Date of Conferral



Doctor of Nursing Practice (DNP)


Health Services


Susan J. Hayden


AbstractThyroid cancer (TC) incidences over the last decade have increased significantly. The practice problem addressed in this project was nurses’ lack of knowledge on how to perform or teach clients how to perform self-exams of the neck region for early detection of TC. This lack of knowledge limits the nurses’ ability to properly educate their clients about TC and recognizing when to seek medical interventions. The purpose of this project was to develop of an evidence-based, clinical practice client education guideline (CPCEG), based on an in-depth literature review, to address the nurses’ lack of knowledge and enable clients to engage in self-care practices in the detection of thyroid abnormalities. The framework used to guide this doctoral project was the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool, a reliable and valid tool, to appraise clinical practice guidelines (CPG) for quality. Results from three content experts using the AGREE ll tool indicated the overall quality of the CPCEG was acceptable and applicable with an AGREE ll mean score of 79%. The area of lowest quality was in the domain of editorial independence (AGREE ll score 45%) evaluating the methodological quality, management of conflicts of interest, and details of CPG implementation and monitoring whereas the strongest domains were related to scope and purpose (98%) and clarity of presentation (98%). The editorial independence will be more fully discussed in future works. This study enhances social change by addressing the gap in practice and demonstrating that a tool can be developed to better prepare nurses to teach self-exam methods, which will better prepare patients to participate in self-care.

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