Nursing Research

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
https://aappolicy.aappublications.org/cgi/content/full/pediatrics;113/5/1451 ? 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.

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. 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.

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