Clinical practice guidelines for comprehensive patient assessment in emergency care: A quality evaluation study

2021 ◽  
pp. 205715852110069
Author(s):  
Åsa Falchenberg ◽  
Ulf Andersson ◽  
Birgitta Wireklint Sundström ◽  
Anders Bremer ◽  
Henrik Andersson
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Emergency Care ◽  
Quality Evaluation ◽  
Evaluation Study ◽  
Evidence Based ◽  
Patient Assessment ◽  
Care Needs ◽  
Home Based

Emergency care nurses (ECNs) face several challenges when they assess patients with different symptoms, signs, and conditions to determine patients’ care needs. Patients’ care needs do not always originate from physical or biomedical dysfunctions. To provide effective patient-centred care, ECNs must be sensitive to patients’ unique medical, physical, psychological, social, and existential needs. Clinical practice guidelines (CPGs) provide guidance for ECNs in such assessments. The aim of this study was to evaluate the quality of CPGs for comprehensive patient assessments in emergency care. A quality evaluation study was conducted in Sweden in 2017. Managers from 97 organizations (25 emergency medical services and 72 emergency departments) were contacted, covering all 20 Swedish county councils. Fifteen guidelines were appraised using the validated Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. The results revealed that various CPGs are used in emergency care, but none of the CPGs support ECNs in performing a comprehensive patient assessment; rather, the CPGs address parts of the assessment primarily related to biomedical needs. The results also demonstrate that the foundation for evidence-based CPGs is weak and cannot confirm that an ECN has the prerequisites to assess patients and refer them to treatment, such as home-based self-care. This may indicate that Swedish emergency care services utilize non-evidence-based guidelines. This implies that ECN managers and educators should actively seek more effective ways of highlighting and safeguarding patients’ various care needs using more comprehensive guidelines.

scholarly journals Quality Evaluation of Clinical Practice Guidelines for Comprehensive Patient Assessment in Emergency Care: A National Cross-sectional Survey

2020 ◽  
Author(s):  
Åsa Falchenberg ◽  
Ulf Andersson ◽  
Birgitta Wireklint Sundström ◽  
Anders Bremer ◽  
Henrik Andersson
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Emergency Care ◽  
Evidence Based ◽  
Patient Assessment ◽  
Agree Ii ◽  
Cross Sectional ◽  
Patient Assessments

Abstract Background Clinical practice guidelines (CPGs) provide guidance for emergency care clinicians to perform patient assessments. Neglecting CPGs may lead to incomplete or fragmented assessments and cause ad-verse events. However, it is important for CPGs to be evidence based, and patient assessments must be conducted in such a manner that high levels of patient safety can be achieved. The aim of this study was to explore and evaluate the quality of emergency medical services (EMS) and emer-gency departments (EDs) CPGs for comprehensive patient assessments. Methods A national cross-sectional design was used, and the listed managers from 97 organizations (25 EMS and 72 EDs) were contacted, covering all 20 Swedish county councils. Fifteen guidelines were ap-praised using the validated Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. Results The results revealed that none of the CPGs outlined a comprehensive patient assessment. The main characteristic of the CPGs was their focus on the medical assessment of patients with life-threatening conditions, mostly based on initial assessment and the A-E principle (airway, breathing, circulation, disability, and exposure). According to the AGREE II analysis, the overall quality of the guidelines was poor. CPGs lacked scientific support, underlying evidence, descriptions of how that evidence was collected, and explanations of the criteria used for CPG development. Conclusions This research indicated that there were no Swedish CPGs with comprehensive patient assessments in emergency care and that the foundation for evidence-based CPGs for comprehensive patient assessments was weak.

Validation of a Model for Developing Evidence-Based Clinical Practice Guidelines for School Nursing

2019 ◽  
Vol 36 (6) ◽  
pp. 410-414
Author(s):  
Angela M. Lepkowski ◽  
Robin Adair Shannon ◽  
Erin D. Maughan
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Health Condition ◽  
Development Project ◽  
School Nursing ◽  
Evidence Based ◽  
Care Needs ◽  
Nursing Clinical Practice ◽  
Evidence Based Care

The paucity of scientifically rigorous school nursing clinical practice guidelines (CPGs) presents barriers to evidence-based care of students with special health-care needs. A Model for Developing Evidence-Based Clinical Practice Guidelines for School Nursing (School Nursing CPG Model) was developed under the auspices of the National Association of School Nurses (NASN) to address this need. To test and validate this School Nursing CPG Model, a trial CPG development project was conducted to (1) identify structure and process gaps and areas for improvement within the School Nursing CPG Model and (2) develop an evidence-based CPG for school nursing practice that addresses a priority student health condition: seizures and epilepsy. The School Nursing CPG Model was validated through a trial CPG project which followed the systematic, standardized process of the School Nursing CPG Model while responsively implementing quality improvement measures through the Plan–Do–Study–Act cycle. Both specific aims were accomplished.

A Model for Developing Evidence-Based Clinical Practice Guidelines for School Nursing

2019 ◽  
Vol 36 (6) ◽  
pp. 415-422 ◽  
Author(s):  
Robin Adair Shannon ◽  
Erin D. Maughan
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
School Nurses ◽  
School Nursing ◽  
Evidence Based ◽  
Health Care Needs ◽  
Care Needs ◽  
Special Health Care ◽  
Special Health

School nurses need evidence-based clinical practice guidelines (CPGs) to provide quality care for students with special health-care needs. However, a gap analysis revealed a paucity of rigorous school nursing CPGs. To fill this gap, a Model for Developing Evidence-based Clinical Practice Guidelines for School Nursing (School Nursing CPG Model) was designed under the auspices of the National Association of School Nurses to offer school nurse scholars, school health leaders, and pediatric clinical experts a standardized structure and systematic process to create rigorous evidence-based CPGs. The aim is to employ the School Nursing CPG Model to build a repository of CPGs that are projected to improve the quality of school nursing practice, thereby improving health and educational outcomes for students with special health-care needs. The School Nursing CPG Model is anticipated to apply to CPG development for other nursing specialties.

Tonsillektomia w populacji pediatrycznej – główne wskazania, aktualne wytyczne Amerykańskiej Akademii Otolaryngologów Chirurgów Głowy i Szyi

2019 ◽  
Vol 23 (4) ◽  
Author(s):  
Anna Wierzbicka-Rot ◽  
Artur Gadomski
Keyword(s):  
Clinical Practice ◽  
American Academy ◽  
Head And Neck ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Postoperative Care ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Evidence Based ◽  
Practical Information

In February 2019 American Academy of Otolaryngology-Head and Neck Surgery published clinical practice guidelines which provides evidence-based recommendations that applies to children under consideration for tonsillectomy. This update to the 2011 publication includes large amount of new, practical information about pre-, intra- and postoperative care and management, that can be useful for surgeons as well as GPs and pediatricians

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