Dissertations / Theses on the topic 'Clinical Practice Guidelines (CPG)'
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Mac, Donald Tanya. "Standardized functional capacity outcome measures in post-operative cardiac surgery: A survey of current clinical practice and development of a clinical practice guideline (CPG)." Thesis, University of Ottawa (Canada), 2009. http://hdl.handle.net/10393/28369.
Full textShibu, Litty Mathew. "Examining the research-practice gap in Physical Therapy (PT) in the United States of America using knowledge translation interventions (KTIs) : a comparative study." Thesis, Brunel University, 2018. http://bura.brunel.ac.uk/handle/2438/17553.
Full textYoussef, Sarah Jane. "Implant Maintenance Curriculum Among U.S. Dental Hygiene Programs." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1586814568072554.
Full textTaylor, Michael Dennis. "Prostate cancer clinical practice guidelines clinical and economic outcomes /." [Gainesville, Fla.] : University of Florida, 2005. http://purl.fcla.edu/fcla/etd/UFE0010098.
Full textTypescript. Title from title page of source document. Document formatted into pages; contains 99 pages. Includes Vita. Includes bibliographical references.
Freemantle, Jane. "The impact of clinical practice guidelines for preterm labor on clinical care /." Title page, table of contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmf855.pdf.
Full textMsosa, Yamiko Joseph. "Modelling evolving clinical practice guidelines: a case of Malawi." Thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/28388.
Full textIrving, Michelle. "Implementation of evidence in nephrology using clinical practice guidelines." Thesis, The University of Sydney, 2010. http://hdl.handle.net/2123/13637.
Full textNupdal, Jason Bentley. "Implementing Clinical Practice Guidelines in Family Practice: Caring for Children with ADHD." Diss., North Dakota State University, 2014. https://hdl.handle.net/10365/27368.
Full textChan, Kit-ling Amy, and 陳潔玲. "Strengthening Hong Kong's primary care: role of clinical practice guidelines." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45170848.
Full textSantana, Sondra Michelle Phipps. "Practitioners' Use of Clinical Practice Guidelines: An Evidence-Based Approach." UNF Digital Commons, 2013. http://digitalcommons.unf.edu/etd/462.
Full textTaylor, Rosemary. "Clinical Practice Guidelines for Home Management of Intravenous Immunoglobulin Therapy." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7342.
Full textGravas, Stavros. "TUMT treatment of BPH from evidence based guidelines to clinical practice /." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2007. http://dare.uva.nl/document/45890.
Full textFung, Yiu-ting Tina, and 馮耀婷. "Evidence-based clinical practice guidelines of smoking cessation programs for COPD patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46581856.
Full textBorok, Kathi Keaton. "Clinical practice guidelines for emerging ultrasound applications drafting for validity and usability." Master's thesis, University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/4540.
Full textID: 029050071; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (M.A.)--University of Central Florida, 2010.; Includes bibliographical references (p. 102-105).
M.A.
Masters
Department of English
Arts and Humanities
Cragin, Casey A. "Early Psychosis and Trauma-Related Disorders: Clinical Practice Guidelines and Future Directions." Antioch University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1490872798406533.
Full textMarcos, Cláudia. "Qual deverá ser a intervenção da fisioterapia no tratamento da lombalgia? - uma revisão de orientações clínicas." Bachelor's thesis, [s.n.], 2021. http://hdl.handle.net/10284/10605.
Full textObjetivo: Avaliar criticamente as Normas de Orientação Clínica (NOC) mais recentes, com o intuito de resumir as recomendações e aferir a sua consistência no tratamento fisioterapêutico da lombalgia. Metodologia: Pesquisa nas bases de dados da PubMed, PEDro e Web of Science e o motor de busca Google Académico, recorrendo à expressão de pesquisa: (“Clinical Practice Guidelines” OR “Clinical Guidelines”) AND (“lumbar pain” OR “low back pain”). Também foram usados quatro repositórios de Guidelines online: Guidelines International Network (G-IN), National Health and Medical Research Council (NHMRC), National Guideline Clearinghouse of the Agency for Health Care Research and Quality (USA) e National Institute for Health and Care Excellence (NICE). Critérios de elegibilidade: NOC publicadas com um limite temporal de 5 anos (2016 e 2021), escritas em português,inglês ou espanhol, com foco na intervenção fisioterapêutica em indivíduos com diagnóstico de lombalgia. Resultados: Um total de 11 NOC atenderam aos critérios de elegibilidade e foram avaliadas. No geral, o domínio com maior classificação média foi Âmbito e Propósito (84%), seguido por Independência Editorial (83%), Clareza e Apresentação (81%), Rigor de Desenvolvimento (78%), Envolvimento das Partes Interessadas (75%) e Aplicabilidade (55%). Na avaliação geral das NOC, a média do item de Avaliação geral foi de 69% e a qualidade foi classificada na sua maioria como baixa. Foram identificadas 4 recomendações consistentes para o tratamento da lombalgia, nomeadamente, a favor da manipulação, aconselhamento e exercícios terapêuticos e contra a tração lombar. Conclusão: Foram encontradas limitações metodológicas que afetam a qualidade das NOC. Com base nas NOC revistas, o fisioterapeuta deverá intervir na lombalgia através de um programa multimodal que deve incluir a manipulação, o aconselhamento e os exercícios terapêuticos.
Objective: To critically evaluate the most recent Clinical Practice Guidelines (CPGs), in order to summarize the recommendations and assess their consistency in the physiotherapeutic treatment of low back pain. Methodology: Research in PubMed, PEDro and Web of Science databases and the search engine Google Academic, using the search expression: (“Clinical Practice Guidelines” OR “Clinical Guidelines”) AND (“lumbar pain” OR “low back pain”). Four online guidelines repositories were also used: Guidelines International Network (G-IN), National Health and Medical Research Council (NHMRC), National Guideline Clearinghouse of the Agency for Health Care Research and Quality (USA) e National Institute for Health and Care Excellence (NICE). Eligibility criteria: CPG’s published with a time limit of 5 years (2016 and 2021), written in portuguese, english or spanish, with a focus on physical therapy intervention in individuals diagnosed with low back pain. Results: Overall, the domain with the highest average rating was Scope and purpose (84%), followed by Editorial independence (83%), Clarity of presentation (81%), Rigour of development (78%), Stakeholder involvement (75%) and Applicability (55%). In the overall assessment of the guideline, the average for the Overall assessment item was 69% and the quality was mostly rated as low. Four consistent recommendations were identified for the treatment of low back pain, namely, in favor of manipulation, counseling and therapeutic exercises and against lumbar traction. Conclusion: Methodological limitations that affect CPGs quality have been found. Based on the revised CPG’s, the physiotherapist should intervene in low back pain through a multimodal program that should include manipulation, counseling and therapeutic exercises.
N/A
Robin, Wilhelmus Maria Vernooij. "Updated clinical guidelines: improving their methods and reporting." Doctoral thesis, Universitat Autònoma de Barcelona, 2018. http://hdl.handle.net/10803/462100.
Full textIntroduction Clinical guidelines (CGs) aim to guide healthcare professionals, patients, and policymakers in decision-making by providing recommendations for a healthcare problem. However, since new evidence is published on a regular basis, CGs may require to be updated in order to guarantee the validity of recommendations. As opposed to the methodology for developing de novo CGs, there is scarce guidance available for the updating process of CGs and little is known about the methodology that CG institutions use to maintain the validity of their CGs. Objectives The objectives of this thesis are: 1) to identify and describe the updating guidance available in CG methodological handbooks, 2) to develop a checklist for the reporting of updated CGs, and 3) to assess the completeness of reporting of updated contemporary CGs. Methods For the first study, we conducted a systematic review of CG methodological handbooks searching in MEDLINE, the Guidelines International Network (G-I-N), and the US National Guidelines Clearinghouse. Two authors independently selected evidence and extracted data. We used descriptive statistics and a narrative synthesis to analyse the extracted data. For the second study, we developed a reporting instrument for the updating process of CGs. This tool was constructed through a multi-step development process that included an assessment of updated CGs, semi-structured interviews with key informants, a Delphi consensus survey, a single-round survey with CG methodologists, and semi-structured interviews with CG users. For the third study, we systematically assessed the reporting of the updating process in updated CGs published in 2015. To be eligible, CGs had to be developed by a professional society, report a systematic review of the evidence, and contain at least one recommendation. Three reviewers independently applied the reporting instrument developed in the second study to the included CGs. Results For the first study, we included 35 handbooks. Little guidance for updating CGs was identified. Most handbooks focused mainly on providing guidance for developing CGs de novo. The majority of the handbooks did not provide guidance for the literature search, evidence selection, quality assessment, evidence synthesis, or external review during the updating process. In the second study, we developed the Checklist for the Reporting of Updated Guidelines (CheckUp), which includes 16 items regarding: 1) the presentation of an updated guideline, 2) editorial independence, and 3) the methodology of the updating process. We also developed and explanation and elaboration document for CheckUp with the goal to facilitate the potential users. In the last study, we included 60 updated CGs. The median overall score with CheckUp on a 10-point scale was 6.3 (range 3.1 to 10). The presentation and justification items at recommendation level and the methods for external review and implementing changes in practice were poorly reported. Conclusions The guidance available for the updating of CGs and the reporting of updated CGs is suboptimal. CheckUp is the first reporting instrument in the CG enterprise with a focus on the updating process. CheckUp can be used to assess the completeness of reporting of the updating process in updated CGs, and also guide CG panels by providing methodological and reporting principles that should be incorporated into the updating process.
Aziz, Ayesha. "A service oriented architecture to implement clinical guidelines for evidence-based medical practice." Thesis, University of Sussex, 2015. http://sro.sussex.ac.uk/id/eprint/53223/.
Full textIsmaile, Samantha. "Nursing studies : promoters and barriers for adherence to clinical practice guidelines among nurses." Thesis, Durham University, 2014. http://etheses.dur.ac.uk/10893/.
Full textDe, Angelis Gino. "The Dissemination of Clinical Practice Guidelines to Arthritis Health Professionals Using Innovative Strategies." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37802.
Full textChua, Kao-Ping. "Quasi-Experimental Evaluations of Pediatric Health Care: Clinical Practice Guidelines and Insurance Coverage." Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:17467284.
Full textHealth Policy
Keller, Linda. "Assessment of Evidence-Based Practice Readiness and Plan for Implementation of Clinical Practice Guidelines in a Tertiary Hospital." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5208.
Full textGaines, Jenna H., and Jenna H. Gaines. "Barriers to Implementing Clinical Practice Guideline Nutrition Recommendations in Mild Acute Pancreatitis Patients: Provider's Knowledge and Practice." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/624502.
Full textPrentice, Jennifer Lorna. "An evaluation of clinical practice guidelines for the prediction and prevention of pressure ulcers." University of Western Australia. School of Surgery and Pathology, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0170.
Full textSin, Tak-nam, and 冼德藍. "Evidence-based clinical practice guidelines for care of skeletal pin sites in orthopaedic patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44626332.
Full textLundy, Jo Lynne. "Using The Internet to Build Community and Provide Clinical Practice Guidelines for Camp Nurses." NSUWorks, 2002. http://nsuworks.nova.edu/gscis_etd/690.
Full textFiset, Valerie Jean. "Nursing Students' Use of Guidelines for Pain Management in Clinical Practice: Context and Influencing Factors." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/39856.
Full textMpasa, Ferestas. "Strategies for the implementation of clinical practice guidelines in the intensive care : a systematic review." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/d1020046.
Full textSimon, Judit. "Developing a systematic framework for the integration of health economic evidence into clinical practice guidelines." Thesis, University of Oxford, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.497096.
Full textLedward, Alison. "The interface between evidence-based maternity care clinical practice guidelines and the pregnant woman's autonomy." Thesis, University of Leicester, 2017. http://hdl.handle.net/2381/40446.
Full textBrown, Bernadette. "Clinician-Led Improvement in Cancer Care (CLICC): Complementing Evidence-Based Medicine with Evidence-Based Implementation." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/15660.
Full textEnochs, Shannon. "Bridging the Gap between Emotional Trauma Practice Guidelines and Care Delivery in the Primary Care Setting." Thesis, Brandman University, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13428017.
Full textWhen patients present with complaints of anxiety or depression, providers in the primary care setting often prescribe anxiolytics or antidepressants without conducting an early emotional trauma or adverse childhood experiences assessment. Several studies demonstrate the link between early emotional trauma (EET) or adverse childhood experiences (ACEs) and the increased risk of anxiety or depression as adults. This Clinical Scholarly Project (CSP) implemented the use of the Adverse Childhood Experience (ACE) Questionnaire with patients who had a diagnosis of anxiety or depression in the primary care setting to increase patient access to resources and align clinical practice with practice guidelines. Participants included eight primary care providers, 30 patients and 21 chart review patients. The CSP utilized a quasi-experimental design to determine if the use of the ACE Questionnaire by patients with anxiety or depression would result in patients receiving more community resources (to include counseling), strengthen the provider-patient relationship, increase provider comfort in discussing ACEs with their patients and result in patients receiving care that was evidence based. Patient sample participants received significantly more resources (M = 8.27, SD = 2.27) than the chart audit sample (M = 0.90, SD = 0.30). Patient sample members received an average of eight resources (M = 8.27) and utilized an average of five resources (M = 5.07). Use of the ACE Questionnaire resulted in more trust in provider-patient relationship by patients (80.0%) and the majority of the provider sample more comfortable discussing ACEs after the project (85.7%).
Al-Ketbi, Latifa Mohammed Baynouna. "The use of clinical practice guidelines in General Practice : a study to examine the effect of implementing radiological guidelines in General Practice clinic in the Al-Ain district of the United Arab Emirates." Thesis, University of Aberdeen, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.394556.
Full textCluzeau, Françoise AndreÌe. "Development and application of an appraisal instrument for assessing the methodological quality of clinical practice guidelines." Thesis, St George's, University of London, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249676.
Full textKaranfil, Özge 1978. "Why clinical practice guidelines shift over time : a dynamic model with application to prostate cancer screening." Thesis, Massachusetts Institute of Technology, 2016. http://hdl.handle.net/1721.1/107531.
Full textCataloged from PDF version of thesis.
Includes bibliographical references.
Essay 1: A Dynamic Model for Understanding Long-Term Trends in Prostate Cancer Screening Cancer remains the second leading cause of death in the U.S. after heart disease. After 35 years of routine cancer screening, we still have only a limited understanding of screening dynamics. There is evidence of over-screening and resulting overtreatment in certain cases, and significant provider variation and fluctuations over time in screening criteria. Here I present empirical data for fluctuations in official screening guidelines and in actual practice for the use of the prostate-specific antigen (PSA) test. I explore how these dynamics are affected by the main guideline-issuing organizations in the U.S. and by clinicians, patient groups, and the media. Essay 2: Our Walk to the End of Cancer? Understanding Long-Term Trends in Medical Screening In this study we develop the first integrated, broad boundary feedback theory and formal model to explain the dynamics of medical screening. The theory includes a decision-theoretic core around harms and benefits including the fundamental tradeoff between sensitivity and specificity; and feedbacks that condition guidelines and actual practice. To provide context we use the case of PSA screening for prostate cancer as a motivating example, but our model is generic and applicable to other contexts. We present a behaviorally realistic, boundedly-rational model of detection and selection for health screening that creates oscillations in policy recommendation thresholds of formal guidelines. This core model, entailing only the evidence generation and translation processes, demonstrates how oscillations are natural to this category of problems due to inherent delays in evidence-based screening. These fluctuations lead to long periods during which screening guidelines are suboptimal. Essay 3: A Dynamic Model for Understanding Long-Term Trends in Prostate Cancer Screening Whereas guidelines for routine screening should be based on medical evidence, evidence often has relatively little impact on practice. This situation has led to ongoing controversy and conflict over appropriate guidelines among scientists, clinicians, and patient advocacy groups. There are significant variations in clinical practice, including evidence of over-screening for some diseases, and under-screening for others. To explain the patterns of over-screening, fluctuations, low adherence to guidelines, and conflict, I develop the first explicit broad boundary feedback theory of the dynamics of medical screening, tested in a formal mathematical model. The model presents an extended case study specific to PSA screening for prostate cancer, including realistic presentations for the fundamental tradeoff between test sensitivity and specificity, the natural progression of the disease, and respective changes in population size and composition.
by Özge Karanfil.
A dynamic model for understanding long-term trends in prostate cancer screening -- Our walk to the end of cancer?: understanding long-term trends in medical screening -- A dynamic model for understanding long-term trends in prostate cancer screening.
S.M. in Management Research
Hoomans, Ties. "Economic evaluation of change in clinical practice methods for informing decisions about guidelines and implementation strategies /." Maastricht : Maastricht : Universitaire Pers ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?fid=14837.
Full textPettersson, Billie. "Lipid‐modifying and glucose-lowering therapies in clinical practice : The impact of guidelines and changing reimbursement schemes." Doctoral thesis, Linköpings universitet, Utvärdering och hälsoekonomi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75545.
Full textReddy, Cordelia Kruparakshnam. "Guidelines for clinical research nurses about their self-leadership role in nursing practice at nursing units in the southern suburbs of Cape Town, Western Cape." University of the Western Cape, 2014. http://hdl.handle.net/11394/4692.
Full textClinical research nurses are at the frontline of clinical research. They act as nurse leaders in the area of patient-orientated research. This leadership role requires that they work independently with limited support from other nurses. The nursing practice of clinical research nurses’ associates patient care with research protocols, administration duties, management responsibilities, and role specific authority. At hospitals in the Western Cape, clinical research nurses support principal investigators in the conducting of clinical research. It was unclear how clinical research nurses in nursing units in southern suburbs, Cape Town, Western Cape Province experienced their self-leadership role in nursing practice. The aim of the study was to explore and describe the experiences of clinical research nurses’ self- leadership role in nursing practice in nursing units in the southern suburbs of Cape Town, Western Cape. In this study; a phenomenological, exploratory, descriptive, and contextual design was followed. The population consisted of all the clinical research nurses (n = 22) at Western Cape hospitals and health care institutions in the southern suburbs. Purposive sampling was applied according to selection criteria. Unstructured individual interviews were conducted until data saturation occurred. These interviews took place at a private office in the southern suburbs of the Cape Town and lasted between 45 minutes and an hour. Observation and field notes were taken during the interviews. Data was analysed by using open coding and data triangulation. The researcher applied Lincoln and Guba’s (1985) model of trustworthiness. Four themes and twenty one categories emerged from the data analysis. The findings emphasised that the clinical research nurses’ experienced their self-leadership role in nursing as an evolutionary process. The evolutionary role required that they needed to develop strategies with the aim of surviving the initial tedious and daunting phase that facilitated the development of skills needed for collaborative partnerships with stakeholders. As her general confidence increased, the clinical research nurse would be able to recognise her professional attributes and use self-leadership behaviour to enhance her daily practice. Appropriate self-leadership behaviour would assist the clinical research nurse to successfully navigate the complex, dynamic clinical research environment. Guidelines were developed from the four themes that were the result of the data analysis; namely the initial tedious and daunting phase, working in pursuit of collaborative action, personal traits of the clinical research nurse, and self-leadership behaviour. The UWC Higher Degree Committee at the Faculty of Community and Health Sciences and the Senate Research Committee respectively approved this research project. No risks were anticipated for participants in the study.
Kardakis, Therese. "Strengthening lifestyle interventions in primary health care : the challenge of change and implementation of guidelines in clinical practice." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-141323.
Full textBakgrund: Levnadsvanor som tobaksbruk, riskbruk av alkohol, ohälsosamma matvanor och otillräcklig fysisk aktivitet är riskfaktorer för att utveckla kroniska sjukdomar, vilka orsakar de flesta dödsfallen i världen. Ohälsa och dess följdsjukdomar utmanar också samhällen och hälsosystem världen över p.g.a. de höga kostnader som de medför. För att förbättra situationen så försöker regeringar och organisationer förändra hälso- och sjukvårdens perspektiv till att fokusera mer på hälsa och att arbeta med effektiva interventioner för att förebygga och att förändra människors ohälsosamma vanor. År 2011 i Sverige, publicerades nationella kliniska riktlinjer för vårdens arbete med att förebygga sjukdom genom att stödja förändring av patienters ohälsosamma levnadsvanor. Det är dock välkänt hur svårt det är att förändra klinisk praxis och att introducera riktlinjer, och interventioner på området hälsa i sjukvården brottas med specifika utmaningar. Det övergripande syftet med den här avhandlingen har varit att bidra till en bättre förståelse av komplexiteten i att hälsoorientera primärvården, och att utforska förutsättningarna till att implementera kliniska riktlinjer för att stödja förändring av patienters levnadsvanor. De mer specifika syftena var: att (I) utforska hur implementeringsutmaningarna behandlades i utvecklingsprocessen av riktlinjerna ; att (II) undersöka dimensioner av beredskapen för förändring i primärvården för att implementera riktlinjerna om levnadsvanor inkluderande aspekter av interventionen själv samt kontexten ; att (III) utforska i vilken utsträckning hälsoprofessionerna arbetar med levnadsvanor i primärvården, och att beskriva deras kunskap, attityder och uppfattat organisatoriskt stöd för livsstilsinterventioner ; att (IV) i en två-årig uppföljning utvärdera utvecklingen av arbetet med levnadsvanor i primärvården, och användningen av de specifika nationella riktlinjerna för levnadsvanor. Metod och resultat: En intervjustudie med riktlinjeutvecklare på nationell nivå (n = 7) visade att många utmaningar för implementeringen av riktlinjerna identifierades och bemöttes under utvecklingsprocessen i fyra teman av strategier: breda överenskommelser och konsensus om inriktning och syfte, systematiskt och aktivt inkluderande av stakeholders, formaliserad och strukturerad utvecklingsprocess, öppenhet och insyn utvecklingsprocess. Samtidigt utmanade dock riktlinjerna om livsstilsinterventioner Socialstyrelsens utvecklingmodell p.g.a. deras förebyggande och icke sjukdomsspecifika fokus (I). En multipel fallstudie med nyckelpersoner ansvariga för implementeringen av riktlinjerna i sjukvårdsorganisationerna (n = 10) samt vårdpersonal och chefer (n = 340), visade på gynnsamma villkor för förändring i båda organisationerna rörande förändringsfokus (d.v.s. hälsoorientering) och den specifika interventionen (d.v.s. riktlinjer om metoder för att stödja förändring av ohälsosamma levnadsvanor). Stödet för förändring och lärande visade på något svagare resultat, likaså formen för förändringen d.v.s. nationella riktlinjer i allmänhet. Faktorer i den yttre kontexten visade sig kunna påverka prioritering av och optimalt val av tidpunkt för interventionen, likaså betydande skillnader i uppfattningar mellan yrkesgrupperna (II). En tvärsnittsstudie bland läkare och sjuksköterskor (n = 315) i primärvården visade att de har en positiv attityd och en god kunskapsnivå om metoder för livsstilsförändring. Både kunskapsnivå och i vilken utsträckning man arbetar med patienters livsstil skiljer sig mellan yrkesgrupper. Organisatoriskt stöd som nationella riktlinjer och utvecklandet av primärvårdens samarbete med intressenter i närområdet identifierades som viktigt för att förbättra arbetet med livsstil interventioner (III). En longitudinell undersökning bland vårdpersonal visade att användning av metoder för att förändra patientens vanor beträffande tobaksbruk och riskbruk av alkohol har ökat över tid, och att sjuksköterskorna arbetar i högre utsträckning med alla fyra levnadsvanorna än i tidigare. Implementeringen av de nationella riktlinjerna för levnadsvanor hade inte kommit så långt vid det andra mättillfället, och stora skillnader visade sig i hur läkare och sköterskor ser på riktlinjer och i vilken utsträckning de använder dem (IV). Slutsats: Hälsofrämjande och prevention skiljer sig på många sätt från mer traditionella fält inom medicinen. För att stärka implementeringen av det här viktiga (men ej akuta) fältet i hälso- och sjukvården, så måste det först av allt prioriteras på alla nivåer! Resultatet visar på ett svagt upptag av riktlinjerna för livsstilsinterventioner i klinisk praxis, och lämnar utrymme till förbättring. Aspekter av resultatet som presenteras i avhandlingen kan vägleda fortsatt utveckling och implementering av hälsoorientering och riktlinjer för livsstilsinterventioner inom primärvården, samt användas för att påverka policy, praxis och framtida forskning. Det gäller framför allt aspekter av utveckling av nationella riktlinjer på området; hälso- och sjukvårdsorganisationernas beredskap till förändring; hälsoprofessionernas attityder, kunskap och i vilken utsträckning de arbetar med livsstilsinterventioner och riktlinjer.
Westby, Marie D. "First steps in developing clinical practice guidelines for post-acute rehabilitation after primary total hip and knee arthroplasty." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/23734.
Full textMedicine, Faculty of
Graduate
Westby, Marie D. "First steps in developing clinical practice guidelines for post-acute rehabilitation afater primary total hip and knee arthroplasty." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/23734.
Full textBrink, Filip. "Safe handling of antineoplastic drugs at a public hospital in Guangzhou, China : an observational study in clinical practice." Thesis, Sophiahemmet Högskola, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-2471.
Full textNilsson, Karin. "Adherence to Venous Blood Specimen Collection Practice Guidelines Among Nursing Students and Healthcare Staff." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-120082.
Full textHayawi, Lamia. "Assessment of an Evidence Practice Gap at the Population Level: Screening for Osteoporosis in Ontario." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37926.
Full textQuam, Jennifer M. "Knowledge of Assessment and Management of Childhood Obesity Among Rural Primary Care Nurse Practitioners." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/612863.
Full textPaulus, Deborah Marie. "Performance of a Process Evaluation System in Outpatient Hospital-Based Cardiac Rehabilitation." Thesis, Virginia Tech, 1997. http://hdl.handle.net/10919/10169.
Full textMaster of Science
Fung, Ching-shan, and 馮清珊. "Evidence-based clinical practice guidelines on the frequency of central venous catheter (CVC) dressing change for hematologicalmalignancy adult patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46581686.
Full textAbdullah, Ghadah Mubarak. "Mentoring as a Knowledge Translation Intervention to Inform Clinical Practice: A Multi-Methods Study." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32497.
Full textMayers, Patricia Margaret. "Nurses’ experiences of guideline implementation in primary health care settings." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/1437.
Full textENGLISH ABSTRACT: This dissertation examines how nurses in primary health care in South Africa make use of guidelines. Primary level health care is reliant primarily on nurses, who are under-resourced and often overwhelmed by the complex needs of their clients in the context of the TB and HIV/AIDS epidemic. Despite various continuing education strategies to promote current and evidence-based practice, there are many barriers to providing optimal care. Clinical practice guidelines using best evidence are an important tool for updating health professionals in current practice, particularly at primary care level, where busy practitioners often do not have time or sufficient access to the best evidence. Despite this, we know little of the practitioners’ experiences of guideline use. This study describes experiences of nurses in implementing clinical practice guidelines in the delivery of health care in selected primary level contexts in the Free State Province. The primary research question for this study was “What are the experiences of nurses in using guidelines in primary health care facilities?” A qualitative research approach, drawing on a psychoanalytic framework, was adopted. Three linked studies were conducted, utilising secondary data analysis of transcripts collected during the PALSA (Practical approach to Lung Health in South Africa) RCT study (sub-study 1), document description and review of guidelines used in primary care settings (sub-study 2), observation of nurses in practice and during patient consultations, and focus group discussions with nurses in primary health care facilities (sub-study 3). After the introduction of new format guidelines with onsite training and access to good support and updates, nurses reported feeling more confident, as the guidelines were explicit and gave them clear direction as to when a patient would need referral to the medical practitioner. When the guidelines were followed, and the patient responded positively to an intervention, this gave nurses a sense of credibility and validated their role as primary level health care providers. Guidelines available in the primary care clinics covered a wide variety of clinical conditions, were inconsistent, often outdated and even contradictory. A detailed comparison of two selected guidelines, the South African TB control guidelines and the PALSA PLUS guidelines, both in everyday use in the Free State province, shows that the preferences expressed by the nurses in sub-study 1 are evident in the layout, colour, and user-friendliness of the PALSA PLUS guideline. Nurses in the Free State province do use guidelines, but not consistently. Nurses make clinical judgments and decisions based on experience, alternative knowledges and intuitive responses, in consultation with colleagues and through the use of guidelines. Very few guidelines were used regularly, and each nurse had her preferences for a limited number of guidelines which she found useful. There is a clear need for integrated approaches to the information needs and support of nurses and nurse practitioners at primary care level. Guidelines play a role in promoting learning, changing professional practice and strengthening health care delivery by nurse practitioners at primary level. They can also be thought of as a strategy the health care system uses to defend against the possibility of its health professionals not meeting its expectations of providing quality care. Guidelines may contain anxiety and improve the quality of care, or compromise practice through the imposition of controls. The use of guidelines in primary care settings facilitates decision making, may contain practitioner anxiety and improve the quality of care, yet guidelines pose challenges to creative discernment of the patient’s symptoms in relation to his/her personal circumstances and may impact on the personalised holistic care approach which characterises the essence of nursing. Today’s primary care nurse and nurse practitioner needs to be a competent clinician, compassionate carer, and confident co-ordinator – the overlapping roles of caring, diagnosing and treating and managing. The challenge for the nurse in primary care is to combine her traditional caring and co-ordination role into a role which encompasses curing, caring and co-ordination, a new, yet critically important identity for the 21st century nurse.
AFRIKAANSE OPSOMMING: Die proefskrif ondersoek hoe verpleegsters in primêre gesondheidsorg in Suid-Afrika van riglyne gebruik maak. Primêre vlak gesondheidsorg steun hoofsaaklik op verpleegsters, alhoewel hulle verswelg word deur die komplekse behoeftes van hul kliënte in die konteks van die TB en HIV/AIDS epidemie. Ten spyte van verskeie volgehoue onderrigstrategieë om die huidige en bewese basiese te bevorder, is daar verskeie struikelblokke om optimale versorging te voorsien. Kliniese praktyk riglyne voorsien die beste bewyse en is 'n belangrike hulpmiddel om praktiserende professionele gesondheidswerkers, veral op die vlak van primêre gesondheidsorg, op hoogte van sake te hou. Besige programme en onvoldoende toegang tot hierdie riglyne weerhou dikwels die gesondheidswerkers van bestaande inligting. Dit is egter onbekend wat gesondheidswerkers se ondervinding en gebruik van riglyne is. Die studie beskryf versorgers se ervaring van die implementering van kliniese praktyk riglyne vir gesondheidsorg in primêre vlak kontekste in die Vrystaatprovinsie. 'n Kwalitatiewe navorsingsbenadering wat steun op 'n psigoanalitiese raamwerk, is gebruik. Drie verbandhoudende studies is gedoen wat sekondêre data analise transkripsies gebruik het wat verkry is gedurende die PALSA (Practical Approach to Lung Health in South Africa): RCT (Willekeurig Gekontroleerde Toets) studie (sub-studie 1), beskrywing van dokumentasie en oorsig van riglyne wat in primêre vlak ontwikkeling gebruik is (sub-studie 2), en observasie van verpleegsters in die praktyk en gedurende konsultasies met pasiënte, en fokusgroep besprekings met verpleegsters in primêre vlak gesondheidsorg fasiliteite (sub-studie 3). Na die bekendstelling van 'n nuwe formaat riglyne vir indiensopleiding en toegang tot goeie ondersteuning, het die verpleegsters meer selfversekerd gevoel omdat die riglyne duideliker was en aan hulle 'n beter aanduiding gegee het wanneer 'n pasiënt verwysing na 'n mediese praktisyn benodig het. Wanneer die riglyne gevolg is en die pasiënt positief op behandeling gereageer het, het dit aan hulle 'n gevoel van agting en deug vir hulle rol in primêre vlak gesondheidsorg gegee het. Beskikbare riglyne in primêre sorg klinieke dek 'n wye verskeidenheid kliniese kondisies, is onsamehangend, dikwels verouderd en selfs soms weersprekend. 'n Gedetailleerde vergelyking is tussen twee geselekteerde riglyne gedoen: die Suid-Afrikaanse TB kontrole riglyne en die PALSA PLUS riglyne. Beide word daagliks in die Vrystaatprovinsie gebruik. Die verpleegsters in sub-studie 1 het a.g.v. die uitleg, kleur en gebruikersvriendelikheid die PALSA PLUS riglyne verkies. Verpleegsters in die Vrystaat gebruik wel riglyne maar nie op 'n gereelde grondslag nie. Hulle maak eerder kliniese keuses en besluite gebaseer op ondervinding, alternatiewe kennis en intuïtiewe gevoel, in konsultasie met kollegas en na bestudering van die riglyne. Baie min riglyne is gereeld gebruik, en elke verpleegster het haar voorkeure vir 'n beperkte aantal riglyne wat sy bruikbaar vind. Daar is 'n duidelike behoefte aan 'n geïntegreerde benadering tot die informasiebehoeftes en ondersteuning aan verpleegsters en praktisyns op primêre sorg vlak. Riglyne speel 'n belangrike rol in die bevordering van onderrig, verandering van professionele praktyke en die versterking van gesondheidsorg wat deur verpleegsters in primêre vlak gesondheidsorg gelewer kan word. Dit kan ook gesien word as 'n strategie wat die gesondheidsorgsisteem kan gebruik om te verseker dat gesondheidswerkers kwaliteit diens lewer. Riglyne kan moontlik angstigheid beperk en verhoogde versorgingskwaliteit bring, of dit kan gesondheidsorg benadeel deur die afdwing van kontrolemaatreëls. Die gebruik van riglyne in primêre sorg fasiliteer besluitneming, en mag dalk angstigheid by die praktisyn beperk, wat dan die kwaliteit van versorging kan verhoog. Riglyne bied uitdagings aan die kreatiewe oordeelsvermoë om die pasiënt se simptome te sien binne die konteks van sy/haar omstandighede en mag 'n impak hê op persoonlike holistiese versorging wat die aard en kern van verpleging is. Die huidige primêre sorg verplegingspraktisyn moet 'n bekwame klinikus, ontfermende versorger en betroubare koördineerder wees – met oorvleuelende rolle van versorging, diagnosering en behandeling, en bestuur. Die uitdaging vir die verpleegster in primêre sorg is om die tradisionele versorging en koördinering te kombineer tot 'n omvattende rol van genesing, versorging en koördinasie; 'n nuwe, maar krities-belangrike identiteit vir die 21ste-eeuse versorger.
Zolezzi, Cédric. "La force juridique des recommandations de bonne pratique : regards croisés France - Etats Unis." Thesis, Rennes 1, 2016. http://www.theses.fr/2016REN1G008.
Full textWhat's the legal strength of CPGs in healthcare, in France and in the United States?The Institute of Medicine has defined as soon as 1992 Clinical Practice Guidelines as "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances." As they derive from various public and private bodies, and from the consensus of experts, CPGs are considered as consensus statements representing the prevailing standard of care in the medical profession. Clinicians and judges use clinical practice guidelines in their everyday life to appreciate individual situations and reach the best solutions for patients and plaintiffs: CPGs help improve their decision-making. But the legal strength of these tools is not totally consensual. In France, CPGs are seen as evidence of the standard of care expected from physicians. In theUnited States, where CPGs appeared some years earlier, they have been subject to questions, denounced as symptoms of a “cookbook medicine” and object of experiments by various States and insurance companies – not to mention lobbies. Their legal weight seems all the same better established in the U.S. than in France, although rulings in 2011 and 2016 by the french Conseil d’Etat have given them a more central role and a more recognized legal position in France