Clinical Practice

by | Feb 20, 2025 | anthropology

 

Identify a clinical practice guideline in your specialty area. You will be challenged to evaluate this guideline and discuss its use in clinical practice. This assignment is due at the end of Week 7 but can be completed anytime during this course. This assignment requires a considerable amount of time for completion. Do not wait until week 7 to begin this assignment.

Choose a health problem that you may commonly see in primary care nurse practitioner practice. Describe the health problem and recommended medical management for it. Research published clinical practice guidelines and evaluate the practice guideline you have selected based on the components listed in the Clinical Practice Guideline Template below.

Clinical Practice Guideline Prompts:

HEALTHCARE PROBLEM IDENTIFIED: Briefly describe the health problem you have identified. Include a discussion of morbidity, mortality, epidemiology and pathophysiology related to this health problem

Describe the clinical practice guideline used for this problem. Reflect on the questions included. Expand on your answer using support from evidence

Does the clinical practice guideline adequately address the health problem? Describe.
Is this practice guideline based on current evidence (within 5 years)? What is the strength of this evidence?
Does this clinical practice guideline adequately direct the healthcare provider in the management of a patient with this problem?
How effective is this clinical guideline in the management of patients with this healthcare problem? Think about how you would assess the effectiveness of patient management.
ANALYSIS: Think about future healthcare needs of patients with this problem, changing demographics, and changes in healthcare policies. Address these questions.

Does this clinical practice guideline need revision(s)? Please explain your answer in detail.
If you were going to revise this clinical practice guideline, what would you change? What evidence would you use to base your changes on?
How might changes in US demographics and healthcare reform affect this clinical practice guideline?
What strategies would you use to increase the likelihood that a new or modified clinical practice guideline would be adopted and used in clinical practice?

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Let’s focus on Type 2 Diabetes Mellitus (T2DM) as the health problem and use the American Diabetes Association (ADA) Standards of Medical Care in Diabetes as the clinical practice guideline.

HEALTHCARE PROBLEM IDENTIFIED:

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia arising from insulin resistance, relative insulin deficiency, or both. It’s a significant public health concern due to its increasing prevalence and associated complications.

  • Morbidity: T2DM is a leading cause of morbidity, contributing to cardiovascular disease, retinopathy (eye disease), nephropathy (kidney disease), neuropathy (nerve damage), and lower limb amputations. These complications significantly impact quality of life and increase healthcare costs.
  • Mortality: T2DM is a major contributor to mortality, primarily due to cardiovascular events. People with diabetes have a significantly higher risk of heart attack, stroke, and other cardiovascular diseases.

Let’s focus on Type 2 Diabetes Mellitus (T2DM) as the health problem and use the American Diabetes Association (ADA) Standards of Medical Care in Diabetes as the clinical practice guideline.

HEALTHCARE PROBLEM IDENTIFIED:

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia arising from insulin resistance, relative insulin deficiency, or both. It’s a significant public health concern due to its increasing prevalence and associated complications.

  • Morbidity: T2DM is a leading cause of morbidity, contributing to cardiovascular disease, retinopathy (eye disease), nephropathy (kidney disease), neuropathy (nerve damage), and lower limb amputations. These complications significantly impact quality of life and increase healthcare costs.
  • Mortality: T2DM is a major contributor to mortality, primarily due to cardiovascular events. People with diabetes have a significantly higher risk of heart attack, stroke, and other cardiovascular diseases.
  • Epidemiology: T2DM prevalence is rising globally, with a disproportionate impact on certain populations, including older adults, racial and ethnic minorities, and individuals with obesity or a family history of diabetes. The rise is linked to lifestyle factors such as physical inactivity, poor diet, and increasing rates of obesity.
  • Pathophysiology: The core defects in T2DM involve insulin resistance (cells don’t respond properly to insulin) and progressive beta-cell dysfunction (the pancreas’s ability to produce insulin declines over time). These lead to elevated blood glucose levels.

Clinical Practice Guideline:

The ADA Standards of Medical Care in Diabetes is a comprehensive clinical practice guideline updated annually. It provides evidence-based recommendations for the diagnosis, management, and prevention of diabetes and its complications.

Evaluation of the ADA Standards of Medical Care in Diabetes:

  • Adequacy: The ADA guideline comprehensively addresses T2DM, covering screening, diagnosis, glycemic control, management of complications, lifestyle interventions, pharmacotherapy, and patient education.
  • Evidence-Based: The ADA guideline is based on current evidence, with regular updates reflecting the latest research. The strength of evidence is graded and clearly indicated within the guideline, ranging from high-quality randomized controlled trials to expert opinion. Most recommendations are supported by evidence within the last 5 years.
  • Direction for Management: The guideline provides clear and specific recommendations for healthcare providers, offering algorithms and tables to guide decision-making. It covers various aspects of patient care, from initial assessment to ongoing management.
  • Effectiveness: The effectiveness of the guideline is assessed through its impact on clinical practice and patient outcomes. Studies have shown that adherence to ADA guidelines is associated with improved glycemic control, reduced complications, and better quality of life for people with diabetes. Effectiveness can be assessed by tracking HbA1c levels, complication rates, patient satisfaction, and other relevant metrics.

ANALYSIS:

  • Need for Revisions: The ADA guideline is regularly revised annually to incorporate new evidence and address emerging challenges. Continuous research and evolving understanding of diabetes necessitate ongoing updates.
  • Specific Revisions: Potential areas for revision could include:
    • Expanding recommendations on the use of newer diabetes medications (e.g., SGLT2 inhibitors, GLP-1 receptor agonists), including their cardiovascular benefits and cost-effectiveness.
    • Strengthening guidance on personalized medicine approaches, considering individual patient characteristics and preferences.
    • Enhancing strategies for addressing social determinants of health that impact diabetes management.
    • Integrating more detailed guidance on the use of technology in diabetes care (e.g., continuous glucose monitoring, telehealth).
    • Incorporating more research on effective interventions for diabetes prevention.
  • Evidence for Revisions: Revisions would be based on the latest published research, including randomized controlled trials, meta-analyses, and observational studies. Expert consensus and clinical experience would also be considered.
  • Impact of Demographics and Healthcare Reform:
    • Demographics: The aging population and increasing prevalence of obesity and diabetes in certain ethnic groups necessitate culturally sensitive and tailored approaches to diabetes care.
    • Healthcare Reform: Changes in healthcare policies, such as value-based care and emphasis on preventative care, can influence the delivery of diabetes care. The guideline needs to be adaptable to these changes.
  • Strategies for Guideline Adoption:
    • Dissemination through professional organizations, conferences, and publications.
    • Integration into electronic health records (EHRs) with clinical decision support tools.
    • Educational programs and training for healthcare providers.
    • Performance measures and quality indicators linked to guideline adherence.
    • Incentives for adoption and implementation.
    • Collaboration with stakeholders, including patients, to ensure the guideline is user-friendly and relevant.

By continually evaluating and updating clinical practice guidelines like the ADA Standards of Medical Care in Diabetes, and by implementing effective strategies for dissemination and adoption, healthcare professionals can improve the quality of care and outcomes for people with diabetes.

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