Clinical Practice Guidelines ( Cpg )

Once an area of evidence-based practice has been chosen for investigation, the reviewer must locate current evidence sources and, using a structured approach, assess each for applicability to the issue being investigated. The aim of this paper is to use a Rapid Critical Appraisal Checklist (Melnyk and Fineout-Overholt, 2011) to support these sources of evidence into a review that discusses the importance of daily, high-level, multidisciplinary communication and patient safety. The summaries of these evaluations will be provided as an appraisal of each study.

The researchers sought out to understand the factors that contribute to the progression and limitation of guideline implementation within the primary health care setting. These emphasized guidelines are throughout the introduction portrayed as a positive implementation that will elevate the health care system as well as improve the assessment and management of cardiovascular risk. The adversity within these proposed implantations lie within their validity, such as which guidelines are effective and the reason for their effectiveness. The researchers also alluded to the efforts of New Zealand and their use of an Assessment and Management of

Sam is a recently graduated health professional and has observed that clinical practices vary in the different health care facilities. Sam is confused about which practice is the most effective to give patients better health outcomes according to the latest research literature.

The National Guideline Clearinghouse provides information on clinical practice guidelines and the US Preventive Task Force provides recommendations for screenings and counseling based on the patient’s gender, age, race, etc. Both supply information for disease prevention and evidence based clinical practices that providers can use daily while caring for their patient. The recommendations and guidelines that are provided on the AHRQ website are ever evolving as new information becomes available thus allowing providers to keep up with current practice. The days of providing care based on “this is how it has always been done” are gone. The AHRQ guidelines and recommendations is the go-to website for medical providers looking to provide best care for their patients by following evidence based

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

Many organizations have developed practice guidelines for a myriad of clinical scenarios which include the use of specific drugs or classes of medications, typically in a step-wise pattern. These “Best Practice” guidelines are built on evidence based criteria and systematic reviews. It has been shown that these clinical guidelines, with their list of essential medications, improve the quality of care and lead to better outcomes, but have not been shown to reduce costs.4,5 The practice of medicine has moved dramatically towards the use of these guidelines in recent years. For example, best practices for diabetic care recommends that all patients be placed on an ACE (angiotensin converting enzyme) inhibitor or ARB (angiotensin receptor blocker) for prevention of diabetic nephropathy and a statin for prevention of coronary artery disease. However, each patient’s insurance may cover a different medication in this class

According to Stevens (2013), the call to develop and implement evidence-based practice (EBP) within all healthcare disciplines is fueled by legislative demands for improvement in standard medical metrics such as mortality and morbidity. However, increasing demands by the public for evidence related to the metrics and outcomes of such concepts as quality of life illustrate what may be more important to the client (Stevens, 2013). This client-directed focus has resulted in patient-centered outcomes research (PCOR) (Stevens, 2013). "The Patient-Centered Outcomes Research Institute (PCORI) helps people make informed health care decisions, and improves health care delivery and outcomes, by producing and promoting high integrity, evidence-based information

* Checking the information against reliable sources, including the National Practitioner Data Bank and the American Board of Medical Specialties

'Are Guidelines and Protocols an effective way to ensure that we "get care right?" '

Each account of evidence is investigated by a number of health care professionals, nurses, and public representatives to establish clinical, organizational, educational, and system-level recommendations. These recommendations will be graded on both qualitative and quantitative scales, and when these recommendations are approved they are revised by experts relative to the guideline (RNAO, n.d.). Following this process, the guideline is published. Every five years all guidelines are reviewed to assess the relevance of the evidence in terms of contemporary application. The Best Guidelines are selected to be revised and published with a new editor (RNAO, n.d.).

validated through research (Monti & Tingen, 1999). This author believes that the basis of a good practice is through the use of evidence based findings. If the procedure or care plan is supported by research, and the findings are reproducible, then this author is more likely to implement it into his practice.

As the recommendation has been established as best practice this chapter will propose a clinical audit to review the extent to which the recommendation is applied in practice. Practitioners have a responsibility to continually improve their standards of care (Nursing and Midwifery Council, 2010). Clinical audits are a valuable tool for professionals to monitor their current practice and promote improvements in care (Benjamin, 2008).

The Institute of Medicine (IOM) Committee to Design a Strategy for Quality Review and Assurance in Medicare defines quality of care to be “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Ransom, Joshi, Nash & Ransom, 2008). Making sure to have current knowledge on healthcare services is crucial to the quality of care provided, and health care professionals are expected to continuously stay updated on the changing trends. The IOM later released six aims for improvement, or also known as the six dimensions of quality, which are safe, effective, efficient, timely, patient-centered, and equitable.

Clinical practice guidelines (CPG) are designed to improve the quality of healthcare services, decrease unwanted, ineffective and harmful interventions for patients. CPG are used to facilitate treatments for each individual patient’s by maximizing the benefits, minimizing the risk of harm and obtain treatment with an acceptable cost. Researchers had proven that CPG is a bridge for change and improving health outcomes. The effectiveness of CPG is perceived to be helpful in clinical decision making. CPG are developed to assist healthcare providers such as doctors and nurses in decision making for specific clinical outcomes (Vlayen, et. al. 2005)

Absence of national guidelines: A need for the national clinical guidelines was identified. Such guidelines prepared by Indian physician associations and endorsed by the Govt. would help to build the trust among the payers and providers, if followed strictly.