Clinical Practice Guidelines - Essay Example

Clinical Practice Guidelines Presented By Presented To Lecturer Introduction Clinical Practice guideline refers to a systematically created statement that seeks to help the practitioner and patient decision concerning the right health care for explicit clinical situations. Evidence-based means that the recommendation or document has been developed by means of a transparent and balanced procedure of systematically appraising, reviewing and making use of the best findings of clinical research of the best value to help in delivery of ideal clinical care to the sick. It is, therefore, clear that evidence-based Clinical Practice Guidelines are a sequence of recommendations on clinical care aided by the best present indication in a clinical literature (Castellani, Girlanda, & Barbu, 2014). Scope and Purpose of Clinical Guidelines For a long time, Clinical Practice Guidelines on several occasions have been used and abused. Although position statements on the best care were meant to be unbiased, the documents were problematic. The process of development did not meet transparency requirements, and the experts involved in the development made the material beneficial to themselves. Patients and practicing physicians usually felt cheated in cases where decisions on health care were focused on guidelines concerned with economic and not quality goals. Through application of evidence-based medicine techniques in development of guidelines, opinion and biases are remarkably minimized and the elevation of rich scientific literature is witnessed and assessed in a systematic fashion to offer transparency and reduce imbalance in evidence-based Clinical Practice Guidelines. Evidence-based Clinical Practice Guidelines are greater than non-evidence-based Clinical Practice Guidelines and are right tools of better quality patient care. The structured, transparent process used in developing Clinical Practice Procedures makes them difficult to abuse and easy to use. Evidence-based Clinical Practice Procedures are being used to create quality measures as well as used to aid referrals when insurance companies question them. In addition to that Clinical Practice Procedures act as patient’s education tools. Evidence-based Clinical Practice Procedures on a national level are a direct means of improvement of quality and play a big role in the making of measures of performance for pay-for-performance repayment programs. Practicing orthopedists are given a voice by the evidence-based clinical practice guidelines. Society based Clinical Practice Guidelines on a local level are used to influence and inform hospital guidelines in order to enhance best practices. Apart from that, they also reduce the usage of opinion- based guidelines and can as well be used to contest the decisions of payer which are not based on evidence that is termed high quality. Evidence-based Clinical Practice Guidelines relieve practicing physicians their efforts to read and assess all the published information in their practice area (Castellani, Girlanda, & Barbu, 2014). These guidelines encourage decent clinical practice through rating, reviewing and synthesizing a big amount of literature and later develop a balanced, evidence-based series of recommendations on problems facing clinical sector. Evidence- based Clinical Procedure, therefore, serves to advance the performance of physicians and the outcomes of patients. The aim of guidelines is to aid the process of decision making in patient care. The guide’s content is based on a systematic analysis of clinical proof. Drive towards evidence-based health care has quickly gained ground in the last few years, stirred by politicians, management, and clinicians concerned costs, quality, and consistency. Clinical Practice Guidelines have shown that they can support improvements in consistency and quality in health care. Many clinical guidelines have been developed, although the development process is resource and time-consuming (Guthrie, Payne, Alderson, et al. 2012). Bicycle deaths and injuries affect young people and children more often in comparison to other age groups. 50% of nonfatal bicycle injuries in 2008 occurred in children that have ages between 5 and 20 years. In the same year, the rate per million of nonfatal injuries resulting from bicycle accidents for children aged between 5 and 20years was 318.9 in comparison to 172.3 overall. In addition to that, 20.5% of bicycle fatalities in 2008 were of the youths and children aged between 0 and 20 years. The annual cost of bicycle fatalities in youths and children in the age bracket of 0 to 19 years from 2001 to 2004 was $993 million and the average annual cost in 2008 for nonfatal bicycle injuries in youths and children aged between 0 and 19 stood at $4.7 billion. Stakeholder Involvement Expert panels are appointed by NHLBI to carry out reviews on systematic evidence enable development of clinical practice guidelines. An expert panel is a committee of experts that are not remunerated. The members and the chair are chosen primarily for their clinical and scientific expertise. Individuals with clear financial conflicts, as well as those with intellectual and professional bias, are excluded because they would diminish the review’s credibility. The panel of experts confirms the requirements for the new systematic evidence analysis, gives a call to the public for critical questions, gives a definition of the ultimate critical questions, creates selection and screening principles, and creates the analysis procedure (Watters, 2008). An independent entity which is guided by experts from the panel carries out the study selection and rating, extraction of data and a summary of the evidence. Panel of experts uses this information to create graded evidence statements. To manage conflicts of interest, the members of review and writing groups voluntarily verbally reveal any possible conflicts of interest to others while holding a general meeting, and if they have a possible conflict of interest they reuse themselves of voting. A methodologist is employed to work with the groups writing to offer objectivity in analyzing data and evidence ranking through preparing evidence tables and consensus facilitation. Opportunities are offered for public review and comments through scheduled public forums or NHLBI Website. While developing this document, the experts brought on board various stakeholders including; directors of state injury prevention programs, state4-H chapters, alliance for walking and biking, league of American cyclists, state highway safety officers, organizations involved in traffic safety and injury prevention, injury free coalitions for kids, bicycle clubs and bicycle shops. Rigor Development The document identifies visibility aids that are lights or fluorescent materials that cyclists use to help drivers see them clearly or sooner. Though there is evidence that visibility aids improve driver recognition and detection, no studies exist that assess their impacts on cyclists-motor vehicles injuries or collisions. This, therefore, means that the experts involved in developing this document should carry out intensive studies to verify visibility aids roles. Area-wide traffic calming has constantly been viewed to minimize traffic-related injuries; however no study has independently scrutinized its impacts on injuries to children cyclists. This document provides relevant articles with their websites that can be accessed by any child, parent or interested party with a need to acquire information on safety measures for young bicycle riders. Recommendations Inclusive reviews of high-quality analysis indicate significant, consistent reductions of injuries and fatalities related to bicycles in children when the following strategies are abided by children to properly wear helmets while riding. Properly worn helmets help reduce brain and head injuries by 88%.Education on helmet use should draw from research data, and be focused on children who are the main victims. Clear information about access to bicycle helmets should be provided be it through discounts or donations and practice and demonstrations on how to properly fit a helmet. Education can be effective when reinforced by other interventions like helmet discounts, public service announcements and bicycle rodeos. Effective helmet use legislation should be put in place and implemented by the law enforcers. Parents, relatives, and other stakeholders must ensure that children abide by all the safety rules like proper wearing of helmets before riding bicycles. Implementation Rodeos, bike fairs and skills training help children be aware of legislation and safe cycling manners. There should be a provision of visibility aids that are fluorescent materials that cyclists use so that drivers can see them clearly or sooner. In addition, enforcement of laws related to bicycles like impounding bicycles of children riding without helmets and also imposing fines to riders disobeying safety rules. Lastly, the government should pave paths and bike lanes and parental modeling of proper use of helmets that make children learn to put helmets on. References Castellani, A. Girlanda, F. & Barbu, C., (2014). Rigour of development of clinical practice guidelines for the pharmacological treatment of bipolar disorder: Systematic review. http://dx.doi.org/10.1016/j.jad.2014.11.032 Guthrie B, Payne K, Alderson P, et al. (2012). Adapting Clinical Guidelines to take Account of Multimorbility. BMJ 345:e6341 Watters, W. C. (2008).Defining evidence-based clinical practice guidelinesAAOS Now July 2008 Issue http://www.aaos.org/news/aaosnow/jul08/research2.asp. Children Safety Network (CSN).National Injury and Violence Resource Center.PROMOTING BICYCLE SAFETY FOR CHILDREN: Strategies and Tools for Community Programs (2011). Read More