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Critical Appraisal of Practice Guidelines

Assignment Brief

The purpose of this assignment is to apply findings from evidence-based practice and research to enhance practice guidelines and health care outcomes. While there are several tools available for evaluating practice guidelines, the most comprehensively validated appraisal tool is the AGREE II Instrument. This tool can be used both by individual practitioners to critically appraise health guidelines and by decision-makers to inform policy decisions. The purpose of the AGREE II Instrument is to provide a framework for assessing the quality of guidelines, present a methodological strategy for developing guidelines, and inform what/how information should be reported in the guidelines. The AGREE II Instrument examines the following six domains relevant to the practice guideline being assessed:

  • Domain 1: Scope and Purpose
  • Domain 2: Stakeholder Involvement
  • Domain 3: Rigor of Development
  • Domain 4: Clarity of Presentation
  • Domain 5: Applicability
  • Domain 6: Editorial Independence

In addition to each of the six domains, the tool also includes a space for rating the overall quality of the practice guideline to determine whether it should be recommended for use in practice. Criteria are rated on a 7-point scale from 1 (Strongly Disagree) to 7 (Strongly Agree). A rating of 1 is given when there is no information relevant to an item, the item is poorly reported, or it is explicitly stated that the criteria are not met. A rating between 2 and 6 is given when the item as reported does not fully meet the criteria. A rating of 7 is given when the quality of reporting is excellent, and the full criteria have been met. Further rating explanations can be found in the Users Manual section of the AGREE II Instrument resource. For this assignment, choose an evidence-based practice guideline relevant to your DPI project or chosen area of study. Refer to the “Evidence-Based Guidelines” study material for websites where a specific guideline can be identified for the purposes of this assignment or select a guideline of your own choosing.

General Requirements

Use the following information to ensure the successful completion of this assignment.

  • Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center. An abstract is not required.
  • This assignment uses a rubric. Please review the rubric prior to the beginning to become familiar with the expectations for successful completion.

Directions

Perform the following tasks to complete this assignment:

  • Provide a link to your selected guideline and explain why you chose it, supporting your response with an explanation of why you selected it. Using the AGREE II Instrument Users Manual for reference, complete the “DNP-820 AGREE II Instrument Table” template for your chosen guideline.
  • Include comments after each domain to support your rationale for providing the rating you chose and include any considerations that influenced your rating decision.
  • Cite all sources referenced.
  • AGREE II TEMPLATE DNP-820 AGREE II Instrument Table Link to selected practice guideline:

The rationale behind choosing the guideline

For each item, choose the rating that best characterizes the guideline assessed. Domain Item Rating 1 Strongly Disagree 2 3 4 5 6 7 Strongly Agree Scope and Purpose.

  1. The overall objective(s) of the guideline is(are) specifically described.
  2. The health question(s) covered by the guideline is(are) specifically described.
  3. The population (patient, public, etc.) to whom the guideline is meant to apply is specifically described. Comments Stakeholder Involvement
  4. The guideline development group includes individuals from all relevant professional groups.
  5. The views and preferences of the target population (patients, public, etc.) have been sought.
  6. The target users of the guideline are clearly defined. Comments Rigor of Development
  7. Systematic methods were used to search for evidence.
  8. The criteria for selecting the evidence are clearly described.
  9. The strengths and limitations of the body of evidence are clearly described.
  10. The methods for formulating the recommendations are clearly described.
  11. The health benefits, side effects, and risks have been considered in formulating the recommendations.
  12. There is an explicit link between the recommendations and the supporting evidence.
  13. The guideline has been externally reviewed by experts prior to its publication.
  14. A procedure for updating the guideline is provided. Comments Clarity of Presentation
  15. The recommendations are specific and unambiguous
  16. The different options for management of the condition or health issue are clearly presented.
  17. Key recommendations are easily identifiable. Comments Applicability
  18. The guideline describes facilitators and barriers to its application.
  19. The guideline provides advice or tools to put the recommendations into practice.
  20. The potential resource implications of applying the recommendations have been considered.
  21. The guideline presents monitoring or auditing criteria. Comments Editorial Independence
  22. The views of the funding body have not influenced the content of the guideline.
  23. The competing interest of guideline development group members has been recorded and addressed. Comments Overall Guideline Assessment
  24. Rate the overall quality of this guideline. 1 Lowest possible quality 2 3 4 5 6 7 Highest possible quality
  25. I would recommend this guideline for use. Yes Yes, with modifications No

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