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Sample from a HLLG 6018 Summative Assignment
Section on Guidelines – comparison of 2 guidelines using a guideline appraisal tool. Comments in red are those added by the tutor. Note the suggestions for adding an extra layer of critical analysis at different points in the discussion. This will get higher marks.

“There are several tools available that will assist in critically appraising evidence and guidelines; one example is the AGREE II tool (Appraisal of Guidelines, Research and Evaluation), which was created by a group of international guideline development and research experts (citation given). The aim of the tool is to assess the quality of the guideline. This addresses any bias and gives confidence that any recommendations made in the guideline are valid (citation given).
A number of citations are used to support the flow throughout this section of the assignment, although a wider range of EBP sources could have been used.
The AGREE II tool has 23 key points that cover 6 aspects relating to i) the scope and purpose of the guideline, ii) – remaining 5 points briefly discussed – as an alternative this rather descriptive section of text could have been included as an Appendix to save word count.
The AGREE II tool can be used by any healthcare practitioner and is used here to compare 2 guidelines relating to the pre-hospital administration of intravenous fluids in the trauma patient. TRIP was used to search for these guidelines, which is a search engine used to find high quality evidence. The first guideline to be critiqued was produced by the National Institute for Health and Care Excellence (NICE) titled “Pre-hospital Initiation of Fluid Replacement Therapy in Trauma” (NICE 2004) and results are shown in Appendix 2 – note how the Appendix has been used here to include the detailed analysis of the guideline. This isn’t a requirement though, as what follows here in the discussion should be a summary of the process which captures the key points raised. The guideline scored highly on scope and purpose identifying clearly its purpose and target population. It was well written, descriptive and easy to locate. Stakeholder involvement was very descriptive, detailing …………………, with a good mixture of external bodies who were invited to participate. The target user groups were not clearly stated….. Additional analysis (and extra marks) could be included here. Something along the lines of “Bloggs (20xx) indicates that this can enhance how guideline recommendations are implemented.” ……, but when reading the guideline it is clearly aimed towards ambulance staff. Rigour of development scored high where a very detailed section highlighted the evidence included and excluded, with more detailed information located in the supporting evidence describing the search; terms used, time frames, databases accessed, and was detailed enough to replicate the search – again, additional analysis could be added here – “Smith (20xx) indicates that this can enhance the ……..” Overall, this guideline and supporting evidence scored highly, and was very detailed and transparent.

In comparison, the second guideline was produced by the National Guideline Clearinghouse (NGC) titled “Guidelines for Prehospital Fluid Resuscitation in the Injured Patient” (NGC 2009). All guidelines for NGC use a set template and have to meet specific criteria, making all their guidelines easy to compare. Using the AGRRE II tool, the score for scope and purpose was reasonably high, using clear bullet points to state the aim of the guideline. The guideline development group included a wider range of relevant professionals and involved patient / users (could add additional analysis – “Jones (20xx) highlights how the latter can enhance the quality of guideline recommendations).…; Stakeholder involvement scored slightly lower….;.discussion continues……..The search criteria was very systematic with inclusion/exclusion material clear and concise in the supporting evidence could add additional analysis along the lines of (Brown, 2009) demonstrates how this approach can improve……”, giving evidential reasons using……………….., but information regarding the guideline being externally reviewed was poorly documented, with no reference to updates at all (Bates (20xx) recommends that guidelines should be updated every………). Clarity of presentation scored……….ongoing discussion continues in line with the analysis tool. Note how a critical approach is sustained using “however” and “but”.

Type Of Service: Academic paper writing
Type of Assignment: Case study
Subject: Healthcare & Medicine
Pages / Words: 9/2300
Number of sources: 25
Academic Level: HNC / HND
Paper Format: Harvard
Line Spacing: Double
Language Style: UK English

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