Evaluation of Guideline Quality and Applicability for Advanced Practice Nursing Assignment

Background Information for the Assignment

Health care policies are developed and implemented based on EBP. Advanced practice nurses (APNs) serve a critical role in this implementation process: evaluating and critiquing EBP to inform, create and change the delivery of health care while guiding policy formation. Since policies promote the care of patients, they are often governed by other agencies or organizations. For example, the World Health Organization describes health policy as actions that have been instituted by local, state and national government entities to influence health care outcomes. Even the International Council of Nurses feels that EBP is a problem-solving approach that influences decision making in the clinical setting (Hall & Roussel, 2017, p. 248-249).

However, just because you find a guideline or position statement does not mean that it will work for your facility, your group of patients, and so forth. To determine whether the recommendations in that guideline or position statement fit the needs of your facility, population, problem, APNs must determine the strength of the recommendations to regulate whether policy changes are warranted. Through this process the APN may begin with the development of a clinical question and a thorough search of the literature on the proposed changes needed. This question is typically presented in a PICO framework, which shapes how the question is searched, the outcomes intended, and timing of those outcomes (Hall & Roussel, 2017, Ch. 14). Sometimes as you uncover more research on the problem, the question can become revised, but nonetheless, any problem starts with a typical question that needs to be answered. This assignment will start by taking your POI and PICO clinical question and determine if the guideline or position statement should be implemented into practice by completing a thorough appraisal of it. Then you will determine who will be needed for implementation to occur, what barriers may be present, and ultimately why should it be done. 

Introduction

A good introduction should be no more than 1 paragraph grabbing the reader’s attention providing insight to the POI, guideline, and significance to the APN's role. End with a strong thesis or purpose statement. 

Note: the thesis should be condensed to 1 brief purpose statement. The introduction should be one paragraph in length. 

Tool Completion

While this is the next step on the rubric, you will not be writing anything directly in the paper for this section. However, it must be completed as the next step because this is where you will appraise the guideline or position statement. Therefore, you will need to submit a copy of your completed tool to the assignment area. When you submitted your POI topic you also submitted a guideline/position statement for approval. You should be using your approved guideline/position statement to complete the tool for this section. If for some reason you were unsuccessful in gaining approval for your guideline/position statement, you still must complete this section by finding a guideline/position statement, but the opportunity to have that pre-approved is now past the deadline. 

Guideline or Position Statement

This section will not have any written text in the paper but serves as a reminder to submit the proper documents to the assignment. Please submit the guideline or position statement to the assignment area. If your guideline has been updated or revised, you need to submit the original and updated versions to the assignment area. Do not submit a link as links often do not open or require a login. Faculty need to see your document so they can refer back to it and add any comments directly on the document as needed for clarification. Guidelines/position statements should be current, within 5 years. 

Appraisal of the Guideline/Position Statement

Appraise the guideline or position statement by providing a robust discussion of the following criterions. 

1. Summarize the purpose of the guideline and who the guideline impacts. (1 paragraph)
2. Explain who developed the guidelines and their significance to practice. Do not give names, instead provide the groups of nationally recognized experts by group, organization, or expertise in the field. What makes the developers experts? Explain your answer. (1 paragraph).
3. What different levels of evidence (classes/grades of evidence) were used to develop the recommendations? To complete this step you must look at the studies/references used that support the recommendations or position statements. You must use levels as indicated on the level of evidence hierarchy as described in your book or resource in the Readings/Resources section of the course page to support your answer. You may also include any specific rating system the guideline or position statement referenced as well. How many levels of evidence were used? What is the difference between the various levels? Support your answers by explaining why these various levels of evidence matter when assessing the strength of the guideline. (2-3 paragraphs).
4. Review the levels of evidence discussed in #3 to support the recommendations to explain the following: were the resources consistent, well-designed studies? 2. were the majority of the studies used to form recommendations primarily high level or low level studies? 3. Should the authors consider using more studies, different types of studies? 4. Is the guideline current or do you feel there are any gaps in the guideline/position statement that should have been addressed, but wasn't? Support your statements with peer reviewed resources and thorough rationales to explain your answers (2-3 paragraphs). You may want to revisit the level of evidence hierarchy to assist you in answering this question. 
5. Based on your answers in #3-4, how does this impact your decision to use this guideline in practice or to disregard the recommendation. Explain your answer with fully supported information from the guideline or position statement, and other resources as necessary. (2-3 paragraphs)

Summary of Assessment Requirements

This assignment requires students to evaluate whether a selected clinical guideline or position statement should be implemented into advanced nursing practice. Grounded in Evidence-Based Practice (EBP), the task assesses the student’s ability to critique guideline quality, analyze supporting evidence, and determine the feasibility of implementation within a clinical setting.

The assignment overall assesses understanding of EBP, guideline appraisal, evidence hierarchy, and practical implications for APN-led policy and practice change.

How the Academic Mentor Guided the Student: Step-by-Step Approach

The academic mentor supported the student through a structured, logical workflow, ensuring clarity at every stage of the assignment.

Step 1: Clarifying Purpose and Expectations

The mentor began by explaining the core goal of the assignment determining whether a clinical guideline should be adopted in practice based on rigorous appraisal.
They emphasized alignment with EBP principles, the PICO question foundation, and APNs’ responsibility in policy and practice evaluation.

Step 2: Guiding the Student on the Introduction

The mentor instructed the student to craft a single, concise paragraph that:

• Introduced the clinical problem/POI
• Identified the selected guideline
• Explained its relevance to APNs
• Ended with a strong, one-sentence purpose statement

This ensured the paper opened with clear direction and relevance.

Step 3: Completing the Appraisal Tool

The mentor clarified that no narrative writing is required for this section but that completion of the appraisal tool is critical.
They guided the student to:

• Use the approved guideline
• Critically evaluate each section of the tool
• Reflect on quality, evidence strength, clarity, and applicability

This step served as the foundation for the narrative appraisal later in the paper.

Step 4: Submitting the Guideline

The mentor reminded the student to:

• Upload the guideline document(s)
• Include both original and updated versions if applicable
• Avoid hyperlinks
  The mentor explained this was essential for faculty verification and feedback.

Step 5: Writing the Appraisal Section

a) Purpose and Impact

The mentor guided the student to write a brief paragraph summarizing:

• Why the guideline exists
• Who it benefits
• The clinical issues it addresses

b) Developers and Expertise

Students were instructed to describe:

• The professional bodies, committees, or expert panels
• Why these groups are recognized authorities
• How their expertise strengthens guideline credibility

c) Levels of Evidence Used

The mentor encouraged the student to:

• Identify the evidence hierarchy used
• Explain the meaning of each level
• Discuss how levels differ and why this matters
• Reference the course textbook’s hierarchy

d) Quality, Consistency and Gaps

The mentor walked the student through:

• Evaluating study quality (designs, consistency, sample sizes)
• Determining whether evidence was high-level or low-level
• Identifying gaps or outdated areas
• Supporting claims with peer-reviewed sources

e) Decision Regarding Implementation

Finally, the mentor helped the student synthesize the appraisal to conclude whether:

• The guideline is strong enough for implementation
  or
• Revisions, additional evidence, or alternative guidelines are needed

This step required analytical reasoning supported by evidence from the appraisal tool and scholarly sources.

Final Outcome and Learning Objectives Achieved

Outcome of the Guided Process

By following the structured mentoring steps, the student produced a coherent, evidence-based appraisal that:

• Accurately summarized guideline purpose and authorship
• Evaluated evidence strength using accepted hierarchies
• Identified strengths, weaknesses, and applicability
• Made a justified decision about clinical implementation
• Maintained professional academic formatting and clarity

Learning Objectives Covered

The assignment enabled the student to achieve key APN competencies:

• Evidence-Based Practice competence:
  Understanding how guidelines are constructed and evaluated.
• Critical appraisal skills:
  Assessing quality, consistency, and levels of evidence.
• Application of PICO-driven inquiry:
  Linking clinical questions to guideline appraisal.
• Policy and practice evaluation:
  Determining feasibility and relevance in real clinical environments.
• Professional communication:
  Writing clearly, critically, and academically.

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