Evidence-Based Research: Otitis Media in Children

Sources Review

1. The American Academy of psychiatrists through their article titled “Diagnosis and Management of Acute Otitis Media” arrived at several recommendations regarding the diagnosis of Otitis Media. This was done through systematic grading of the excellence that the evidence had and the potency of the commendations advanced. Expert consensus was sought when important data was unavailable but the practice guideline underwent peer review before a consensus was reached by the deliberating parties. In this regard, the article was a filtered source and since expert opinions from some of the best practitioners in the industry were sought, the article can be relied upon in the nursing practice. Finally, from the article abstract, it can be seen that the nature of the report is based on evidence derived from clinical practice, meaning the report is an evidence-based guideline.
2. The article titled “Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media”, written by Block, S.L. has been relied on by many credible agencies like the U.S National Library Of Medicine and research agencies like Biomed research. The article goes into detail in explaining the underlying factors that influence the treatment of Otitis media in small children; with a specific reference on the strains involved, resistance risks, and the likes. Comprehensively, the article can be classified as a filtered resource because it specifically deals with underlying issues in the treatment of Otitis media and more specifically the use of antibiotics or evidence-based practices. The article can be relied on for nursing-based practices because it is peer-reviewed and even has a stamp of approval by reliable state agencies like the American National Library of Medicine. Finally, the document can be termed as an evidence summary because it summarizes the findings of studies done on the treatment of Otitis Media among children.
3. The sourcebook titled “Current Pediatric and Diagnosis treatment” talks of several treatments for various types of diseases. It is quite useful for medical students who want to grasp important concepts in little time. In addition, the book is quite useful in pediatric treatment because it is based on evidence-based research especially regarding diseases that are common among children. This is because it focuses on children’s health care needs from birth to adolescence. Because the book is based on several pediatric types of practices, it qualifies as an unfiltered source but it can be termed as evidence-based guidelines since it relies more on evidence-based research. With regards to its applicability in nursing practice, it can be used in the general understanding of Otitis Media treatment but cannot be relied upon as a guideline for nursing practices on the same disease. More supplementary research is therefore required to affirm its recommendations for it to be relied on.
4. The source titled “Treatment for Acute Otitis media in an era of increasing microbial resistance” by McCracken majorly talks of resistance concerns in the treatment of Otitis media. To a large extent, this article is an unfiltered source because it concentrates on the resistances involved in the administration of treatment in Otitis treatment but the topic under investigation for this study deals with the use of evidence-based practices as opposed to the use of antibiotics. In addition, the article cannot be used for clinical practices. It is not peer-reviewed because it only incorporates finding derived from departmental level research in the University of Texas, southwestern medical Centre. However, the article is a research evidence study because it relies on historical research evidence to come up with its findings.
5. Information derived from Interviews with parents who have brought their children into the health facility is highly unreliable for use in medical practice because the parents may have little or no information at all, on what is to be considered in the treatment or management of Otitis Media. Parent information can therefore be as good as guesswork. In this regard, parent interviews as a source of information fall under the group of general information and because the information is unfounded, it does not fall in either of the categories of research evidence, evidence summary, or evidence-based summary.

Is watchful waiting for an appropriate approach for treating children with acute otitis media?

Watchful waiting is an approved way of treating children with Otitis media because it has been approved from research findings by the American Academy of Pediatrics that affirms that chances of reduced usage of antibacterial medicine are possible. This conclusion was arrived at after observing children suffering from Otitis media within 48 – 72 hours (American Academy on Pediatrics, 2004, p. 1464).

This is possible because it has been affirmed that management by symptomatic relief can be done especially in the first 48 -72 hours (American Academy on Pediatrics, 2004, p. 1464). However, this does not mean that treatment should not be undertaken because there are instances where it is advisable to immediately treat the patient but this depends on the severity of the disease, the child’s age, and the diagnostic certainty (American Academy on Pediatrics, 2004, p. 1464).

How could the findings of the article “Diagnosis and Management of Acute Otitis Media” be applied to improve nursing practice in the clinic?

The findings of the article titled “Diagnosis and Management of Acute Otitis Media” advanced by the American Academy on Pediatrics are useful in the management and treatment of patients with Otitis treatment because initial, preliminary management procedures for the treatment of Otitis media will be easily outlined by the research’s findings. The evidence-based research emphasizes the age of the child and the risks involved in undertaking watchful waiting; so in the management and treatment of Otitis, what is expected as the outcome of the treatment will be easily predicted.

For example, the study notes that there is an increased risk of undertaking watchful waiting for children under six months and who are suffering from serious Otitis Media (American Academy of Pediatrics, 2004, p. 1464). For older children, it is more advisable to undertake watchful waiting. These factors will be easily applied in the management and treatment of the disease. Comprehensively, accurate diagnosis of the disease will be enhanced through the adoption of the research’s findings.

Ethical issues that could arise in researching and changing clinical practice guidelines, based on the evidence-based research

The ethical issues in changing the course of treatment for Otitis media may vary from family to family or from one geographical location to the other (Block, 2005, p. 75). In determining the type of treatment to be applied for toddlers suffering from Otitis, the decision-making process ought to be comprehensive because it needs to include the input of the physician, parent, and the general health care team (Block, 2005, p. 75). The same decisions ought to be carefully made in consideration of existing laws that guide such sort of treatment as well as any binding court rulings on the same.

In addition, important information ought to be availed to the parents of the children so that they can make an informed decision on whether to use the technique or not. This is by regulations by the American Counseling Association (cited in Rosenfeld, 2003, p. 98) which states that “ A health personnel undertaking new or undetermined medical practice must define the techniques/procedures as ‘unproven’ or ‘developing’ and explain the potential risks and ethical considerations of using such techniques/procedures and take steps to protect clients from possible harm”. In this regard, the patient’s parents ought to be supplied with the necessary information regarding the approach so that they can make or provide informed consent.

In addition, there may be certain vulnerable populations like young mothers or parents from rural populations who may not be aware of the ethical issues in the use of the new clinical approach to treat Otitis Media. Such vulnerable groups need to be educated about the approach before it is used so that they can also give informed consent on the same. In other words, healthcare practitioners should not take advantage of vulnerable groups.

The health care practitioners should therefore provide complete information on the approach and the expected procedures in the management and treatment of the disease. In certain cases, it may be prudent for the health care personnel to give referrals to more competent bodies/agencies or officials so that further action can be taken, either in helping the parents of guardians make informed choices or in mere management and treatment of the disease.

In addition, the health care practitioners should first let the parents know their duties, rights, and obligations in assenting to watchful waiting, but more importantly, the health care staff should understand the cultural contexts in administering such treatment and they should only make such a judgment in accordance to their level of expertise or the position they are in when making such decisions. Also, health care practitioners should exercise the highest form of patient-doctor confidentiality in the use of such techniques so that instances where external parties who are interested in obtaining information for either commercial or research purposes cannot do so.

References

American Academy on Pediatrics. (2004). Diagnosis and Management of Acute Otitis Media. Pediatrics, 113(5), 1451-1465. Print.

Block, M.D. (2005). Diagnosis and Management of Acute Otitis Media. Michigan: Professional Communications. Print.

Rosenfeld, R. (2003). Evidence-Based Otitis Media. New York: PMPH-USA. Print.