Diagnosis and Management of Acute Otitis Media

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Table of Contents

Sources of Evidence
Watchful Waiting
Application of the Findings to Nursing Practice
Ethical and Other Issues
Reference List

The article under consideration is titled Diagnosis and Management of Acute Otitis Media and it is written by the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) (2004).

The article “provides guidelines for primary care clinicians in managing children with uncomplicated acute otitis media (AOM) who are aged between two months and twelve years,” (American Academy of Pediatrics and American Academy of Family Physicians, 2004, p. 1451). This paper is a critical analysis and evaluation of the article.

Sources of Evidence

The study makes use of a wide range of sources of evidence. The types of source of evidence, classification of source and the appropriateness of the sources are illustrated in the table below.

Table showing the sources of evidence and their characteristics

Source	Type of resource	Appropriateness/ inappropriateness of the resource	Classification of source of evidence
1. American Academy of Pediatrics and American Academy of Family Physicians. Clinical practice guideline: Diagnosis and management of acute otitis media	Filtered resource: this resource provides general recommendations for the diagnosis and management of AOM that are based on evidence from other research studies. It is therefore considered to be a filtered resource.	Appropriate: this resource is appropriate because it provides evidence-based recommendations on the ways through which AOM can be diagnosed and managed.	Evidence-based guideline
2. Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. Pediatric Infections Disease Journal.	Unfiltered resource: this is an unfiltered resource because it is a primary research study that was conducted by the researchers.	Appropriate: this resource is appropriate because it provides evidence as to the pathogens that cause AOM and factors that need to be taken into consideration for effective management of AOM.	Primary research evidence
3. Ear, nose, and throat. Current Pediatric Diagnosis and Treatment.	Filtered resource: this is a filtered resource because it provides information on the current techniques used to diagnose and treat ENT problems among children. The information is based on prior primary research studies conducted by other researchers.	Appropriate: this resource is appropriate because it provides further information regarding the current practices in diagnosing and managing AOM.	Evidence summary
4. “Treatment of acute otitis media in an era of increasing microbial resistance,” (McCracken, 1998, p. 576). Pediatric Infectious Disease Journal.	Unfiltered resource: this is an unfiltered resource because it is a primary research study that was conducted by the researcher to determine how AOM can be treated in case of microbial resistance.	Appropriate: this resource is appropriate because it also provides further evidence of more effective ways of treating AOM to avoid microbial resistance.	Primary research evidence
5. Results from interviews with parents who have brought their children into the clinic for acute otitis media.	Unfiltered resource: the results from the interview can be classified as an unfiltered resource because they provide information for a primary research study that was conducted by the researcher to determine the opinions of parents with children suffering from AOM.	Appropriate: the resource is appropriate because the interviews help to identify the risk factors of AOM for instance, the length of time an infant breastfed among other factors.	Primary research evidence

Watchful Waiting

The article provides credible and well-supported discussion of whether watchful waiting is an appropriate approach for treating children with acute otitis media based on the evidence that it presents (Brown, 2009). The term watchful waiting is specified as the observation option.

This is presented by a definition, the basis upon which the decision is made as well as the initial requirements and the systems expected to be in place for its recommended usage. Speziale and Carpenter (2007) suggest that there must be support of evidences, application and summary of the recommendation which the authors of the article have provided.

Application of the Findings to Nursing Practice

The article provides a logical discussion of how to apply the findings of the article to improve nursing practice in the clinic. This is done by presenting a framework for helping primary care clinicians make effective decisions in dealing with AOM (Speziale & Carpenter, 2007).

This is further presented through diagrammatic recommendations, tables and flow charts for simplification purposes (Brown, 2009). The issue of non-conventional ways of treating AOM using complementary and alternative medicine is identified. The changing clinical guideline practices are identified based on the evidence-based research with recommendations made for further studies that provide a guideline for the conclusive nature of research.

Ethical and Other Issues

The article does not include issues of confidentiality and informed consent (Speziale & Carpenter, 2007). However, emphasis is placed on the roles of the parents and guardians especially in the initial examination and follow-up with no evidence of children giving their views.

The role of the parents and guardians in studies involving children is important because children are a vulnerable population and need to be protected from any harm that may arise from such studies. The article therefore presents credible and well-supported discussion of the ethical issues presented in the research.

Reference List

American Academy of Pediatrics and American Academy of Family Physicians. (2004). Diagnosis and management of acute otitis media. American Academy of Pediatrics, 113(5), 1451-1463.

Brown, S. (2009). Evidence-based nursing: the research practice connection. Boston: Jones & Bartlett Learning.

McCracken, G.H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. Pediatric Infectious Disease Journal, 17(6), 576-579.

Speziale, H., & Carpenter, D. (2007). Qualitative research in nursing: advancing the humanistic imperative. Philadelphia, PA: Lippincott Williams & Wilkins.

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Diagnosis and Management of Acute Otitis Media

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