1.Propose how the Delphi Technique can be used to devise a national guideline to improve patient health outcomes.
- How do national guidelines compare to stand-alone articles with regard to practice application?
- Provide an example to the class of a national guideline that is currently being used in health care. Discuss how the DNP-prepared nurse can influence the process of development and/or application of these guidelines.
Write 3-4 pages with 3 references.
The Delphi Technique and Development of National Guidelines: Improving Patient Health Outcomes
Introduction: National guidelines play a crucial role in healthcare by providing evidence-based recommendations to guide clinical practice and improve patient health outcomes. The development of such guidelines involves a comprehensive and systematic process that requires input from various stakeholders, including healthcare professionals, researchers, policymakers, and patients. One approach to gather consensus among these diverse experts is the Delphi Technique. This paper explores how the Delphi Technique can be employed to devise national guidelines, compares national guidelines to stand-alone articles in terms of practice application, and provides an example of a national guideline currently used in healthcare. Additionally, it discusses how Doctor of Nursing Practice (DNP)-prepared nurses can influence the development and application of these guidelines.
- Proposing the use of the Delphi Technique in devising national guidelines: The Delphi Technique is a research methodology that involves multiple rounds of anonymous surveys to gather and synthesize expert opinions. It is particularly useful when a complex problem requires consensus from a group of experts who may have differing perspectives. Here’s how the Delphi Technique can be utilized to devise national guidelines:
a) Identifying the problem and scope: The first step is to clearly define the problem or area of focus for which the national guideline is needed. This could be a specific disease, condition, or healthcare practice that requires evidence-based recommendations for improved patient health outcomes.
b) Selecting the expert panel: A diverse panel of experts, including healthcare professionals, researchers, and other relevant stakeholders, is formed. The panel members are chosen based on their expertise, knowledge, and experience in the specific area of focus.
c) Conducting iterative rounds of surveys: The Delphi Technique involves multiple rounds of surveys/questionnaires. In each round, panel members are provided with a summary of the collective opinions from the previous round. They then anonymously provide their individual opinions, which are aggregated and analyzed by the facilitator.
d) Feedback and consensus building: The facilitator summarizes the responses, highlights areas of agreement and disagreement, and presents this information to the panel members in subsequent rounds. This iterative process continues until consensus is reached on the key recommendations for inclusion in the national guideline.
e) Validation and finalization: Once consensus is achieved, the draft guideline is further reviewed and refined. External experts and stakeholders, as well as relevant professional societies or organizations, may be involved in the validation process. The final national guideline is then published for dissemination and implementation.
- National guidelines vs. stand-alone articles: National guidelines differ from stand-alone articles in terms of their scope, purpose, and application to clinical practice. While stand-alone articles provide valuable research findings and insights, national guidelines offer a more comprehensive and standardized approach to guide clinical decision-making. Here are some key comparisons:
a) Scope: National guidelines address broader clinical topics, diseases, or conditions, providing recommendations that encompass multiple aspects of patient care. Stand-alone articles, on the other hand, typically focus on specific research questions, methods, or results related to a particular study.
b) Purpose: National guidelines aim to improve patient health outcomes by offering evidence-based recommendations for clinical practice. They are developed to guide healthcare providers in making informed decisions, optimize care delivery, and standardize practices. Stand-alone articles primarily focus on reporting research findings, advancing knowledge in a specific area, or exploring a particular research question.
c) Application to practice: National guidelines provide clear recommendations that can be directly implemented in clinical practice. They are intended to bridge the gap between research evidence and the delivery of care. Stand-alone articles, although informative, often require further interpretation and adaptation before their findings can be applied in clinical settings.
- Example of a national guideline and the DNP-prepared nurse’s influence: A prominent example of a national guideline is the “Guidelines for the Prevention of Catheter-Associated Urinary Tract Infections” developed by the Centers for Disease Control and Prevention (CDC) in the United States. These guidelines provide evidence-based recommendations for preventing urinary tract infections associated with indwelling urinary catheters.
DNP-prepared nurses can play a vital role in the development and application of national guidelines. They possess the knowledge, skills, and expertise to contribute to the guideline development process in various ways:
a) Research and evidence synthesis: DNP-prepared nurses can contribute to the evidence base by conducting research, critically appraising existing literature, and synthesizing the evidence to inform guideline development. Their advanced research skills enable them to provide valuable insights into best practices and identify research gaps.
b) Stakeholder engagement and advocacy: DNP-prepared nurses can actively participate in guideline development committees, working groups, or expert panels. They can represent the nursing profession, advocate for patient-centered care, and ensure that nursing perspectives and concerns are incorporated into the guidelines.
c) Dissemination and implementation: DNP-prepared nurses are well-equipped to facilitate the dissemination and implementation of national guidelines. They can play a crucial role in educating healthcare professionals about the guidelines, promoting their adoption in clinical practice, and evaluating their impact on patient outcomes.
Conclusion: The Delphi Technique offers a structured approach to gather expert consensus and develop national guidelines aimed at improving patient health outcomes. National guidelines provide comprehensive recommendations that can be directly applied to clinical practice, bridging the gap between research evidence and patient care. DNP-prepared nurses, with their advanced knowledge and skills, can significantly influence the development and application of national guidelines, ensuring that nursing perspectives are incorporated and promoting evidence-based practice in healthcare.
References:
- Centers for Disease Control and Prevention. (2019). Guidelines for the prevention of catheter-associated urinary tract infection. Retrieved from https://www.cdc.gov/infectioncontrol/pdf/guidelines/cauti-guidelines-H.pdf
- Okoli, C., & Pawlowski, S. D. (2004). The Delphi method as a research tool: an example, design considerations and applications. Information & Management, 42(1), 15-29.
- Woolf, S. H., Grol, R., Hutchinson, A., Eccles, M., & Grimshaw, J. (1999). Potential benefits, limitations, and harms of clinical guidelines. BMJ, 318(7182), 527-530.