Clinical Protocols and AGREE Rating Scale.

Clinical Protocols and AGREE Rating Scale.

 

Complete the protocol evaluation activity by following these instructions: Select a practice protocol related to your mental health clinical setting. These may be from your agency’s policy and procedure manual used in your practice.Clinical Protocols and AGREE Rating Scale. Determine who wrote the protocol and request an interview with one or more individuals who were involved in developing the protocol.

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Interview questions may include, but are not limited to the following: Can you explain how protocols are developed in your agency? What specific information or data was used to develop this protocol? Are there any references you can identify that would give me a better understanding of the rationale for the practices used in the protocol? What rating system was used to critique the protocol guidelines? After the interview, categorize the sources of knowledge identified by the interviewee (e.g., authority, experience, research-based).Clinical Protocols and AGREE Rating Scale. Be specific. After the interview, you may not have enough information on which to rate the protocol. If, for example, the interviewee has not provided you with sources from the literature, you will have to do a search to determine whether research exists to support the protocol you are assessing. Clinical Protocols and AGREE Rating Scale.This does not have to be an exhaustive review, yet you should be able to determine whether there is valid research there to support your rating (see next step). Then, using the AGREE ll rating scale, assess the protocol for its validity in application to practice. Complete a Brief Evaluation of the Protocol Outline by following these steps: Brief description of the protocol. Title and credentials of the individuals who developed the protocol. Parameters of the literature search and a summary of how the protocol was developed. Your summary conclusion about the types and quality of knowledge upon which the protocol was based with supporting rationale. A brief description of the AGREE rating scale used to assess the protocol. Your assessment of the validity of the selected protocol.Clinical Protocols and AGREE Rating Scale.

Introduction

Evaluation forms an integral and objective part of understanding the development and implementation of a policy, its effects, why, and for whom. Proper evaluations provide insights and promote our understanding of what works, what does not, and to use this information to build on future practices. According to Zebrack et al. (2017), evaluation also provides evidence that supports claims on the effectiveness of the intervention and build confidence in what we do. The health sector continues to develop, implement, and evaluate new strategies to promote healthcare delivery, inform clinical decision-making, and minimize harm to promote the integrity and quality of health outcomes. This paper evaluates a clinical protocol for the clinical assessment and management of psychomotor agitation.Clinical Protocols and AGREE Rating Scale.

PART I: Interview

The author selected a protocol for the inpatient clinical management of psychomotor agitation (PMA). A team of experts developed this protocol through consensus using the Delphi method. For the purpose of this assignment, the author interviewed one of the members the head of the expert consensus team, and a specialist in psychiatric emergency.     Clinical Protocols and AGREE Rating Scale.

Interviewer: Can you explain how protocols are developed in your agency?

Interviewee: Often, two triggers influence the development of protocols in our agency; knowledge and clinical problems. Healthcare providers conduct quarterly reviews to identify potential gaps in healthcare delivery and evaluate clinical psychiatric scenarios that healthcare providers could handle differently for better outcomes. From the outcomes of the meetings /reviews, providers unanimously agree if there is need to develop a protocol to guide the actions and decision-making in healthcare delivery. After reaching a consensus on the need for a protocol, a multidisciplinary team under the leadership of a more experienced specialist in the given field.Clinical Protocols and AGREE Rating Scale.

Interviewer: What specific information or data was used to develop this protocol?
Interviewee: This protocol was primarily developed from the recommendations provided by the American Psychiatric Association and other international mental health/psychiatric associations, comprehensive review of literature and expert opinion.

Interviewer: Are there any references you can identify that would give me a better understanding of the rationale for the practices used in the protocol?
Interviewee: Yes. There are several from the best available expertise and evidence that primarily discuss about agitated psychiatric patients.

Interviewer: What rating system was used to critique the protocol guidelines?
Interviewee: We used the GRADE system

Categories of the Sources of Knowledge

Authority-during the development of the protocol, the developers obtained information from psychiatric specialists particularly those who had previously managed patients with psychomotor agitation since they understood and had the knowledge

Research-based- the developers also conducted a research particularly a systematic review to gather past knowledge and make present decisions.Clinical Protocols and AGREE Rating Scale.

Research to Support the Rating

The developers have clearly highlighted the protocol’s purpose and scope (to guide the early identification, intervention, and management of PMA). It involved all the stakeholders with different areas of specialization in mental health involved in daily psychiatric practice. The process of gathering and synthesizing evidence and formulating recommendations was appropriate including the structure, language and guideline format. The developers also highlighted potential implementation barriers and enablers and at the end, it was rather evident that there was editorial independence by acknowledge how there is since there were no conflicts interests. The author would score 7(strongly agree) to indicate exceptionality and validity in the quality of the reporting with well-articulated considerations that match a full criteria.

PART II: Protocol Evaluation

Protocol Description

The protocol describes how to assess and manage patients presenting with PMA. The protocol is a wider compilation of currently available bibliography on PMA that healthcare providers can easily apply in daily practice. The protocol recognizes psychomotor agitation (PMA) as a state of mental tension and motion restlessness, which calls for immediate recognition, evaluation, and management to reduce patient anxiety and the likelihood of progression to violence and aggression.Clinical Protocols and AGREE Rating Scale.

Manzo, Gareri & Castagna (2017) emphasizes that, when hClinical Protocols and AGREE Rating Scale.ealthcare providers have standard protocols, they can easily identify patients who are at high risk of PMA, make a timely diagnosis and implement strategies that are minimally invasive to ensure the safety of staff and patients and resolve a PMA episode. The international expert consensus published some recommendations describing the systematic approach to assessing and managing patients presenting with PMA. However, the guidelines do not provide a standardized protocol or tool to help clinicians achieve the best outcomes for patients presenting with PMA episodes.Clinical Protocols and AGREE Rating Scale.

Credentials and Title of Individuals Who Developed the Protocol

Garriga Marinna, Pacchiarotti Isabella, Kasper Siegfried, Zeller L. Scott, Allen H. Michael, Vazquez Gustavo & Courtet Phillippe developed this protocol. These authors were from different nations such as the USA, Argentina, France, Italy, France, Australia, and Spain are the most cited authors among other additional expert authors from key geographical areas.Clinical Protocols and AGREE Rating Scale.

Literature Search Parameters and Summary of How the Protocol Was Developed

An expert taskforce conducted the literature search the Delphi method to develop a consensus. They used the systematic review of the literature to conduct an initial survey while in other subsequent surveys; they used re-rated or re-worded items(Garriga et al 2016). The protocol was based on findings from peer-reviewed journals, meta-analysis, reviews, clinical trial reports, as well as PMA clinical guidelines. The researchers conducted an extensive search for literature in a wide range of databases namely Cochrane, Scopus, Medline, and CINAHL using keywords such as agitation, assessment, clinical features, and epidemiology (Garriga et al 2016). In the final search, the researchers included articles published between 1970 December to 2015 December on PMA.

Summary Conclusion of the Types and Quality of Knowledge

This protocol included 124 papers from 2175 articles. The author would rate the knowledge as research-based since the developers used a systematic review approach to search for relevant studies and evaluated using an evidence level (Garriga et al 2016). There was also an expert consensus to agree on 22 statements. The developers also referred to the guidelines provided by non-pharmaceutical and pharmaceutical agents of Emergency Psychiatry.Clinical Protocols and AGREE Rating Scale.

Brief description Of Agree Rating Scale to Assess the Protocol

The developers used a descriptive rating scale where reach response had an elaborative explanation. Although there was also a numerical value related to the responses, the developers provided a detailed discussion of all the response options to ensure that every person thoroughly understood the protocol(Garriga et al 2016). Therefore, the researchers rated the survey items as ‘endorsed, re-rated’ or ‘rejected’ and conducted it using a similar method that was used in developing the use of antidepressants for patients with bipolar in clinical practice. All items noted as endorsed rated 80%, re-rated items ranged between 65%-75% while rejected was at least 65%.Clinical Protocols and AGREE Rating Scale.

Validity Assessment of Selected Protocol

The selected protocol has a high validity since the developers used the Jadad scale to rate the methodological quality of every report either as poor or good (0-2 & 3-5 respectively). Besides, for the general quality, the developers rated their quality as A, B, C, or D (Garriga et al 2016). To support the information that researchers could not obtain from individual studies, the developers used reviews and meta-analysis as evidence. Besides, all the systematic reviews adhered to the PRISMA guidelines and statements. At the end of the systematic reviews, the developers used the Delphi method to do a table of agreed recommendations using three surveys to develop consensus.Clinical Protocols and AGREE Rating Scale.

Complete the protocol evaluation activity by following these instructions:

  1. Select a practice protocol related to your clinical setting. These may be from your agency’s policy and procedure manual used in your practice.
  2. Determine who wrote the protocol and request an interview with one or more individuals who were involved in developing the protocol. Interview questions may include, but are not limited to the following:Clinical Protocols and AGREE Rating Scale.
    1. Can you explain how protocols are developed in your agency?
    2. What specific information or data was used to develop this protocol?
    3. Are there any references you can identify that would give me a better understanding of the rationale for the practices used in the protocol?
    4. What rating system was used to critique the protocol guidelines?Clinical Protocols and AGREE Rating Scale.
  3. After the interview, categorize the sources of knowledge identified by the interviewee (e.g., authority, experience, research-based). Be specific.
  4. After the interview, you may not have enough information on which to rate the protocol. If, for example, the interviewee has not provided you with sources from the literature, you will have to do a search to determine whether research exists to support the protocol you are assessing. This does not have to be an exhaustive review, yet you should be able to determine whether there is valid research there to support your rating (see next step).
  5. Then, using the AGREE ll rating scale, assess the protocol for its validity in application to practice.Clinical Protocols and AGREE Rating Scale.
  6. Complete a Brief Evaluation of the Protocol Outline by following these steps:
    1. Brief description of the protocol.
    2. Title and credentials of the individuals who developed the protocol.
    3. Parameters of the literature search and a summary of how the protocol was developed.
    4. Your summary conclusion about the types and quality of knowledge upon which the protocol was based with supporting rationale.
    5. A brief description of the AGREE rating scale used to assess the protocol.

Your assessment of the validity of the selected protocol.

Introduction

Evaluation forms an integral and objective part of understanding the development and implementation of a policy, its effects, why, and for whom. Proper evaluations provide insights and promote our understanding of what works, what does not, and to use this information to build on the future. According to Zebrack et al. (2017), the evaluation also provides evidence that supports claims on the effectiveness of the intervention and build confidence in what we do. The health sector continues to develop, implement, and evaluate new strategies to promote healthcare delivery, inform clinical decision-making, and minimize harm to promote the integrity and quality of health outcomes. This paper presents the findings of an evaluation of a clinical protocol that guides the clinical assessment and management of psychomotor agitation.Clinical Protocols and AGREE Rating Scale.

Protocol Description

The protocol describes how to assess and manage patients presenting with PMA. The protocol is a wider compilation of currently available bibliography on PMA that healthcare providers can easily apply in daily practice. The protocol recognizes psychomotor agitation (PMA) as a state of mental tension and motion restlessness, which calls for immediate recognition, evaluation, and management to reduce patient anxiety and the likelihood of progression to violence and aggression. Manzo, Gareri & Castagna (2017) emphasizes that, when healthcare providers have standard protocols, they can easily identify patients who are at high risk of PMA, make a timely diagnosis and implement strategies that are minimally invasive to ensure the safety of staff and patients and resolve a PMA episode. The international expert consensus published some recommendations describing the systematic approach to assessing and managing patients presenting with PMA. However, the guidelines do not provide a standardized protocol or tool to help clinicians achieve the best outcomes for patients presenting with PMA episodes.

Credentials and Title of Individuals Who Developed the Protocol

Garriga Marinna, Pacchiarotti Isabella, Kasper Siegfried, Zeller L. Scott, Allen H. Michael, Vazquez Gustavo & Courtet Phillippe developed this protocol. These authors were from different nations such as the USA, Argentina, France, Italy, France, Australia, and Spain are the most cited authors among other additional expert authors from key geographical areas.

Literature Search Parameters and Summary of How the Protocol Was Developed

An expert taskforce conducted the literature search the Delphi method to develop a consensus. They used the systematic review of the literature to conduct an initial survey while in other subsequent surveys; they used re-rated or re-worded items(Garriga et al 2016). The protocol was based on findings from peer-reviewed journals, meta-analysis, reviews, clinical trial reports, as well as PMA clinical guidelines. The researchers conducted an extensive search for literature in a wide range of databases namely Cochrane, Scopus, Medline, and CINAHL using keywords such as agitation, assessment, clinical features, and epidemiology (Garriga et al 2016). In the final search, the researchers included articles published between 1970 December to 2015 December on PMA.Clinical Protocols and AGREE Rating Scale.

Summary Conclusion of the Types and Quality of Knowledge

This protocol included 124 papers from 2175 articles. The author would rate the knowledge as research-based since the developers used a systematic review approach to search for relevant studies and evaluated using an evidence level (Garriga et al 2016). There was also an expert consensus to agree on 22 statements. The developers also referred to the guidelines provided by non-pharmaceutical and pharmaceutical agents of Emergency Psychiatry.Clinical Protocols and AGREE Rating Scale.

Brief description Of Agree Rating Scale to Assess the Protocol

The developers used a descriptive rating scale where reach response had an elaborative explanation. Although there was also a numerical value related to the responses, the developers provided a detailed discussion of all the response options to ensure that every person thoroughly understood the protocol(Garriga et al 2016). Therefore, the researchers rated the survey items as ‘endorsed, re-rated’ or ‘rejected’ and conducted it using a similar method that was used in developing the use of antidepressants for patients with bipolar in clinical practice. All items noted as endorsed rated 80%, re-rated items ranged between 65%-75% while rejected was at least 65%.Clinical Protocols and AGREE Rating Scale.

Validity Assessment of Selected Protocol

The selected protocol has a high validity since the developers used the Jadad scale to rate the methodological quality of every report either as poor or good (0-2 & 3-5 respectively). Besides, for the general quality, the developers rated their quality as A, B, C, or D (Garriga et al 2016). To support the information that researchers could not obtain from individual studies, the developers used reviews and meta-analysis as evidence. Besides, all the systematic reviews adhered to the PRISMA guidelines and statements. At the end of the systematic reviews, the developers used the Delphi method to do a table of agreed recommendations using three surveys to develop consensus.Clinical Protocols and AGREE Rating Scale.