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Critique a Clinical Practice Guideline
Student Name
Maryville University
NURS601
Professor Name
Submission Date
AGREE II Score Sheet (Scope and Purpose of the Clinical Practice Guideline)
Dementia is a process of worsening of the brain and a getting worse of the brain in terms of 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 expresses itself in numerous neurological forms, as well as the psychological and behavioral conditions of the patient, depending on the stage of the disease. 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 are extremely well-laid-out guidelines to help healthcare providers recognize and record the numerous manifestations of dementia. They include detailed and precise instructions on how to approach the treatment of individuals on particular medications and the required dose of treatment (Gale et al., 2021). Within this manner, the guidelines suggest a certain pattern of how to handle patients so that it can provide evidence-based care that is suitable for the needs of specific patients.
This is where the American Psychiatric Association has indicated that the main interest of these guidelines is to facilitate the formulation of effective plans to deal with the group of patients with dementia. The guidelines cover all the possible management of dementia, both medical and non-medical management, since dementia is a heterogeneous condition. This comprehensive approach is intended to increase patients’ quality of life by decreasing symptoms, decreasing the rate of disease progression, and increasing functionality.
The need to use patient-centered care plans is also addressed in the guidelines. The conditions and symptoms of each person are taken into account, and medications and treatments administered to the patient are appropriate and helpful for the condition. This practice is crucial in a situation where you are dealing with a disease such as dementia that is so heterogeneous in its occurrence and development.
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 guidelines were specifically targeted by these clinicians, especially when they were addressing utilizers of antipsychotics when managing the experiences of dementia patients who are affected by agitation or psychosis (Gale et al., 2021).
Rigor of Development
The following are some of the features that have been taken into consideration whilst developing this document. The conflict of interest was avoided by ensuring that the members of the review group declare any conflict of interest prior to 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, APA Council and workgroup provided the experts’ point of view on data collection, systematic review methods, the systematic review in the present work, the diagnosis of BDS is defined by the APA board of trustees (Mühlbauer et al., 2021).
The development of this guideline has been done in a systematic manner with the assistance of guideline work group members. A snowball technique survey was therefore applied in order to get the most knowledgeable respondents. 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.
The guidelines are formulated according to the procedures that are presented in the six actions proposed by the Institute of Medicine (2017). These guidelines were created in accordance with approaches outlined by the Institute of Medicine, the Council of Medical Specialty Societies, and the Agency of Healthcare Research and Quality. These values highlight the significance of methodological approach, accountability, and involvement of the stakeholders in the clinical practice guidelines. To come out with these enhanced guidelines, the American Psychiatric Association provided the following principles under which the guidelines would be of a high standard.
The second paper on the guideline is the guideline document, where a sub-section on page 6 lists the benefits that were created and acquired during the guideline development. All of these recommendations are presented systematically, and each of the quality of each recommendation 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 assess the quality of 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). Thus, the methodical character of the development of recommendations enables basing it on the findings of the systematic review, as well as achieving good results in the management of patients.
Each of the sections of the document explains the implementation plan of each of the recommendations, with the level of evidence behind the recommendation. The final section, a subtitle C Rating the Strength of Research Evidence and Recommendations, has a comprehensive summary of the research evidence and recommendations, commenting on the strengths of the research and potential limitations. This straightforward methodology can help the users of the guidelines understand the reason behind the recommendations offered, therefore, empowering them to make appropriate decisions concerning their use.
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 recommendation is timely in order to sustain or even improve the quality of management of dementia patients and the provision of care to this vulnerable population 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 as such, not as a standard (psychiatryonline, 2023). The guideline includes a heading as the Strength of Supporting Research Evidence which appears in page 29, Strength of Recommendations which appears in page 29, Practical Barriers to Measure Development on page 25. and External Review on page 30 The Silence and Wheatley paper it is the way you play the game identifying the ways that organizational control influences work the paper demonstrates that complexity and uncertainty reinforce The APA suggests that in the process of assessing each recommendation, it is level and strength attached to it scientific evidence.
Conclusion
I discovered that the guideline covered almost all of the grading points of the AGREE II Score Sheet and performed good quality evidence-based research using qualified clinicians and evidence-based research data. At least in my case, I would like to implement this guideline without modifications. The information that will be recovered in this guideline will positively impact the treatment of antipsychotics in dementia patients.
References
Gale, A., Stoesser, K., Fortenberry, K., Ose, D., & Migdalski, A. (2021). 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). 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
