Clinical Practice Guidelines of Chronic Condition

Clinical Practice Guidelines of Chronic Condition

Chronic Condition

a chronic condition is a health problem that is commonly seen in primary care nurse practitioner practice. The long-developing syndrome such as osteoporosis or asthma is the condition that causes chronic conditions. The chronic syndrome is caused by acute disease such as first asthma attack when it is not treated (Feistein & Bennett, 2018). The morbidity concept of the chronic condition has been able to evaluate the general health status, the prevalence of health problems, health inequalities and health care needs at the population level. In the united state, the chronic condition such as heart disease, cancer and diabetes are the leading cause of death and disabilities (Feistein & Bennett, 2018). the other genetic disorders of chronic disease include visual impairment and blindness, hearing impairment and deafness, and oral disease the condition is caused by poor nutrition, and this is where the diet is low rich in fruits and vegetables and high sodium and saturated fats (Pei Y, 2016). The other cause of the chronic condition is the usage of tobacco and the exposure to the secondhand smoke. Lack of physical exercise is likely to be another cause of the chronic condition. The other pathology includes the poor lifestyle choices and inadequate relief of chronic stress (Pei Y, 2016). Eventually, excessive alcohol usage is a cause of chronic disease. The mortality, as indicated by the world health organization, show that sixty per cent of the death rate is due to chronic problems. The epidemiology of chronic condition is that In the united states, the disease is counted as the among top seven causes of death; this is according to Centers for Disease Control and Prevention. Chronic diseases are more infective and lead to death fore than infectious condition such as pneumonia and influenza (Pei Y, 2016). The condition of this disease is mostly overseas increasing as the population ages in the developing countries. Nurse practitioners (NPs) diagnosis and manage this chronic condition.

Clinical Practice Guidelines

the patient outcome and local management are improved by the guidelines, and I also describe the decision points of the management of chronic condition such as asthma, it also provides the practices for practitioners throughout the primary care of a nurse. The key role is played by optimizing clinical practice guidelines for the care of the patient with chronical diseases. The guidelines are disseminated through a particular educational programmed and are implemented using patient specific reminders at the time of consultation. The clinical practice guidelines (CPG) for patient with chronic condition are counseling, diagnosis, evaluation, management, prevention, rehabilitation, screening and treatment The Agency for Healthcare Research and Quality ( AHRQ) through its EPCs, has provide comprehensive, science based information ,  costly medical condition and health care technologies and strategies (Qaseem, 2017). The American Academy of Family Physicians has provided the key recommendation for oral pharmacologic treatment of type 2 diabetes mellitus (Qaseem, 2017), as follow

• When pharmacologic therapy is needed to improve glycemic control, the patient should prescribe with metformin.
• When the second oral medication is needed, thy practice practitioner should consider a sulfonylurea, thiazodinedione, SGLT-2, or DPP-4 inhibitor this is to improve glycemic.

The clinical practice guidelines addressed the quality of healthcare adequately, the researcher investigated patterns of morbidity and were able to identify the mix of the most prevalent chronic conditions (Qaseem, 2017). The epidemiology data may help in addressing either the frequent combination of chronic medical condition or combination of specific hard to be handled (Qaseem, 2017). The clinical practice guidelines when developed the show the proceeding of and management of the condition. for example, the clinical practice guidelines management for chronic of ischemic heart disease shall indicate on the treatments for hypertension, chronic low back pain, diabetes mellitus, and osteoarthritis that interface with such kind of diseases (Qaseem, 2017). The clinical practice guidelines direct the primary care nurse practitioners by focusing on the benefits of health of a patient with chronical condition. the team manage the patient with chronic condition with interspine and support the essential goal of the patient.

The clinical practice guidelines for direct the healthcare provider in the management of the patient with chronic condition. for example, the patient with type 2 diabetes clinical practice guidelines are clinical goals and are recognized in primary care (Qaseem, 2017). Primary care nurse practitioner has the resources to apply the guidelines.

The clinical practice guidelines are effective to patient with chronic condition by the it support the self-management of the patient and this improve the patient outcomes (Qaseem, 2017). Physician such as primary care practitioner support this by structuring patient-physicians interaction and identify the issue from the patient perspective, they also provide education individually and through the patient with chronic condition. the education provided is based on the problem of the patient and solving skills, improving the real life of the patient with chronic disease.

Analysis

The clinical practice guidelines are required to be revised because we primary care nurse practice practitioner are able to identify essential new evidence (Robbins, 2017). By revising these CPGs, they can assess whether the new evidence warrants are updated. When revising such evidence, the NPS can determine the invalid and current recommendations. The consensus of the primary nurse practice practitioners can change when revised (Robbins, 2017). The need for revision is that to find the indication of new clinical evidence than can come earlier than schedule one (Hudon, 2018). To improve the quality of medical practice the clinical practice guidelines should be revised and look for clinical recommendation based on recent evidence.

I would change the outdated evidence and try to adopt the new practices, the new evidence resulted to high value care. The old evidence needs to me omitted because the adaptation of the new clinical practice guidelines supports best practice, and as a result of it there is improvement of patient with chronic condition outcome. Moreover, I would also change the evidence that the clinical practice guidelines have not follow a sound, transparent methodology to translate best evidence. Consequently, the evidence that does not produce high-quality evidence -based guidelines is required to be removed after revising the CPGs. The clinical practice guidelines that are not feasible, measurable and achievable I will also change them. The implementation of CPGs, in the clinical setting, should be removed if they are not prioritized to those that have deep supporting evidence, and the most resulted on patient population morbidity and mortality.

The introduction of new demographics in United states will change healthcare system, in terms of delivery clinical practice guidelines (Robbins, 2017). When the U.S government improve the healthcare and clinical care the impact will be an increase in the average life span, this mean that the population will increase with 20 percent in the year 2020 and that there will be more aged 65 or older (Hudon, 2018). The diversity of general population and multiculturalism can affect the nature of chronic condition as well as its morbidity and mortality, primary care nurse practice practitioners should adapt their practice to various culture values and beliefs (Hudon, 2018). The change in the demographics will lead to demand of more complex and long-term care. U.S need to extend the primary care nurse practice practitioners’ scope of practice to reflect the true extent of nursing professionals (Robbins, 2017). The ANA should promote the ongoing case of our aging population, this is be committed to educating about the importance of primary care nurse practice practitioners. This can be done by advocating the nurses and their patients to get best quality care.

The effective strategies getting healthcare systems should adopted by the implementers to promote adherence to trust worthy of clinical practice guidelines. This means that when there is an increase in adoption of clinical decision supporter, there will be new opportunities to rapidity move clinical practice guidelines to the patient encounter (Robbins, 2017). The adapted guidelines should structure the format and content of clinical practice guidelines for example particular statement of evidence and the targeted population. When the adopted guidelines believed they are offering malpractice litigation protection. The primary care nurse practice practitioner implements the clinical practice guidelines should also collaborate in an effort to align their needs.

Evaluation

To determine the effectiveness of the revised clinical practice guideline in directing care for the patient with chronic condition, the patient will be referred by primary care providers that is primary nurse practice practitioners (Hudon, 2018). The approach of chronical condition requires a review of its function to better reflect the reality of patient follow up and needs. The multiple intervention should be interlinked to determine the effectiveness of revised CPG and minimize the results on patient behavior, life-style and self- management (Hudon, 2018). further, the evaluation approach will also focus on health intervention. The healthcare must acquire practical evaluation tools to guide quality improvement effort and assess changes in chronic condition care. The development of instrument by the united state health service for evaluating diabetes care, the instrument was to be used by the primary care nurse practice practitioner (Hudon, 2018).

• to identify the areas improvement in care for chronic disease before starting quality.
• Development of improved strategies.
• Evaluating the nature of improvement

Steps employed in evaluation

The first step is implementation evaluation, it involves the investigating the connection between an intervention and its context during implementation. In this step it explains the effectiveness of the observed changes and also determine essential element that could potentially inform future intervention and decision making consulted by primary health care (Woods & Walker, 2019). The second step is evaluation of affects, this step is where the primary care nurse practice practitioners are referred by the patient (Woods & Walker, 2019). To determine the decision explored by the chronic conditions was preferred with disease design for many reasons. To determine the effectiveness the professionals should comply with the pragmatic nature of the intervention (Woods & Walker, 2019). The primary nurse practice practitioners training is delivered from the intervention that is delivered in primary care settings. The step three, targets for each intervention, the target should be set when the intervention strategies has been determined. These targets will later be used to evaluate the effectiveness of clinical preventive guideline. These targets are specific, measurable, achievable, relevant and timely.

References

Feinstein, J. A., Russell, S., DeWitt, P. E., Feudtner, C., Dai, D., & Bennett, T. D. (2018). R package for pediatric complex chronic condition classification. JAMA pediatrics, 172(6), 596-598.

Hudon, C., Chouinard, M. C., Aubrey-Bassler, K., Burge, F., Doucet, S., Ramsden, V. R., … & Guénette, L. (2018). Case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs: an implementation and realist evaluation protocol. BMJ open, 8(11).

Pei Y. Chronic Condition Management. Epidemiology: Open Access. 2016;06(06). doi:10.4172/2161-1165.1000280

Qaseem, A., Barry, M. J., Humphrey, L. L., & Forciea, M. A. (2017). Oral pharmacologic treatment of type 2 diabetes mellitus: a clinical practice guideline update from the American College of Physicians. Annals of internal medicine, 166(4), 279-290.

Robbins, R., Krebs, P., Jagannathan, R., Jean-Louis, G., & Duncan, D. T. (2017). Health app use among US mobile phone users: analysis of trends by chronic disease status. JMIR mHealth and uHealth, 5(12), e197.

Woods, L., Duff, J., Cummings, E., & Walker, K. (2019). Evaluating the Development Processes of Consumer mHealth Interventions for Chronic Condition Self-management: A Scoping Review. CIN: Computers, Informatics, Nursing, 37(7), 373-385.