Many people with intellectual and developmental disabilities communicate pain and other ailments through their behavior. To the unaware family members or caregivers, this may result in treatment of a perceived behavioral issue rather than the underlying medical issue that maybe the course of the behavior.

It starts with the family members, and caregivers knowing the baseline, detecting changes, and communicating the changes to nurses and other healthcare professionals.

Family members and caregivers will therefore need to be educated. This nursing education to family members and caregivers will provide them with the education of common medical behaviors that should prompt nursing care.

Educating parents and caregivers is the solution to this problem!!!

Develop a paper that addresses the clinical need to educate family members and caregivers, discusses the nursing guideline, and critically analyze three (3) research studies that support the guideline.

Following this you will present the intellectual and developmental disability clinical setting and discuss how you might implement the guideline within that setting. You are not required to implement, just formulate a plan.

Review a variety of web sites such as:

Agency for Healthcare Research and Quality National Guideline Clearinghouse

FINDING THE EVIDENCE Clinical Practice Guidelines
Best Practice Guidelines RCN Clinical Guidelines Nursing Best Practices professiionals

Look for the best NURSING guideline that will provide the solution and evidence-based interventions for the identified clinical concern and that will provide the support for the development of this evidence-based assignment.

The important deciding factor is whether the intervention is something registered nurses have decisional control over. Be careful NOT to choose an intervention that is a medical intervention that is simply carried out by nurses. You need to find a guideline that supports nursing actions and nursing sensitive outcomes.


1. Establish the Research Support

Using the existing nursing research protocols, the clinical guideline you have designed, identify at least three (3) research articles from references of the nursing research protocol, clinical guideline, or best practice.

Look for meta-analyses, integrative reviews of research, clinical trials, and quasi-experimental studies related to your topic.

2. Once you find the research studies, you will examine EACH source/study and describe the SETTING, PURPOSE, RESEARCH DESIGN, SAMPLE, FINDINGS, AND LIMITATIONS. This will be quite easy to do as it should be clearly identified in the study. Fill this in the REVIEW OF THE EVIDENCE FORM (attached) for each study. PLEASE USE THE FORM PROVIDED – IT IS REQUIRED AND SHOULD BE IMBEDDED WITHIN YOUR PAPER as shown in the attached sample paper.

3. Then note the levels of evidence for each study. Use the table attached. USE THIS TABLE TO MAKE A JUDGMENT AS TO THE LEVEL EACH RESEARCH ARTICLE FITS.
Rating System for the Hierarchy of Evidence/Levels of Evidence;

Level I Evidence for a systematic review or meta-analysis of all relevant RCTs or evidence-based clinical practice guidelines based on systematic reviews of RCTs.

Level II Evidence obtained from at least one well-designed RCT

Level III Evidence obtained from one well-designed controlled trials without Randomization

Level IV Evidence from well-designed case-control and cohort studies

Level V Evidence from systematic reviews of descriptive or qualitative study

Level VI Evidence from single DESCRIPTIVE or QUALITATIVE study

Level VII Evidence from the opinion of authorities and/or reports of expert committees

Note that when you determine the LEVEL OF EVIDENCE, YOU MUST JUSTIFY WHY YOU CHOSE THAT LEVEL. Please do this carefully as this will reflect your understanding of levels of evidence.
4. Following the completion of the review of the three articles, you will complete this assignment by writing a narrative summary of the levels of evidence of the studies. This represents the “body of evidence” supporting your proposed clinical change. Summarize how strong you feel the evidence is to support your proposed change.

5. Thus, you will submit three completed evidence based tables (sample and blank one attached) forms within the paper, a brief explanation at the end of each signifying the strength of the evidence, and ONE paragraph at the end summarizing the BODY OF EVIDENCE supporting your proposed change. These three forms are to be included in the body of the paper and should NOT be submitted separately.

6. Application of the Guideline, Protocol, or Best Practice to the Clinical Setting

During this section of the paper you will describe the intelelctual and devlopmental disability clinical setting in which you propose to implement the guideline and you will address how you will accomplish this taking into consideration the agency, administration, staff, and desired outcomes of the intervention. You will specify how you will plan this change and utilize a specific theory of change (Lewin works best for this) to support your plan.

7. Summary

Synthesize the content of the paper with a full summary of the paper and provide at least four significant summary points.

8. Reflection

End the paper with a thoughtful reflection on the experience of seeking the evidence for a change in clinical practice and the planning it takes to implement this change. Has this experience broadened and strengthened your understanding of evidence-based nursing practice? How do you see yourself moving forward and using the understanding and skills you developed through this assignment? Note that this is the only section of the paper where you will use personal pronouns.

9. References

Provide full APA formatted references for all research studies and be sure that you have provided citations for all the sources in your paper as well as full references for these citations. It is expected that the content of the paper will be well supported with support from credible and scholarly nursing sources.


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