practitioner and patient decisions about appropriate health care for specific clinical circumstances". Their purpose is "to make explicit recommendations with a definite intent to influence what clinicians do". Additionally, guidelines have an important role in standardization care and health policy formation such as health promotion, screening etc.
Cyprus due to the recent financial meltdown has been aiming to reduce the cost and maintain or even improve the quality of care therefore an array of tools have been used to achieve this. Inter alia, the development, implementation and monitoring of clinical guidelines, implementation of clinical governance and clinical audit, implementation of Diagnosis Related Groups (DRGs), restructuring of the public hospitals, and reforming of the Healthcare system introducing a universal coverage and with the concept of a gatekeeper general/family practitioner being the cornerstone of the reform. Interestingly, primary care will be delivered through 3 different specialties namely General Practitioners, Paediatricians and Obstetricians and Gynaecologists. Clinical guidelines and chronic disease management programs will be an integral part of the reformed Cyprus primary care
We will describe the policy, the process and methods of preparing and implementing clinical guidelines in Cyprus Primary Care.
Methods
Development of a local guideline by a local stakeholder group provides ‘sense of ownership’ – a factor thought to be associated with increased likelihood that the guideline will actually be adopted. Producing a clinically valid and utilizable guideline is a labour and resource intensive process. It is also time consuming.
The adoption of an existing guideline has advantages namely it removes...
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...tronic educational platform.
8. Monitoring. Effective clinical audit and provision of constructive/balanced feedback to providers is crucial. A comprehensive clinical audit policy for guidelines is in the process of being finalized. We plan to publish online all the results from the selected guidelines quality indicators.
Conclusions
Cyprus healthcare system is under enormous pressure of cost savings due to the financial crisis. The universal introduction of clinical guidelines in all levels of care and particularly in primary care can be an important evidence-based tool to promote ´´efficiency´´ savings hence without diminishing the quality of care. The successful implementation of guidelines in a previously guideline-naive environment will heavily depend on the high quality adaptation process of existing guidelines and the appropriate change management policy
The six standards of practice are very important. Under the first standard, assessment, the nurse evaluates health information related to the patient. This information could be a health issue such as asthma, or a psychological issue such as anxiety that is necessary knowledge needed before treatment can begin. Once this is accomplished the second standard, diagnosis, begins. Under this standard the nurse takes the information gained from the assessment and utilizes it to derive a diagnosis of the individual. The third standard, outcomes identification, has
In conclusion, clinical decision support systems provide a mechanism for improving the quality of care services when integrated with evidence-based practice and clinical guidelines. These systems would particularly improve health care quality when combined with evidence-based medicine. This process may also include the use of databases and condition-specific clinical guidelines to improve their effectiveness and efficiency.
As the field of healthcare has changed, new diseases and disorders have developed. It is impossible for one doctor to know how to recognize and treat every disease in the world. With evidence-based guidelines, they can come close. These guidelines may not have a perfect success rate, but they can make diagnosing illness easier.
Many GPs produce practice charters that offer information about that standard of service delivered by their particular health centres. Information which most probably be covered is time schedule, collection of test results, how to get proscribed medication, facilities available to disabled people and further treatment.
A mandate will be made through this health care reform plan that will make providers more involved in the care of their patients. Steps will be taken to help increase the number of physicians in areas experiencing shortages along with incentives for physicians to become family practitioners. Preventative care will be the focus therefore annual checkups and routine procedures will be covered by all insurances. A coordination track where doctors, nurses, and other providers work effectively and efficiently in teams, analyzing the outcomes and processes of care to rid the system of waste will be created (Cortese & Korsmo, 2009).
230) in EBP. Clinical opinion, together with the best relevant research evidence, provides the framework to for the best patient outcome. The nurse’s clinical opinion is acquired through knowledge and skills developed from undergraduate, graduate, or continuing education, clinical experience, and clinical practice (Melnyk & Fineout-Overholt, 2010). Clinical opinion also includes internal evidence, which is generated within a clinical setting from quality improvement outcomes, management initiatives or EBP implementation projects (Melnyk & Fineout-Overholt, 2010). Nurses use their clinical opinion when they identify each patient’s condition, individual risks, personal values and expectations, benefits of possible interventions, and gather evidence for EBP. When searching for the best available evidence, there is a hierarchy in the strength of evidence. The highest level of evidence usually comes from a systematic review or an evidence-based clinical practice guideline based on a systematic review. Systematic reviews provide the strongest evidence through a summary combining the results from many relevant, unbiased studies, to answer a particular clinical question. Nurses critically assess the individual studies, to gather the best evidence available for patient care. Systematic
The NHS Outcomes Framework (NHSOF) has identified five key domains in order to deliver Evidence-Based Practice (EPB) to the patient. These five domains of the Department of Health (2014-15)
Towle, A., Godolphin, W., Grams, G. and LaMarre, A. (2006) 'Putting informed and shared decision making into practice', Health Expectations, 9 (4), pp. 321-332. doi:
Provide consistency in healthcare members who care for the client. Rationale: will help to reduce client confusion and
Nursing is the balance between art and science. Caring is an important aspect that patients expect but also is knowledge in current practices. Integrating current practices into care improves quality outcomes. Evidence-based practice is the best approach in planning care for patients, it is the basis for proven, factual outcomes that we expect. Experience and personal opinions are great assets but are not sound ideals to provide safe and effective care. Evidence-based practice uses clinical judgment with selective research to deliver the most effective, cost-efficient outcomes (Wilkinson et al., 2014). Standards are held to the highest of quality, helping to reduce or eliminate errors. Standardizing healthcare to science and evidence-based practice helps to reduce variations among facilities (Stevens, 2013). All healthcare professionals need to adopt this practice in order for its success. With more participation, quality of care increases, the patient is the core
Dougherty, L. & Lister, s. (2006) ‘The Royal Marsden Hospital manual of Clinical Nursing Procedures: Communication 6th Edition Oxford: Blackwell Publishing Ltd
Berwick, D. M. (2002). A user's manual for the IOM's 'quality chasm' report. Health Affairs,
When caring for patients it is fundamentally important to have a good selection of up to date evidence Based Practice clinical articles to support research strategies, this allows professionals to assemble the most resent and accurate information known which enables them to make decisions tailored to the individual’s plan of care. It is essential to have clinical expertise and have the involvement from the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.
Thus, it is imperative that evidence-based practice is conducted to provide the best current, valid and reliable evidence in an aim to close the gap between non-conformity and coincide with the professional obligation of providing the patient with the best possible care (Liamputtong, 2013).... ... middle of paper ... ... Patient safety and quality of care. Rockville, MD: Agency For Healthcare Research And Quality, U.S. Dept. of Health.
The principles of documentation is clear, confidential, accurate, complete and concise, objective, organized and timely. Using documentation nurses are required to legally and ethically keep all information in the patient record confidential. There is the Health Insurance Portability and Accountability Act, known as HIPAA, which helps gives patients a greater control over their health care record (). Precise measurements and times must be used as much as possible. Accuracy can be enhanced through point of care documentation (Craven, 2017). The accuracy of documentation can be view from three perspectives veridical reflection of nursing, comprehensive while through detail of a patient journey and finally clarity in usage terms (Britain Summer of Nursing). The accuracy part is the really vital part in documentation within nursing because it shows the complete reflection of the stages of care that was provided by the health care professionals to an individual. Next, when an individual is documenting it needs to be complete and concise and organized. Having the report done as so allows for any health professional to find any information quick as possible without having to search throughout the entire chart for answers. When reporting it needs to be in a chronical flow order of the information about the patient care and procedures being done, within the chronological