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.


Sample Solution

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.

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.



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 Studies4(8), 487.

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