s six proposed actions. The guidelines were produced following methodologies described by the Institute of Medicine, the Council of Medical Specialty Societies, and the Agency for Healthcare Research Quality. These principles underline the importance of the methodological approver, the accountability, and the stakeholder’s engagement in clinical practice guidelines. In order to come up with enhanced guidelines, the American Psychiatric Association offered the following principles that would ensure that the guidelines are of a high standard.   The second document regarding the guideline is the guideline document, where a sub-section starting on page 6 outlines the benefits that were generated and procured in the course of developing the guideline. All of these recommendations are presented systematically, and each of the recommendations’ quality is evaluated with the use of the GRADE system. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) is an internationally accepted framework that can be used to award the quality of the guidelines based on the recommendations made by the authors on how to apply the intervention in practice, considering the balance between benefits and harms (Mühlbauer et al., 2021). Therefore, the systematic approach to the development of recommendations allows for basing them on the results of a systematic review and obtaining positive outcomes in patient management.  The implementation plan for each recommendation is described in detail in each section of the document along with the level of evidence supporting the recommendation. The last part, with the subtitle “Rating the Strength of Research Evidence and Recommendations,” contains a detailed summary of the research evidence and recommendations, discussing the merits of the research and possible drawbacks. This clear approach aids the users of the guidelines in knowing the rationale for the recommendations made, thus enabling them to make proper decisions with regard to their application.   The methods of identifying experts through the snowball survey, following the recommendations of the Institute of Medicine and the GRADE system for the review of evidence, helped to develop a high-quality clinical practice guideline. This guideline is well-placed to maintain or increase the quality of management of patients with dementia and care for this frail group of patients. Applicability  In the “Proper Use of Guidelines” section, the American Psychiatric Association highlighted that APA Practice Guidelines are evaluations of existing literature that are employed for educational purposes and should be treated

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