Evidence-Based Practice Resource Filtered Unfiltered Article Review

Pages: 3 (1025 words)  ·  Style: APA  ·  Bibliography Sources: 3  ·  File: .docx  ·  Level: College Junior  ·  Topic: Medicine

This does not mean that antibiotics would never be used, but only that they are used appropriately instead of blindly. Instead, evidence-based practice suggests that the healthcare professional should: 1) Review and confirm the diagnosis of AOM; determine if chronic or not. If the symptoms are irregular and not chronic, treat only overt symptoms; 2) Assess the discomfort level of the patient; use Tylenol or Motrin, topical agents, warm compresses, etc. To relieve pain and reduce symptoms; 3) Observe patient for 48-72 hours; educate parent in ways to mitigate symptoms and procedure if condition becomes worse; 4) If chronic or severe, or if AOM is worse after the watchful waiting period, Rx of amoxicillin, 80/90mg/kg per day; 5) Check in 3-4 days for reduction in symptoms, etc.

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Part D -- Ethical issues do surround the idea of watchful waiting. In one opinion, watchful waiting is experimenting with a human patient -- waiting to see what develops. The other view holds that watchful waiting is actually more compassionate, because in the long run too many antibiotics are being prescribed and bacterial resistance is increasing. For the medical professional, though, the ethical mandates are: beneficence forming the locus of the Hippocratic Oath - "as to disease, do no harm;" Justice in care - providing the best care equally and fairly; and Autonomy -- the respect to allow each individual to make informed decisions and not push treatments that the client may or may not wish. This also includes saying "no" to the parent who insists on an antibiotic. Instead, explain that viruses do not respond to antibiotics, and overuse could actually put their child in danger (Timko, 2001, 62-5, 121-45).

Article Review on Evidence-Based Practice Resource Filtered Unfiltered Assignment

The ethical nature of research is especially relevant when dealing with disenfranchised populations. Children, for instance, do not yet have the cognitive development to understand the issue of experimentation, and therefore must rely on the parent or guardian for guidance. HIPPA (The National Health Insurance Portability and Accountability Act) is designed to protect the confidentiality of all health information (through case notes, the Internet, to insurance or any agency). In fact, each professional organization must regularly preform a formal risk assessment by documenting how HIPPA rules are followed (Minors Privacy Rights, 2010).


Diagnosis and Management of Acute Otitis Media. (2004). Pediatrics. 113 (5): 1451-65.

Sources of Evidence-Based Literature. (2006). NYU School of Medicine. Ehrman Medical

Library. Retrieved from: http://library.med.nyu.edu/library/instruction / handouts/pdf/ebmsources.pdf

Minors, Privacy Rights of HIPAA. (2010). University of Miami -- Miller School of Medicine. Retrieved from: http://privacy.med.miami.edu / glossary/xd_minors.htm

Block, S.L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acude otitis media. Pediatric Infections Diseases. 16 (2): 449-56.

Glasziou, P., et.al. (2004). Antibiotics for Acute Otitis Media In Children. Cochrane Database System Review. 1 (1): Retrieved from: http://www.ncbi.nlm.nih.gov / pubmed/14973951

Kelley, P., et al. (2007). Ear, nose and throat. In Hay, et al., eds. Current pediatric diagnosis and treatment, 18th ed. New York: McGraw Hill, pp. 459-92.

McCracken, G. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. Pediatric Infectious Disease Journal. 17 (1): 576-79.


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