Identify a clinical area in which to promote best practice. What are the reasons for selecting this particular area? What is the clinical question you would like addressed by a guideline?
Cardiovascular disease (CVD) is one of the leading cause of deaths in the US accounting 10 million lives annually. It is important to review and assess latest recommendations, protocols, and guidelines associated with CVD in order to reduce mortality rate and improve quality of life of patients. Since CVD is associated with major complications such as hypertension and diabetes, it is essential to review related guidelines. Does a clinical guidelines such as the American College of Cardiology (ACC) and American Heart Association (AHA) have an impact on CVD outcomes? This is a major clinical question that should be addressed while referring the 2013 ACC/AHA guidelines (Bansal, M., & Chandra, K. S. 2014).
How would you go about searching for practice guidelines that might be relevant to your clinical question? What databases would you search? Which search terms would you use? What other criteria would you use to restrict your searching and why (e.g. year of publication, language, etc.)?
The search method including secondary research over the internet by using keywords such as CVD, Heart Disease, CVD Impact, Guidelines CVD, Heart disease and US, Clinical CVD, Complications of CVD, and Treatment of CVD. Some of the databases used to identify key guidelines included PUBMED, CINHAL, EMBASE, Google Scholar, and the National Cardiovascular Disease Database (NCDD). In order to shortlist and restrict my search, only guidelines published in English and published 2012 and beyond were selected. Only guidelines pertaining to CVD only were identified. Other guidelines for other disease conditions such as stroke, hypertension, diabetes etc. were excluded (Finfgeld-Connett, D., & Johnson, E. D. (2013).
Based on the clinical area you identified, develop a strategy for how you would go about adopting / adapting practice guidelines in your setting. Think about how you might operationalize or measure each step of the Practice Guideline Evaluation and Adaptation Cycle.
Many patients in the clinical setting approach healthcare professionals with varying symptoms of CVD. In order to provide the best health outcome, it is essential to adopt the 10 year CVR risk assessment from the ACC/AHA guidelines. The risk assessment tool is ideal since it takes into consideration the ethnicity, race, age, and gender of an individual which would provide accurate predictions. The CVD risk assessment tool/criteria should be adopted in all clinical and healthcare settings (Ziaeian, B., Dinkler, J., & Watson, K. 2015).
The ACC/AHA guidelines also comprises of key treatment algorithms based on the individuals current and past medical data. The treatment algorithm should be adapted in the healthcare setting to provide the best treatment or intervention for individuals with or at risk of CVD. The treatment algorithm is also based for individuals with other comorbid conditions and thus should be adapted in the clinical setting. Furthermore, the treatment algorithm is provided in a tabular form that can be printed for ease of use by the healthcare professional. One of the most unique feature of the algorithm is that it provides treatment protocols for all age groups and algorithms for emergency situations (Virani, S. S. 2014).
Based on the Appraisal of Guidelines for Research and Evaluation (AGREE), the objective of the guideline is described appropriately. The target users of the guidelines have been appropriately defined. The guideline is comprehensive and systematic methods were utilized in the development. All recommendations are precise and unambiguous. Lastly, the guidelines include practice tools which makes in one of the best to adapt and adopt for clinical settings (Semlitsch, T., et al. 2015).
References
Bansal, M., & Chandra, K. S. (2014). The 2013 American College of Cardiology
(ACC)/American Heart Association (AHA) guidelines for cholesterol management and for cardiovascular risk stratification: A reappraisal. Indian Heart Journal, 66(1), 1–4. http://doi.org/10.1016/j.ihj.2014.01.003
Finfgeld-Connett, D., & Johnson, E. D. (2013). Literature Search Strategies for Conducting
Knowledge-building and Theory-generating Qualitative Systematic Reviews: Discussion Paper. Journal of Advanced Nursing, 69(1), 194–204. http://doi.org/10.1111/j.1365-2648.2012.06037.x
Semlitsch, T., Blank, W. A., Kopp, I. B., Siering, U., & Siebenhofer, A. (2015). Evaluating
Guidelines: A Review of Key Quality Criteria. Deutsches Ärzteblatt International, 112(27-28), 471–478. http://doi.org/10.3238/arztebl.2015.0471
Virani, S. S. (2014). What Is New in the 2013 ACC/AHA Guideline on the Treatment of
Blood Cholesterol to Reduce Atherosclerotic Risk in Adults? Texas Heart Institute Journal, 41(3), 304–305. http://doi.org/10.14503/THIJ-13-4077
Ziaeian, B., Dinkler, J., & Watson, K. (2015). Implementation of the 2013 American College
of Cardiology/American Heart Association Blood Cholesterol Guideline Including Data From the Improved Reduction of Outcomes: Vytorin Efficacy International Trial. Reviews in Cardiovascular Medicine, 16(2), 125–130.
