Recent clinical guidelines suggest that watchful waiting is better than immediately beginning treatment with antibiotics when a child presents with otitis media. A group of nurses in the outpatient clinic decide to use evidence-based research for this practice to help them understand whether this is the appropriate care for the children they see.

If they find it is grounded in the research, they will suggest a change in the clinical policy guidelines. They are aware that this policy may be a concern for parents who are used to getting antibiotics immediately when they bring their children to the clinics.

The nurses brought the following sources of evidence to their first meeting: • American Academy of Pediatrics and American Academy of Family Physicians. (2004.)
Clinical practice guideline: Diagnosis and management of acute otitis media. Retrieved May 17,
2008, from http://aappolicy.aappublications.org/cgi/content/full/pediatrics;113/5/1451
Task:
A. Review the sources of evidence listed above and do the following: 1. Classify the type of each source of evidence as either a general information resource, a filtered resource, or an unfiltered resource. 2. Discuss whether each source of evidence is appropriate for this nursing practice situation. 3. Classify each source of evidence as primary research evidence, evidence summary, evidence-based guideline, or none of these.
• Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. Pediatric Infectious Disease Journal, 16, 449–456.

• Kelley, P. E., Friedman, N., Johnson, C. (2007). Ear, nose, and throat. In W. W. Hay, M. J. Levin, J. M. Sondheimer, & R. R. Deterding (Eds.), Current pediatric diagnosis and treatment (18th ed., pp. 459–492). New York: Lange Medical Books/McGraw-Hill.
• McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. Pediatric Infectious Disease Journal, 17, 576–579.
• Results from interviews with parents who have brought their children into the clinic for acute otitis media.B. Review the article (see “Clinical Practice Guideline” attached below) and do the following:

  1. Discuss whether watchful waiting is an appropriate approach for treating children with acute otitis media, based on the evidence presented in the article.
    C. Discuss how you would apply the findings in the attached article to improve nursing practice in the clinic.
    D. Discuss ethical issues that could arise in researching and changing clinical practice guidelines, based on the evidence-based research. 1. Include issues of vulnerable populations, confidentiality, and informed consent when research involves children. E. If you use sources, include Citation and APA format

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