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Article
Publication date: 1 December 2004

Ash Samanta and Jo Samanta

Clinical guidelines from National Institute of Clinical Excellence (NICE) have been developed by a rigorous process using the highest‐level evidence base. Their objectives…

Abstract

Clinical guidelines from National Institute of Clinical Excellence (NICE) have been developed by a rigorous process using the highest‐level evidence base. Their objectives are to reduce the variations in clinical care and end the postcode lottery of healthcare delivery. They are backed strongly by the government's agenda, are expected to be implemented and to be monitored, and this is to be monitored by CHAI. Up until now, clinical guidelines have had a secondary status to expert witness testimony in determining the standard of care in law in medical litigation. However, guidelines from NICE may have a more influential role in determining the standard of care in law by setting the standard of expected clinical practice. Trusts need to be sensitive to this as part of their risk management strategy. Trusts should facilitate the implementation of guidelines from NICE and audit their use through the framework of clinical governance. In the rare event that a trust should decide to positively diverge from such guidelines, it should do so only through a mechanism of due process that is required in public law for the accountability of the reasonableness of such a decision.

Details

Clinical Governance: An International Journal, vol. 9 no. 4
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 3 April 2017

Mary Busk

The purpose of this paper is to provide a commentary, from a parent carer perspective, on Murphy’s overview of the NICE guidelines and quality standards on learning…

Abstract

Purpose

The purpose of this paper is to provide a commentary, from a parent carer perspective, on Murphy’s overview of the NICE guidelines and quality standards on learning disabilities and behaviour that challenges.

Design/methodology/approach

The paper discusses the NICE approach, the content of these specific guidelines and quality standards and considers their practical relevance, with a particular focus on families of children and young people with learning disabilities and behaviour that challenges.

Findings

Gaps in research affect recommendations in some key areas including around transition and early intervention. Risk factors are not linked to clear recommendations for early identification and prevention. For families, additional work is needed to highlight where these guidelines fit with related national law and policies. Families also need to see how the guidelines can positively influence commissioners to improve life outcomes and avoid crises and deterioration in behaviour. Although NICE guidelines are often condition specific, many of our children and young people have co-existing conditions and so do not fit neatly into just one set of guidelines. That is why data collection is very important to understanding needs and to effective commissioning. There is a need to urgently identify and address the research gaps so that essential interventions are included in future NICE guidelines and standards.

Originality/value

A family carer perspective suggests ways in which implementation of the NICE guidelines can be supported and argues for the importance of the further research that will strengthen future versions of the guidelines.

Details

Tizard Learning Disability Review, vol. 22 no. 2
Type: Research Article
ISSN: 1359-5474

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Article
Publication date: 23 October 2007

Abhijit Basu and Amanda Bellis

This purpose of this study is to look at the availability of routine antenatal anti‐D prophylaxis (RAADP) in the maternity units within the North‐west Deanery, England…

Abstract

Purpose

This purpose of this study is to look at the availability of routine antenatal anti‐D prophylaxis (RAADP) in the maternity units within the North‐west Deanery, England five years after the publication of this technology appraisal guideline (no. 41) by the National Institute for Clinical Excellence (NICE).

Design/methodology/approach

Antenatal clinics of all the major 18 maternity hospitals were contacted about their existing practice on RAADP. Responses were obtained by facsimile and telephone.

Findings

A total of 11 of the 18 units had implemented the practice between April 2003 and May 2007. Some had changed their practice from two doses to a single dose on the grounds of logistics. Cost appeared to be the most important reason in non‐user units. The practice is under consideration in two units.

Practical implications

There may be difficulty in universal implementation of NICE guidelines despite the supporting evidence.

Originality/value

This study demonstrates the issue of difficulty of local health economies in supporting national guidelines.

Details

Clinical Governance: An International Journal, vol. 12 no. 4
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 1 January 2014

Pallab Majumder, Lina Gatsou and Alistair Hay

The purpose of this audit cycle was to compare the clinical practice of treating children and adolescents with moderate to severe depression with the NICE guidelines. The…

Abstract

Purpose

The purpose of this audit cycle was to compare the clinical practice of treating children and adolescents with moderate to severe depression with the NICE guidelines. The second aim was to recommend changes in practice to improve compliance to the guidelines and reinvestigate the degree of change two years after the initial recommendations.

Design/methodology/approach

A total of 40 patients within Secondary Care with moderate or severe depression were selected. Data were collected, analyzed and recommendations were made. The second phase of the audit cycle was completed after two years, following similar methods.

Findings

On most of the parameters the clinical practice improved in the re-audit, indicating better compliance with the NICE guidelines. However, on a few areas the compliance did not improve or even deteriorated.

Research limitations/implications

The implications of the results were discussed and final recommendations were made based on the findings and the perceived change in practice.

Originality/value

Literature searches revealed no previous audit cycles to have been conducted on CAMHS compliance to NICE guidelines with regards to treating depression.

Details

Clinical Governance: An International Journal, vol. 19 no. 1
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 1 January 2014

C. Ellie Wilson, Ged Roberts, Nicola Gillan, Chris Ohlsen, Dene Robertson and Janneke Zinkstok

This paper aims to provide an overview of the recent National Institute for Health and Clinical Excellence (NICE) clinical guidance for diagnosis and treatment of adults…

Abstract

Purpose

This paper aims to provide an overview of the recent National Institute for Health and Clinical Excellence (NICE) clinical guidance for diagnosis and treatment of adults with Autism Spectrum Disorder (ASD) and to discuss clinical and practical implications.

Design/methodology/approach

This is a summary and discussion of the NICE guidance for adults with autism. This includes discussion of relevant related guidance, the need for transition services for young people with ASD, education of professionals, applicability of the guidance to people with intellectual disabilities and challenges related to implementation of the guidance in a changing National Health Service.

Findings

The guidance provides an excellent overview of current and state-of-the-art strategies for diagnosis and treatment of ASD-related behaviours, and their level of evidence. In terms of diagnosis, the main recommendation for clinicians is to carry out a comprehensive assessment for adults with suspected autism, taking into account co-morbid mental health problems and potential unmet needs. In addition, NICE makes recommendations regarding pharmacological and psychological interventions and these are discussed. The guidance also makes specific recommendations regarding service design, for example the formation of Autism Strategy Groups. This will hopefully support the development of specialist adult autism services.

Originality/value

This paper provides new insights into the implications of the recently published NICE clinical guidance for autism in adults, relevant for health care professionals, service managers and service users.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 8 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

Content available
Article
Publication date: 21 February 2011

Abstract

Details

Advances in Dual Diagnosis, vol. 4 no. 1
Type: Research Article
ISSN: 1757-0972

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Article
Publication date: 14 September 2015

Andrew Robson and Lyn Robinson

This study investigated the application in the field of healthcare of a recently developed model of information seeking and communication. The purpose of this paper is to…

Abstract

Purpose

This study investigated the application in the field of healthcare of a recently developed model of information seeking and communication. The purpose of this paper is to test the model’s validity and to identify insights that it may provide.

Design/methodology/approach

To investigate the model’s application to information users, the findings from published literature on physicians’ information behaviour were studied. To investigate its application to information providers, interviews were carried out with staff working for the National Institute for Health and Care Excellence and with employees of pharmaceutical companies. The findings were examined using deductive content analysis.

Findings

The findings endorse the validity of the model, with minor modifications. The model provides practical insights into the behaviour of both users and providers of information and the factors that influence them. It can be used to identify ways in which information behaviour may be positively modified in both finding and communicating healthcare information.

Originality/value

This research demonstrates the practical value of a new model of information behaviour which was developed using insights from earlier models. In doing so it answers criticisms that research in library and information science often fails to build on previous research and that it has little practical usefulness.

Details

Journal of Documentation, vol. 71 no. 5
Type: Research Article
ISSN: 0022-0418

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Article
Publication date: 9 August 2011

Michael Ogundele

This article aims to review the available literature on how clinicians meet the daily challenge of translating medical information into clinical EBM. It also seeks to…

Abstract

Purpose

This article aims to review the available literature on how clinicians meet the daily challenge of translating medical information into clinical EBM. It also seeks to describe the procedures involved in a local initiative in the UK to develop software applications for implementation of national clinical guidelines to enhance EBM in routine clinical practice.

Design/methodology/approach

It was hypothesised that improved access to these guidelines in routine clinical practice could be achieved through integrated local procedures, thereby enhancing the quality of care provided to children and adolescents with asthma or UTI. A literature search was performed using databases. To explore the preferences of the doctors and other healthcare professionals on how they accessed clinical guidelines, feedback was obtained. Stepwise implementation of the clinical guidelines was instituted over a period of three years in different primary care and hospital settings.

Findings

The professionals actively engaged with all the different stages in the implementation of the clinical guidelines. The majority preferred the interactive computerized system based on its ease of use, better aesthetic features, familiarity with the software and limited dependence on the technical skills of the users.

Research limitations/implications

The limitations of this study include lack of systematic data to assess the clinical effectiveness of the guidelines' implementation. Another apparent limitation of the study is the small size of participants within the paediatric unit of each organisation where the study was conducted.

Practical implications

There is a need for further comparative studies between the local intervention strategies described in this study and other implementation strategies, to identify the most effective implementation methods for electronic guideline‐based systems.

Social implications

Reliable high quality guidelines from reputable professional bodies could be successfully implemented at the primary or hospital‐based levels through a series of coordinated multidisciplinary interactive processes. This study has positive implications for improving the quality of care provided to children and adolescents, enhancing the role of clinical governance, provision of useful information to patients/carers and other healthcare providers.

Originality/value

This study highlights a potentially effective way of implementing and integrating an electronic guideline‐based computer system into local practice.

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Article
Publication date: 1 June 2001

Vivienne Harpwood

Explores the relationship between doctors, lawyers and the government in the context of the explosion in clinical negligence litigation, clinical governance and the…

Abstract

Explores the relationship between doctors, lawyers and the government in the context of the explosion in clinical negligence litigation, clinical governance and the introduction of the Human Rights Act 1998. Examines these issues from a legal perspective. Concludes that successful risk management, careful monitoring and the implementation of authoritative guidelines hold the key to legal change.

Details

Journal of Management in Medicine, vol. 15 no. 3
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 31 December 2009

Nick Midgley

Ambiguities in the term ‘evidence‐based practice’ (EBP) are often used to hide some of the tensions within the idea itself. This article seeks to clarify what EBP means…

Abstract

Ambiguities in the term ‘evidence‐based practice’ (EBP) are often used to hide some of the tensions within the idea itself. This article seeks to clarify what EBP means and how evidence and knowledge can contribute to the development of children's services. It acknowledges the ‘implementation gap’ between evidence‐based practice and evidence‐based practitioners, and discusses two contrasting perspectives on the problem and its solution. For ‘disseminators’ the primary issue is better translation of findings into practice, illustrated here by the work of the National Institute of Health and Clinical Excellence (NICE). ‘Revisionists’ look beyond obstacles and drivers to implementation and instead advocate looking again at the relationship between research and practice and propose a number of radical proposals for how this relationship can be re‐envisioned.

Details

Journal of Children's Services, vol. 4 no. 4
Type: Research Article
ISSN: 1746-6660

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