The Role and Application of Clinical Practice Guidelines in Healthcare- A Focus on Nurse Practitioners, Physician Assistants, and Medical Doctors

The Role and Application of Clinical Practice Guidelines in Healthcare- A Focus on Nurse Practitioners, Physician Assistants, and Medical Doctors

Importance of Clinical Guidelines

Clinical guidelines are statements that are developed systematically to help practitioners make patient decisions on the appropriate healthcare for the particular clinical scenario (Guerra-Farfan et al., 2022). These guidelines are thoroughly interpreted and synthesized by expert methodologists and clinicians. They are then transformed into practice recommendations that have the possible impact of improving patient outcomes and the care process. Clinical guidelines help medical professionals make the best decision based on the credible research available, reduce practice discrepancies, help save costs, and improve healthcare quality (Guerra-Farfan et al., 2022).

Governing Bodies for Clinical Practice Guidelines

There are different governing bodies for clinical practice guidelines. The first body is the World Health Organization (WHO), which provides guidelines on the diagnosis, treatment, and infection control strategies. Secondly, the American College of Cardiology (ACC) provides guidelines on the management of heart failure (Agency for Healthcare Research and Quality, 2021). The third body is the Centers for Disease Control (CDC), which provides guidelines on the management of HIV/AIDS and the treatment of opportunistic infections in HIV-positive adults. The fourth organization is the American College of Physicians (ACP), which issues guidelines for the treatment of diabetes mellitus type 2. The last body is the National Institute for Health and Care Excellence (NICE), which publishes guidelines on depression (Agency for Healthcare Research and Quality, 2021).

Contents Provided in Clinical Practice Guidelines

Clinical practice guidelines usually provide comprehensive information for the management of patients across different healthcare conditions. Diagnostic criteria are one of the details in a guideline that specifies how to diagnose a condition, including lab tests, symptoms, imaging studies, and the appropriate assessments. Guidelines also offer treatment options based on the patient characteristics, condition severity, and evidence efficacy (American Academy of Family Physicians, 2023). Follow-up and monitoring details elaborate on the most recommended intervals of follow-up for patients under treatment, including symptom monitoring, laboratory parameters, and response to treatment. Clinical guidelines also underscore the importance of patient education and communication, patient risk factors assessment, multidisciplinary collaboration, and quality measures to evaluate adherence to the clinical guidelines (American Academy of Family Physicians, 2023).

Clinical Practice Guidelines to Use for STI Visits

For the treatment of sexually treatment infections, I anticipate that the Public Health Department would use the CDC’s Sexually Transmitted Infections Treatment Guidelines of 2021. This clinical guideline provides the most recent evidence-based treatment, diagnostic, and prevention recommendations (CDC, 2021). For patients presenting with syphilis, the clinical guideline recommends the use of treponemal and nontreponemal tests in the diagnosis of syphilis and the use of penicillin G as the preferred drug for treating patients. The guideline also recommends evaluation and treatment of sexual partners of the patient to prevent transmission (CDC, 2021). On the other hand, the clinical guidelines recommend that patients with chlamydia are diagnosed by using first-void urine cervical or vaginal swabs for women and testing urethral swab or first-void urine. Doxycycline is the most recommended regimen for treatment, while alternative regimens that can be used include levofloxacin or azithromycin. Also, patients with chlamydia are encouraged to get their sexual partners tested and follow-up tests to be done after four weeks (CDC, 2021).

Recommendation for Mammogram Screening

The American College of Gynecology recommends different breast cancer screening guidelines for women at average risk and those who are at higher than average risk. Women at average risk are categorized into different groups with different recommendations (Ren et al., 2022). For instance, the guidelines recommended that all women aged between 40 and 54 should do mammograms. The guidelines state that those aged between 40 and 44 years are recommended to have mammograms annually, while those aged 45 to 54 years should have them at an interval of two years. Furthermore, the guidelines recommend breast awareness to all women but do not recommend breast examination and clinical breast examination (Ren et al., 2022).

On the other hand, the American Cancer Society recommends that women aged 19 years and older conduct clinical breast exams annually while those aged 40 years and above do screening mammograms annually. Also, the guideline endorses breast awareness but does not address breast-self examination (Ren et al., 2022). Further, the United States Preventive Services Task Force directs that all women aged between 40 and 75 years should do mammograms as follows: Those between 40 and 49 should have annual mammograms, while those aged 50 to 74 should have mammograms once every two years. No mammogram is recommended for women above the age of 75 years. The USPST, however, does not address clinical breast examination, breast self-examination, or breast awareness (Ren et al., 2022).

Clinical Scenario

According to the Journal of Allergy and Clinical Immunology, it is recommended that a patient with allergic rhinitis should be prescribed an oral second-generation antihistamine. It is recommended that the patient should be educated on avoiding allergens that may trigger the symptoms, like dust mites and pollen (Dykewicz et al., 2020). Also, the patient should be educated on proper nasal hygiene like saline nasal irrigation, and the use of environmental control measures like air purifiers.

References

Agency for Healthcare Research and Quality. (2021). Clinical guidelines and recommendations | Agency for Healthcare Research & Quality. Ahrq.gov. https://www.ahrq.gov/prevention/guidelines/index.html

American Academy of Family Physicians. (2023). Clinical practice guideline manual. Www.aafp.org. https://www.aafp.org/family-physician/patient-care/clinical-recommendations/cpg-manual.html

CDC. (2021). Chlamydial infections – STI treatment guidelines. Centers for Disease Control and Prevention. https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm

Dykewicz, M. S., Wallace, D. V., Amrol, D. J., Baroody, F. M., Bernstein, J. A., Craig, T. J., Dinakar, C., Ellis, A. K., Finegold, I., Golden, D. BK., Greenhawt, M. J., Hagan, J. B., Horner, C. C., Khan, D. A., Lang, D. M., Larenas-Linnemann, D. ES., Lieberman, J. A., Meltzer, E. O., Oppenheimer, J. J., & Rank, M. A. (2020). Rhinitis 2020: A practice parameter update. Journal of Allergy and Clinical Immunology, 146(4). https://doi.org/10.1016/j.jaci.2020.07.007

Guerra-Farfan, E., Garcia-Sanchez, Y., Jornet-Gibert, M., Nuñez, J. H., Balaguer-Castro, M., & Madden, K. (2022). Clinical practice guidelines: The good, the bad, and the ugly. Injury, 54(5). https://doi.org/10.1016/j.injury.2022.01.047

Ren, W., Chen, M., Qiao, Y., & Zhao, F. (2022). Global guidelines for breast cancer screening: A systematic review. The Breast, 64, 85–99. https://doi.org/10.1016/j.breast.2022.04.003

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Discuss the importance of Clinical Practice Guidelines and how they are used by nurse practitioners, physician assistants, and medical doctors in clinical practice.
List at least 5 different governing bodies for Clinical Practice Guidelines, and for each Clinical Practice Guideline that you list, discuss a health condition that can be managed by the clinical practice guideline.

The Role and Application of Clinical Practice Guidelines in Healthcare- A Focus on Nurse Practitioners, Physician Assistants, and Medical Doctors

Elaborate on the details that are provided in Clinical Practice Guidelines for the management of patients.
Which clinical practice guideline(s) would you anticipate using in a Public Health Department for Sexually Transmitted Infection visits? Why? Discuss the details of the clinical practice guidelines to manage a patient who is presenting for Syphilis and Chlamydia.
Sometimes there are slightly different recommendations from different clinical practice guidelines. Discuss the differences between the American College of Gynecology (ACOG), the United States Prevention Services Task Force (USPSTF), and the American Cancer Society (ACS) for mammogram screening.
Clinical Scenario: A Nurse Practitioner Student is seeing a 31-year-old Male patient who presents with seasonal allergic rhinitis. The symptoms include post-nasal drip, rhinorrhea, itchy nose, and itchy eyes, and the symptoms have not been controlled with diphenhydramine or loratadine. Based on the clinical practice guidelines, discuss the treatment(s), including education and non-pharmacological recommendations for the patient. Be sure to cite the clinical practice guideline that you are discussing.
Expectations

Initial Post:

Due: Thursday, 11:59 pm PT
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA format from within the last 5 years