Understanding Clinical Guidelines: Definition, Uses, And Limitations

Background on Clinical Guidelines

Discuss about the Benefits of Clinical Practice Guidelines.

The use of Clinical Guidelines has spanned over eleven years today (Agha et al., 2016). Most health practitioners are using the protocols to attend to their patients. On a daily basis, treatment of various ailments, management of health facilities, and allocation of funds by the government relies heavily on clinical guidelines. The use of the guidelines started in Europe but is slowing spreading to all other parts of the continents. The main issues that necessitated the onset of clinical guidelines are many. The emergence of strange ailments and expensive technological advancements are some of the main reasons for the development of health care protocols. Additionally, the elevated costs of treatment, inconsistent treatment methods and the increase in the number of patients pushed health practitioners to seek for solutions. The remedy is the development of clinical Guidelines. The development of the guideline involved all stakeholders. This article looks at the definition of the term clinical Guidelines. Furthermore, the paper explains the uses and limitations of the protocols. Additionally, steps in the development of the protocols are in the article. Moreover, the paper looks at the appraisals of key recommendations. Finally, the paper looks at the legal issues on the guidelines and the assessment of the Guardianship protocols.

The essence of clinical guidelines is to upgrade the standards of health care tailor-made by physicians towards patients. A majority of research articles indicate that the guidelines upscale the level of care. However, the interpretation of the importance of the guidelines varies among nurses, patients and other stakeholders.

The clinical guidelines upgrade the level of treatment that patients receive from health facilities. Those Guidelines that call for proper medical attention while shunning outdated techniques greatly benefit the patients (Bruinsma et al., 2016). Properly instituted protocols lower death rates, increases life expectancy and upscale the living nature of patients. Moreover, continuous application of quality guidelines creates a habit of improvement in the level of health care (Von Elm et al., 2014). Recent research shows that different health practitioners use similar guidelines in distinct ways. Consequently, patients suffering from similar ailments face distinct modes of treatment (Velentzis et al., 2017). The nature of the medical attention depends on the nurse but the guidelines are the same worldwide.

A majority of guidelines exist in form of publications, audiovisual and other physical forms. The various forms are available at health facilities or on the internet where patients can have access (Strang et al., 2018). Therefore, patients get the opportunity to study the materials. From the guidelines, the patients can learn about the varieties of guidelines, their drawbacks and importance. Moreover, they can choose the guideline that suits their needs. After going through the guidelines, patients can make conclusive decisions on the most suitable protocol (Reddy et al., 2018). On the other hand, it is the duty of health specialists to do a conclusive research on the guidelines before using them.

Uses of Clinical Guidelines

Clinical guidelines assist patients to mobilize for the creation of an essential healthcare regulation. The guidelines expose areas of medical attention that are rare, unique and affecting few individuals. Furthermore, the guidelines showcase areas of the medical field that have been neglected over an extended period of time (Parikh et al., 2016). Therefore, the national executive can avail the relevant resources and personnel to cater for the forgotten areas of treatment. Resource allocation in struggling economies should follow the guidelines to cover all fields of treatment.

Clinical guidelines buffer physician’s treatment decisions. Furthermore, they can choose the guideline that suits their expertise from the options available. The guidelines improve the confidence levels of clinicians when administering treatment (Nishimura et al., 2014). Physicians can embrace the new recommendations and shun the out-of-fashioned modes of medical administration. Moreover, the guidelines ensure uniformity in the modes of treatment. The guidelines pin point treatment modes that are ineffective hence doctors avoid those methods (Lewinsohn et al., 2018). From the guidelines, clinicians can learn about new ways of treatment.

The guidelines emphasize the essence of proper interventions to aid in patient treatment. Health practitioners use guidelines to make financial decisions when purchasing medical equipment. The guidelines put a spot light on the ineffective research projects. Furthermore, they expose research projects that are incomplete (Lee & Lehman, 2016). Therefore, health stakeholders reinvest on the projects until they reach a conclusive end. Clinical guidelines give directions on bad and good medical practice. Health specialists avoid bad practice, thanks to the guidelines (Laver et al., 2016). Moreover, the guidelines expose the risks that doctors face in their line of duty. Therefore, the legislature can properly compensate physicians against the hardship at work. Physicians use guidelines to win the trust of the directors on matters of procurement of medical tools.

Clinical guidelines have various advantages for both patients and health practitioners. Furthermore, they have a number of limitations. The guidelines may be up to date but the practitioners can apply them inappropriately. In other occasions, the designers of the guidelines may omit important information due to unintentional forgetfulness (Kasperet al., 2015). Additionally, the outline of the guidelines may not suit the interest of patients and physicians.

Designers of guidelines fail to give appropriate options and recommendations on the application of the protocols. When the makers avail the recommendations to health practitioners, they are always not clear enough (Chew et al., 2016). Furthermore, the recommended suggestions do not concur with the guidelines, thus confusing the physicians. Most guidelines are impractical and if implemented, endanger the lives of the patients (Dumbreck et al., 2016).  Recent research shows that the developers of clinical guidelines have insufficient knowledge, skills, and resources (Kim et al., 2014). Therefore, they design incomplete protocols. Furthermore, physicians give inconsistent recommendations on the guidelines.

Advantages of Clinical Guidelines

Modes of treatment that physicians prefer are at many occasions impractical and can harm the patients. Furthermore, there are viable treatment alternatives that lack from the clinical guidelines (Dyer et al., 2016). Evidence shows that some guidelines go against the traditions of most individuals. The implementation of contradicting guidelines poses a health threat to the patients (January et al., 2014). Furthermore, the same implementation threatens the job securities of most health practitioners.

Patients are the ones that get mostly affected by ineffective guidelines. Guidelines that are unclear make clinicians to disregard the past treatment history of their patients. The sections of the guidelines that favor the patient may not be suiting the physicians (Sladden et al., 2018). Certain protocols are expensive hence limiting patients from accessing medical attention. When guidelines are not laid out properly destroys the patient-doctor working relationship.

Guidelines may alter medical regulations. The critical sectors of treatment that are missing from the guidelines are likely to skip inclusion in the rules of a given country. Thus patients suffer due to negligence from the developers of the guidelines. Ambiguous medical suggestions from the protocols lead to bias in medical resource allocation (Burstein, Zacchetti & Griggs, 2016). Therefore, critical segments of treatment receive little or no funding. An imbalanced guideline concentrates on certain infections while leaving the other ailments behind. Lobby groups take undue advantage of the scenario to solicit funds from national government.

False guidelines mislead the physicians. Therefore, they administer the wrong medical attention to the patients. Thus, the general public questions the competency of the practitioner. Ineffective clinical protocols lead to the waste of resources due to inaccuracy in their audit reports (LoBiondo & Haber, 2017). Clinical guidelines may be factual but the implementation process is at times tedious and expensive. Contradicting clinical protocols from various sources are a source of frustration and confusion to the clinicians (Lyman, Bohhlke & Falanga, 2015). Guidelines that contradict their recommendations are harmful to the medical profession.

Clinical guidelines made by unqualified developers put the careers of practitioners at risks. The general public views that particular physician as unqualified personnel. Other guidelines lead to resource misuse by the clinicians (Masters, Johnson & Temin, 2016). Hence, the physicians may risk sacking due to the guidelines. At times, clinicians may feel that the guidelines are misleading and therefore abandon them. The health facilities may terminate the employment of the clinician due to their actions. Guidelines that do not give room for additional investigations are harmful (Chandraratne, Pathirathna, Harrison & Siriwardena, 2018). Such rigid guidelines can harm patients since they lack sufficient evidence to support them.

Limitations of Clinical Guidelines

The development of Clinical Guidelines occurs at three levels. Those are: nationally, regionally, and internationally. Guidelines within a country require little capacity to make (Agha et al., 2016). Furthermore, health facilities quickly integrate them into practice due to the fear of government policies on negligence. However, most countries have meager resources and unskilled personnel. Hence, local guidelines may be inaccurate and unreliable. Guidelines from international sources are easy to implement since the individuals that make have diverse knowledge and skills. Furthermore, scientific resources are plenty at international level.

The making of clinical guidelines follows four major steps. The first step is ensuring that the protocols can easily be traced back to an existing work of research (Dyer et al., 2016). Secondly, the developers should carry out a background study of the research work. Additionally, they should find relevant literature sources to support their guidelines. Thirdly, the developers should use the evidence from the background study plus the relevant literature to develop Clinical guidelines (January et al., 2014). The constructors of the guidelines should present their work in scientific forums and seek for backing from various researchers. The developers then pass the guidelines to different scientists to cross check the work. Afterwards, the guideline constructors put the guidelines to test in verified laboratories (Kasper et al., 2015). Lastly, the clinical guidelines need a constant review and the making of necessary adjustments to accommodate emerging technology, skills, and knowledge.

Effective guidelines have eleven qualities. Firstly, the guideline should be valid (Ahern, Evans, Hopper, & Zalcbergy, 2018). That is, the implementation should provide a solution to a health dilemma. Additionally, treatment expenses should be affordable to the patient. Secondly, the guideline should conserve medical resources during its implementations. When a protocol concentrates on health improvement and minors on resource conservation, the implementation process may be difficult.  A good guide should be reproducible (Bruinsma et al., 2016). The protocol should have same features with another guideline made from similar sources. An efficient guideline should be acceptable to all health practitioners. Proper guidelines should provide a number of alternatives of treatment to the clinicians (Von Elm et al., 2014). The wording of guidelines should be precise and easy to understand by the physicians. An acceptable guideline should indicate the names of the developers and the techniques that the constructors used. Additionally, the guideline document should provide a clear evidence of the relationship between the evidence used and the recommendations. Lastly, a panel of scientists needs to constantly look at the guidelines and adjust them accordingly.

To disseminate a guideline is to avail it to the health practitioners. Afterwards, the developers of the guidelines should ensure that the physicians follow the recommended instructions. The guidelines can reach health practitioners in several ways. The guidelines can be published in scholarly journals (Kasper et al., 2015). Additionally, the constructors can email them to the health specialists. Furthermore, health corporations can teach the clinicians on the basics of the guidelines.  The act of publishing guidelines in scholarly books and sending the guidelines through email reach the least number of clinicians (January et al., 2014). Since most of them take little time to read journals and to check their mail inboxes. However, the two modes are cheaper than other means of distributing guidelines.

When developers educate the clinicians on the guidelines, the health specialists gain more knowledge that when they read about the guidelines. After receiving the guidelines, the developers must ensure that physicians properly use the protocols (Dumbreck et al., 2016). However, all health facilities should enable the possible application of the guidelines. A hospital should allocate sufficient resources and train health workers to ensure that they fully understand the guidelines.

To appraise is to evaluate the effectiveness of a given process. Various researchers have looked into the recommendations of clinical guidelines. They have come up with similar findings. The results attempt to determine if the recommendations have an effect on health specialists across the world (Laver et al., 2016). A notable research evaluated the impact of eighteen guidelines on health specialists. The study looked at clinical guidelines on the following areas. The medical conditions examined include: High blood pressure, hemorrhage management, and the treatment of infections of the bladder (Kim et al., 2014). The results indicated that most specialists accepted the recommendations by the guidelines.

Clinical Practice Guidelines are statements that help both the patients and the physicians in making decisions. They are applied to create an acceptable uniformity in the provision of healthcare. Furthermore, when properly applied, the guidelines ensure an improvement in the level of treatment. Directors of health facilities use them to check for the quality of medical attention that their staff members are offering to the patients (Dyer et al., 2016). Health practitioners use them to offer globally accepted care. Guidelines made in accordance to the evidence from credible research resonate well with health professionals. The patients need the guidelines to check whether the treatment methods conform to the protocols. The Guidelines issue credible recommendations to doctors (Chew et al., 2016). Health practitioners accept recommendations that have verifiable evidence attached.

Guidelines should emanate from a format containing a review. The literature that supports the guidelines should be reviewed widely to gain a global acceptance. A proper treatment protocol must have an in-depth explanation of how the developers arrived at the recommendations (Lee & Lehman, 2016). Furthermore, the clinical guidelines should base on verifiable sources of evidence. Any guideline that lacks any of the basics mentioned above should not get attention from clinicians.

Before developing a guideline, the following considerations are necessary. Firstly, the developers should be clear on the medical topic that they want to cover. Secondly, the guidelines must be unique and offer a solution to a health issue (January et al., 2014). Every member of the panel for guideline creation should know their duty. A good panel should have a representation from all affected stakeholders. The members of the panel should agree on the modes of gathering evidence. Thirdly, any evidence gathered should be relevant to the health topic under research. Fourthly, the recommendations should concur with the gathered evidence.

 The recommendations should show the essence of the guidelines. Additionally, it should state the shortcomings of the guidelines. Moreover, the recommendations should indicate the expenses that the full implementation of the guidelines can accrue. Health practitioners should gauge the types of patients that suit the guidelines by looking at the recommendations (Dyer at al., 2016). The developers of the guidelines should explain how they can modify the protocols from time to time. A guideline remains viable if the evidence concurs with the recommendation. A change in evidence should alter the recommendations.

Clinical guidelines that tag their findings on evidence are only a quarter of all protocols in the world. The basic guideline should rely on approval by as many scientists as possible. Guidelines that lack evidence and approval from researchers are expensive and tedious to make.  Protocols lacking evidence but having the approval of scientists face high rejection rates as compared to the rest (Kim et al., 2014). A majority of scientists are biased when approving protocols hence the rejection of such protocols.

The second kind of clinical guideline relies on the result of tests that it has directed.  These guidelines look at the recommendations that relied on credible evidence. Furthermore, they gauge their effectiveness by examining the opinions of patients and practitioners (Agha et al., 2016). Analysis of decisions by patients and health specialists helps in gauging the effectiveness of a guideline. A protocol that solves most health issues receives wide recognition by health specialists. The third type of guideline depends on preference ratings.

The guideline combines the two previous types and patient choices to gain its relevance. The opinions of patients are personal and should not apply when making a guideline. When specialists consider the views of patients before making guidelines, the process becomes complicated. A majority of doctors find it rough to use such guidelines. There are guidelines that merge the three guidelines to come up with an all inclusive protocol (Chew et al., 2016). Any recommendations in the guidelines should conform to current research. Additionally, a credible source of literature is paramount before looking at a recommendation.

The Australian government has devised several legal instructions to guide the development of Clinical guidelines. The developers of the guideline need to be precise on their goals. Furthermore, they should avail a statement on issues that the guidelines address. The introductory part of the guidelines should show the areas of applications (Chew et al., 2016). The guidelines must mention the targeted individuals. Developers of protocols need to indicate the methods that they use to upgrade them. Additionally, clinicians should abandon obsolete guidelines. The protocols should be flexible. A representation from all stakeholders is a must in the development process.

The Guideline for Guardianship is current since the status is active and it was reviewed latest on June last year. The protocols are based on evidence. The guideline is Australian as it has a statement of purpose and provides a list of the audience that it targets. Furthermore, it gives a list of places where patients can access it. The guideline is easily available since patients can find it at all health facilities. The protocols have a statement of budget on chapter 4, sub-topic 4.2. The development of the protocol was transparent due to the fact that all stakeholders took part in the formation process. The guideline follows all the rules such as the indication of the people it targets among other regulation.

Conclusion

Clinical guidelines are fundamental in the provision of proper health care. They are verified statements that health practitioners use to treat students. They have advantages and disadvantages to both patient and the practitioners. The guidelines enable patients to make informed decisions on the modes of treatment that suits their needs. The guidelines direct the government on the financial allocation towards the health sector. The protocols assist the care givers to decide on the best mode of treatment. However, when the guidelines are made in a haphazard manner, it negatively affects both patients and clinicians. The areas that the guidelines omit, receive no funding from the government. Thus, patients suffering from the neglected areas are disadvantaged. When clinicians use guidelines that lack evidence, the treatment that they offer harms the patients.  All stakeholders should have a say in the development of any clinical guidelines. The recommendations on the guidelines should be based on evidence. Furthermore, the evidence should have a verifiable literature. A proper guideline must follow the rules and regulations of a given country to avoid the conflict of interest. The Guardianship guideline follows all the requirements of an ideal protocol.

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