Nursing assignment on the research process and evidenced nursing practises
Question
Task: How the adoption of Attention-Deficit/Hyperactivity Disorder (ADHD) guidelines becomes difficult? Can you discuss recommendations for the application of ADHD guidelines in your nursing assignment?
Answer
Introduction
As per the findings of thenursing assignment, the clinical guidelines to manage the issue ofAttention-Deficit/Hyperactivity Disorder (ADHD) in Children and Adolescents has been initially published in the year 2000 to provide a set of guidelines to the paediatricians and other PCCs who are the intended audience for this guideline. It assists them to overcome obstacles and barriers associated with ADHD and enhances the effectiveness of the whole care(Storebø, et al., 2018). To make the whole guidelines more specific and useful for the intended audience, a set recommendation has been formulated in the year 2001.
Evaluation of ADHDin the nursing assignment
The guideline tends to addressthe diagnosis, evaluation and treatment of ADHD in children aged between 4 years and 18 years and provides specialized guidance to provide care for them. Though in many cases, primary care clinicians (PCCs) tend to provide care even after the 18th birthday of the children, however,this guideline does not provide any specification beyond that. The guidelines after 11 years have been revised in the year 2011. This revision has been mainly done considering the incorporation of the process of care algorithm (PoCA) which provides discrete as well as manageable steps, with the help of which clinicians can implement the recommendation of the clinical guidelines in a more effective way in their professional practice which was initially missing. The nursing assignment highlights the fact that though this revision does not have any dramatic change in the set of recommendations, however only a few incremental updates are incorporatedsuch as key action statements associated with diagnosis as well as treatment of the comorbid conditions in a patient with ADHD(Wolraich, et al., 2019). Besides, the Diagnostic and Statistical Manual of Mental Disorders has also been modified to the fifth edition and the addition of new ADHD-related research is done.(Ayano, Yohannes, & Abraha, 2020) During the process of revision, numerous errors in the initial document have been reviewed which might hamper the care and have been revised.
Critical analysis of the evidence
The quality of evidence highlights the extent to which confidence that estimates, whether the effect is correct, is determined(Chen, et al., 2019). It further indicates the impact or the extent to which regarding the specific recommendation anyone can be confident enough that the recommendation will be adhered to the need of the population and will benefit the population.considering the same, these clinical guidelines have also implemented quality of evidence which has been discussed in the article.
As per the findings of thenursing assignment, the article tends to follow the latest version of the quality of evidence and its associated base updated format to formulate all the 3 clinical practice guidelines previously done. As per this format,different studies were included in the study, however, there are certain criteria behind the inclusion and once all the criteria are met, they will be included in the studies(García-Holgado, 2020 ). This set of criteriain the nursing assignmentis initially designed to ensure that the research or the recommendationsare based on a strong and effective methodology which furtherleads to confidence in the conclusion of the policy or guidelines. The same process has been followed while formulating this guideline in the present nursing assignment.
In these clinical guidelines, the level of efficacy that is required for every treatment has been defined based on the child-focused outcomes. These outcomes are related in the case of both impairment and symptoms. As the outcomes included in this nursing assignmentare based on impairment and symptoms, therefore improvements associated with thebehaviours, especially on the part of teachers or parents which include the utilization of communication or any sort of positive adorationare excluded in this review(Van der Oord & Tripp, 2020). Though these outcomes mentioned in the nursing assignmentare equally essential, the clinical guidelinestend to only address the process based on which treatment will be provided to the child or an adolescent with ADHD and in such cases, therefore, changes in the behaviour of the child are considered secondary.The guidelines are primarily focusing on the improvements in the symptoms and impairment in a child as well as in the case of an adolescent that emphasises the characteristics of the disorder and manifestations, which further affect the children along with their families. All the shreds of evidence related to the treatment rely on the latest review of the literature from the year gap of 2011 to 2016(García-Holgado, 2020 ). All the reviews included in the study are published by the AHRQ of citations from different scientific databases which include Embase, Medline, and Cochrane Database of Systematic Reviews, PsycINFO(Zendarski, et al., 2020).
The APP rating of evidence and recommendation has been based on Aggregated evidence quality which is further divided into five different levels accounting for level A comma level B, level C, level D, and level X(Hawk Jr, et al., 2018). Each level focuses on rating evidence based on its quality as well as further ensures the efficacy and reliability of the recommendations concerning benefit as well as harmful stuff the level focuses on interventions which are well designed as well as focused on meta-analysis as well as conducted trials on populations which are accurately and appropriately applicable for the particular intervention(Hoogman, Stolte, Baas, & Kroesbergen, 2020). At this particular level in this nursing assignment, the diagnosis is accounted to be independent in gold-standard studies to apply to selected and desirable populations. Based on the benefits and harms of the particular intervention and diagnosis level A is accounted to be categorized as a strong recommendation. Level B focuses on diagnostic studies as well as trials which account for limited or very less limitations. Nursing assignmentalso focuses on consistent evidence and findings extracted from different observational studies and sources of evidence. In the case of level C, the aggregated evidence quality focuses on single or limited observational studies as well as multiple studies which are inconsistent due to the findings as well as sets of limitations identified within this evidence(Shahidullah, Carlson, Haggerty, & Lancaster, 2018). In this particular level, the evidence is accounted for week recommendations due to the low-quality evidence it provides as well as focuses on acknowledging. Level D focuses on using interventions based on expert opinions, reasoning based on first principles as well as case reports of patients suffering from ADHD or associated complications. It is also accounted in this nursing assignmentfor week recommendations based on the low and inappropriate quality of evidence it provides(Hawk Jr, et al., 2018).Further level X in terms of evidence and recommendations focuses on using exceptional situations and circumstances where significant and validating evidence is and studies are inappropriate and irrelevant for further performance. It accounts for the preponderance of harms as well as benefits and it is thus accounted for strong as well as moderate recommendations. Thus, in this nursing assignment, different levels as well as associated standards of recommendations are used to rate and evaluate sets of evidence and recommendations in terms of treatments against ADHD and other related psychological and behavioral complications witnessed by children and adolescents along with their families.
Application of the ADHD guidelines
The recommendations or guidelines whatever is presented for clinical application, are quite clear. The recommendations are given through sections to make it clear for everyone(Kwan & Pil, 2018). The sections are presented as KAS 5a where a group of every age is presented differently like pre-school-aged children, elementary and middle-aged school children, and adolescents. Different programmes are even there for each type of child. KAS 5b, and KAS 5c are even there. Psychosocial treatments are even recommended as behavioural therapy. The section of the nursing assignmentseparately mentions medications for ADHD to make it confirm that not only behavioural therapy but medication is needed.
This evidence as well as recommendations identified in the nursing assignmentcan be significantly used in clinical healthcare settings as it will guide professionals and other clinicians to provide appropriate strong and beneficial recommendations to children and their families against ADHD as well as associated complications(Kwan & Pil, 2018). Nursing assignmentwill help in providing proper diagnosis, treatment as well as recovery from the complications and sustain better behavioural change for both parents as well as the children. The nursing assignment will ensure that limited complications or harms are initiated as well as enhanced performance will be witnessed if the guidelines, as well as appropriate recommendations, are effectively used in clinical settings.
Treating ADHD cannot be accomplished without proper management as management takes care of the effectiveness and efficiency of the professionals. Further, resource allocation and recruitment are even the responsibility of management(Chun Wong & Zaman, 2019). To confirm proper resource allocation or staffing, quality and experience need to be parameters to include efficiency. Different work delivery approaches which are available needs to be considered both at outset of the resource allocation process to finalize the resource allocation plan in this nursing assignment. Often, it is confirmed that multiple allocation scenarios can conduct several delivery approaches (Wolraich, et al., 2019).
Conclusion
The availability of alternative approaches in work delivery can create opportunities in the context of organizations to initiate asset conditions for addressing different needs to justify more efficiency. Thereby, as per the findings of nursing assignment, effective and efficient resource allocation is much important to deal with ADHD. It can make the infrastructure cost-effective to confirm lower risk for management and ADHD children. Different work delivery strategies can direct the best care for ADHD children. Proper planning and execution of all approaches are important to write a nursing assignment. However, the most important things per the nursing assignment is monitoring followed by an evaluation to confirm that deliverables are meeting properly.
Bibliography
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Shahidullah, J. D., Carlson, J. S., Haggerty, D., & Lancaster, B. M. (2018). Integrated care models for ADHD in children and adolescents: A systematic nursing assignmentreview. Families, Systems, & Health, 36(2), 233.
Storebø, O., Pedersen, N., Ramstad, E., Kielsholm, M., Nielsen, S., Krogh, H., . . . Skoog, M. (2018). Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents–assessment of adverse events in nonrandomised studies. . Cochrane Database of Systematic Reviews, 5.
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Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., & Zurhellen, W. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4).
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