Palliative and End Of Life Care in Stroke Scope and Practice Homework

PALLIATIVE AND END-OF LIFE CARE IN STROKE: A GUIDANCE STATEMENT Clinical Guideline Appraisal Christian Bledsoe RN Shona Cook RN Jeanette Jaffe RN Shari Palmer RN College of Central Florida, BSN DOMAIN 1. SCOPE AND PRACTICE • Deals with potential health impact of guideline on society/populations of patients or individuals • Agree II score: 88% • 1. Are overall objectives specifically described? • 2. Are health questions clearly defined? • 3. Is population specifically described? Creator(s) initials: __sp___ DOMAIN 2. STAKEHOLDER INVOLVEMENT • Refers to Professionals involved in development process of guideline; excluding external reviewers • Agree II score: 84% • 4. Is the development group relevant to the guideline? • 5. Are views and preferences of population sought? • 6. Are guideline users clearly defined? Creator(s) initials: __sp___ DOMAIN 3. RIGOUR OF DEVELOPMENT • Refers to the evidence, research, and methods used to develop recommendations • Agree II score 81% • Endorsed guideline by multiple experts, search words included • Inclusion criteria clear exclusion criteria inferred • Bias control discussed but limited and uncertain • Level of evidence and class recommendations available • Supporting data clear and need for further research addressed • Recommendations for discussion revisits but no timeframe given • Purpose and intent clear, expert clinicians endorsed guideline • Recommended further research but no plan visited creator CB DOMAIN 4. CLARITY OF PRESENTATION ● Assesses the language, structure, and format of the guideline ● Agree II score: 72% ● The guideline should be written such that: ● The recommendations are specific and unambiguous ● Many were overly broad with unclear intended population ● The different options for management if the issue are clearly presented ● Different options were presented for this complex issue, but had some issues with clarity ● Key recommendations are easily identifiable ● Typed in bold and followed each corresponding evidence section creator JJ DOMAIN 5. APPLICABILITY • Refers to how the guideline of end of life care and palliative care is applied to patients suffering from strokes in the real world practice • Agree II score- 54.1% • Facilitators are the patients and healthcare staff • Communication techniques are discussed • Criteria for inclusion is ICH, SAH, and ischemic strokes Creator(s) initials: ___sc__ DOMAIN 6. EDITORIAL INDEPENDENCE • Refers to the editorial and governing bodies in reflection to funding for the research guideline • Agree II score 40% • No definite statement supporting or disclosing the use of external funds • No definitive statement made disclosing competing interests. Creator(s) initials: ___sc__ OVERALL GUIDELINE ASSESSMENT ● Overall rating: 5.5 out of 7 ● 1 group member would recommend this guideline for use. ● 3 group members would recommend this guideline for use with modifications. ● Recommendations for practice ○ include practical strategies for implementing general recommendations ○ a more delineated plan for further research and education creator JJ REFERENCES • Holloway RG, Arnold RM, Creutzfeldt CJ, Lewis EF, Lutz BJ, McCann RM, Rabinstein AA, Saposnik G, Sheth, KN, Zahuranec DB, Zipfel GJ, Zorowitz RD; on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, and Council on Clinical Cardiology. Palliative and end-of-life care in stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014; 45:1887-1916. …