scholarly journals Determinants of clinical practice guidelines’ utilization for the management of musculoskeletal disorders: A scoping review

2020 ◽  
Author(s):  
Delphine Sorondo ◽  
Cyrille Delpierre ◽  
Pierre Côté ◽  
Louis-Rachid Salmi ◽  
Christine Cedraschi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Musculoskeletal Disorders ◽  
Health Care Providers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Scoping Review ◽  
Healthcare Providers ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional

Abstract CONTEXT: Many clinical practice guidelines have been developed for the management of musculoskeletal disorders (MSDs). However, there is a gap between evidence-based knowledge and clinical practice, and reasons are poorly understood. Understanding why healthcare providers use clinical practice guidelines is essential to improve their implementation, dissemination, and adherence.AIM: To identify determinants of clinical practice guidelines’ utilization by health care providers involved in the assessment and management of MSDs.METHOD: A scoping review of the literature was conducted. Three databases were searched from inception to December 2019. Article identification, study design, methodological quality, type of healthcare providers, MSDs, barriers and facilitators associated with guidelines’ utilization were extracted from selected articles.RESULTS: 7667 citations were retrieved, and 43 articles were selected. 51% of studies were from Europe, and most were quantitative studies (64%) following a cross-sectional design (88%). Almost 80% of articles dealt with low back pain guidelines, and the most studied healthcare providers were general practitioners or physiotherapists. Five main barriers to guideline utilization were expressed by providers: 1) disagreement between recommendations and patient expectations; 2) guidelines not specific to individual patients; 3) unfamiliarity with “non-specific” term, or with the bio psychosocial model of MSDs; 4) time consuming; and 5) heterogeneity in guideline methods. Four main facilitators to guideline utilization were cited: 1) clinician’s interest in evidence-based practice; 2) perception from clinicians that the guideline will improve triage, diagnosis and management; 3) time efficiency; and 4) standardized language.CONCLUSION: Identifying modifiable determinants is the first step in developing implementation strategies to improve guideline utilization in clinical practice.

scholarly journals Determinants of clinical practice guidelines’ utilization for the management of musculoskeletal disorders: a scoping review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Delphine Sorondo ◽  
Cyrille Delpierre ◽  
Pierre Côté ◽  
Louis-Rachid Salmi ◽  
Christine Cedraschi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Musculoskeletal Disorders ◽  
Health Care Providers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Scoping Review ◽  
Healthcare Providers ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional

Abstract Context Many clinical practice guidelines have been developed for the management of musculoskeletal disorders (MSDs). However, there is a gap between evidence-based knowledge and clinical practice, and reasons are poorly understood. Understanding why healthcare providers use clinical practice guidelines is essential to improve their implementation, dissemination, and adherence. Aim To identify determinants of clinical practice guidelines’ utilization by health care providers involved in the assessment and management of MSDs. Method A scoping review of the literature was conducted. Three databases were searched from inception to March 2021. Article identification, study design, methodological quality, type of healthcare providers, MSDs, barriers and facilitators associated with guidelines’ utilization were extracted from selected articles. RESULTS: 8671 citations were retrieved, and 43 articles were selected. 51% of studies were from Europe, and most were quantitative studies (64%) following a cross-sectional design (88%). Almost 80% of articles dealt with low back pain guidelines, and the most studied healthcare providers were general practitioners or physiotherapists. Five main barriers to guideline utilization were expressed by providers: 1) disagreement between recommendations and patient expectations; 2) guidelines not specific to individual patients; 3) unfamiliarity with “non-specific” term, or with the bio psychosocial model of MSDs; 4) time consuming; and 5) heterogeneity in guideline methods. Four main facilitators to guideline utilization were cited: 1) clinician’s interest in evidence-based practice; 2) perception from clinicians that the guideline will improve triage, diagnosis and management; 3) time efficiency; and 4) standardized language. Conclusion Identifying modifiable determinants is the first step in developing implementation strategies to improve guideline utilization in clinical practice.

scholarly journals The impact of acute care clinical practice guidelines on length of stay: A closer look at some conflicting findings

2014 ◽  
Vol 3 (4) ◽  
pp. 25 ◽  
Author(s):  
Moriah Ellen ◽  
G. Ross Baker ◽  
Adalsteinn Brown
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Acute Care ◽  
Health Care Providers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Organizational Support ◽  
Full Potential ◽  
Care Providers ◽  
The Impact

Systematic reviews have found that clinical practice guidelines (CPGs) are associated with lower lengths of stay (LOS), but a secondary analysis of Ontario acute care hospitals found few significant relationships between CPGs and LOS. This research explored possible reasons for these findings and what other factors may impact the CPG-LOS relationship. Semi-structured interviews were conducted with staff from nine hospitals whose jobs dealt with developing, implementing, monitoring, updating, or evaluating CPGs. Interviews were analyzed utilizing methods outlined by Aurebach. A variety of leaders and hospital types were represented. Five main factors influencing relationships between CPGs and LOS were identified: 1) the purpose of implementation, 2) evidence base for CPG content and selection, 3) health care professionals’ response to change and compliance, 4) dissemination strategies, and 5) organizational support and resources. The interviews suggested possible reasons why CPGs are not realizing their full potential impact on LOS in Ontario hospitals, ranging from poor compliance to resistance from health care providers. CPGs themselves are not perceived to be the reason for ineffectiveness; rather, organizational- and individual-level barriers seem to be the causes.

scholarly journals Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America

2009 ◽  
Vol 49 (1) ◽  
pp. 1-45 ◽  
Author(s):  
Leonard A. Mermel ◽  
Michael Allon ◽  
Emilio Bouza ◽  
Donald E. Craven ◽  
Patricia Flynn ◽  
...  
Keyword(s):  
Health Care ◽  
At Risk ◽  
Clinical Practice ◽  
Infectious Diseases ◽  
Health Care Providers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Care Providers ◽  
Intravascular Catheter ◽  
Management Guidelines

Abstract These updated guidelines replace the previous management guidelines published in 2001. The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them.

scholarly journals Ensuring Consistent European-Wide Urological Care by the Use of Evidence-Based Clinical Practice Guidelines: Can We Do Better

2017 ◽  
Vol 2 (Suppl. 1) ◽  
pp. 1-7
Author(s):  
Emma Jane Smith ◽  
Steven MacLennan ◽  
Anders Bjartell ◽  
Alberto Briganti ◽  
Thomas Knoll ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Best Practice ◽  
Scientific Evidence ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Evidence Based ◽  
Robust Methods ◽  
Practice Recommendations

The European Association of Urology (EAU) annually updates 21 clinical practice guidelines in which summaries of the evidence base and best practice recommendations are made. The methodology applied to achieve this and integrate stakeholder opinion is continuously improving. However, there is evidence to suggest wide variation in clinical practice indicating that many patients receive suboptimal and heterogeneous care. Studies from certain countries suggest that 2 out of 5 patients do not receive care according to the current scientific evidence, and in 1 out of 4 cases the care provided is potentially harmful. Clearly, the harmonisation of care in alignment with evidence-based best practice recommendations is something to strive for. Development of robust methods to disseminate and implement guideline recommendations and measure their impact is an objective the EAU is committed to improving. An important strategy for achieving harmonisation in urological care across Europe is to ensure the availability of high-quality clinical practice guidelines and to actively promote their implementation by clinicians and healthcare providers.

Primer on Clinical Practice Guidelines

2013 ◽  
Vol 26 (2) ◽  
pp. 103-111 ◽  
Author(s):  
Eunice Y. Pyon
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Health Care Professionals ◽  
Guideline Development ◽  
Improve Patient Care ◽  
Care Providers ◽  
Quality Guideline

Clinical practice guidelines (CPGs) are valuable tools for health care providers and support evidence-based medicine (EBM). Many organizations, including medical associations and government-affiliated agencies, develop and publish guidelines using varying methods. Unfortunately, many guidelines are not appropriately developed and certain recommendations are not based on the best available evidence. Recent efforts by EBM advocates are contributing to the improved quality of CPGs and more tools are becoming available to promote high-quality guideline development and use. This article describes the guideline development process and associated concerns and the advances in the field of CPGs. Tools to access and evaluate guidelines are also provided. Health care professionals equipped with an understanding of the process of guideline creation and tools for evaluation can appropriately utilize guidelines to improve patient care.

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.

Co-Sleeping and Bed Sharing in Postnatal Maternity Units

2013 ◽  
Vol 3 (1) ◽  
pp. 13-27 ◽  
Author(s):  
Cassia Drever-Smith ◽  
Fiona Bogossian ◽  
Karen New
Keyword(s):  
Clinical Practice ◽  
Health Care Providers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Policy Development ◽  
Maternal Education ◽  
Care Providers ◽  
Primary Research ◽  
Bed Sharing ◽  
Standard Clinical Practice

BACKGROUND: This 2-part article reviews the primary research on co-sleeping and bed sharing in maternity units and critiques clinical practice guidelines on co-sleeping and bed sharing in maternity units.METHODS: Electronic search strategies were used to identify primary research and to access clinical practice guidelines about co-sleeping and bed sharing on maternity units. Primary research was reviewed and compared. Clinical practice guidelines were critiqued against the United Nations Children’s Fund (UNICEF; 2004) document, Babies sharing their mothers’ bed while in hospital: A sample policy.FINDINGS: There is little published primary research about co-sleeping and bed sharing in maternity units but that which is available is of high standard. Clinical practice guidelines are more plentiful but vary in quality and scope. The primary research and clinical practice guidelines recognize the positive correlates between co-sleeping and bed sharing and the establishment of breastfeeding and the potential for risks to infant safety. There are differences in the acceptance of co-sleeping and bed sharing between geographic regions. The role of health care providers in educating about the benefits and risks of co-sleeping and bed sharing in maternity units is acknowledged but not well explored.CONCLUSION: Further research on co-sleeping and bed sharing in maternity units is needed to provide evidence to inform clinical practice guidelines.KEYWORDS: infant sleep location; policy development and dissemination; risk assessment; maternal education and behavior modeling; co-sleeping; bed sharing

scholarly journals Development and Implementation of Clinical Practice Guidelines: An Update and Synthesis of the Literature With a Focus in Application to Spinal Conditions

2019 ◽  
Vol 9 (1_suppl) ◽  
pp. 53S-64S
Author(s):  
Lindsay Tetreault ◽  
Anick Nater ◽  
Philip Garwood ◽  
Jetan H. Badhiwala ◽  
Jefferson R. Wilson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Guideline Development ◽  
Wide Spectrum ◽  
Care Providers ◽  
Review Of The Literature ◽  
Review Team

Study Design: Review. Objectives: The objectives of this review are to ( a) summarize the role of clinical practice guidelines (CPGs), ( b) outline the methodology involved in formulating CPGs, ( c) provide an illustration of these principles using a CPG developed for degenerative cervical myelopathy, and ( d) highlight the importance of knowledge translation. Methods: A review of the literature was conducted to summarize current standards in CPG development and implementation. Results: CPGs are systematically developed statements intended to affect decisions made by health care providers, policy makers, and patients. The main objectives of CPGs are to synthesize and translate evidence into recommendations, optimize patient outcomes, standardize care, and facilitate shared decision making among physicians, patients, and their caregivers. The main steps involved in the development of CPGs include defining the clinical problem, assembling a multidisciplinary guideline development group and systematic review team, conducting a systematic review of the literature, translating the evidence to recommendations, critically appraising the CPG and updating the document when new studies arise. The final step in developing a CPG is to implement it into clinical practice; this step requires an assessment of the barriers to implementation and the formulation of effective dissemination strategies. Conclusion: CPGs are an important component in the teaching and practice of medicine and are available for a wide spectrum of diseases. CPGs, however, can only be used to influence clinical practice if the recommendations are informed by a systematic review of the literature and developed using rigorous methodology. The opportunity to transform clinical management of spinal conditions is an attractive outcome of the application of high-quality CPGs.

scholarly journals Integrating evidence-based interventions in clinical settings in Jordan: a policy brief

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 933
Author(s):  
Mohammad Alzaatreh ◽  
Obay A. Al-Maraira ◽  
Nazih Abu Tabar ◽  
Mohammad R. Alsadi ◽  
Huthaifah Khrais ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Research Utilization ◽  
Action Plan ◽  
Healthcare Providers ◽  
Clinical Settings ◽  
Evidence Based ◽  
Analysis And Evaluation ◽  
New Evidence

Background: Evidence-based nursing practice (EBNP) is considered a major and very important global paradigm shift. Unfortunately, most healthcare providers and researchers embrace the concept of evidence-based practice (EBP) without integrating this concept in clinical settings. The current situation of EBP and new practice guidelines utilization in Jordan are scarce. This policy brief aimed to discusses the process of utilizing nursing EBP in clinical settings in Jordan. Methods: The authors adopted an action plan utilizing a systematic approach to develop and implement specific strategies and policies to integrate EBP in clinical settings in Jordanian hospitals. We present an experience of one country in terms of introducing a policy brief to establish an EBP policy accompanied by developing an EBP unit in the hospital's country. Results: A comprehensive description of this policy is provided with reference to the eminent steps of policy analysis and evaluation. In fact, EBP policies and clinical practice guidelines should keep a live document and revise regularly or as needed. Overall, the authors suggest the development of a unit for EBP to deal with issues related to clinical practice guidelines. Conclusions: Expected outcomes for the introduction of the EBP unit and its policy include increase research utilization and accelerated adoption of new evidence, increase the quality of care provided, increase patient, staff, and managers satisfaction, and decrease staff workload by reducing complications associated with medical errors and outdated interventions.

Sign in / Sign up

Export Citation Format

Share Document