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Dissertations / Theses on the topic 'Family practice Practice guidelines'

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Published: 4 June 2021

Last updated: 1 February 2022

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1

Nupdal, 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.

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The purpose of this Practice Improvement Project was to promote evidence-based practice in caring for children ages 4-18 with Attention Deficit Hyperactivity Disorder (ADHD) in the family practice setting. The American Academy of Pediatric Clinical Practice Guidelines (CPG) and the Diagnostic and Statistical Manual of Mental Health Conditions, 5th Ed. (DSM-V) diagnostic criteria for ADHD were embedded in the electronic health record (EHR) in the form of an evaluation tool/template to guide the Primary Care Providers (PCPs) in documenting evidence-based practice in the assessment, diagnosis and treatment of ADHD. Primary stakeholders are PCPs of Riverview Clinic who care for children with ADHD. Neuman?s System Theoretical framework was used assuring a comprehensive holistic approach to caring for children with ADHD. The logic model was applied to direct project process while providing a framework for project evaluation. A focused forum was held to educate PCPs on the American Academy of Pediatrics (AAP) CPG and the DSM-V ADHD diagnostic criteria. PCPs were introduced to the tool with instruction on use. Six weeks post launching, a retrospective chart audit was done to evaluate for the presence of evidence basedpractice documentation with the evaluation tool/template versus without. When utilized, the evaluation tool/template demonstrates a higher rate of documentation supportive of evidence-based practice. The tool enhances provider?s comfort level in caring for children with ADHD while promoting optimal quality outcome for the child. Project outcome suggests the tool be used by PCPs in documenting evidence-based practice. Key words: ADHD, children, management, EHR, template, co-morbid conditions, and clinical practice guidelines.

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Santana, Sondra Michelle Phipps. "Practitioners' Use of Clinical Practice Guidelines: An Evidence-Based Approach." UNF Digital Commons, 2013. http://digitalcommons.unf.edu/etd/462.

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Pre-diabetes is a serious health problem in the United States. Distinguished by plasma glucose levels that are above the normal threshold, patients with pre-diabetes are 10 times more likely to develop type 2 diabetes. Patients with pre-diabetes suffer the same complications as patients with diabetes including diabetic retinopathy, nephropathy, and microalbuminuria. There is considerable evidence to support the idea that early identification and aggressive treatment of pre-diabetes has the potential to delay disease progression. The American Diabetes Association’s clinical practice guideline recommends management of with lifestyle modification and metformin for patients who are at risk for developing type 2 diabetes. The purpose of this project was to evaluate the implementation of the 2012 ADA clinical practice guidelines regarding the management of patients with pre-diabetes by the health care providers at a volunteer-run clinic located in a large metropolitan area in the southeastern United States. This study, even with a small sample size (n=26) revealed that the providers at the clinic had not implemented the 2012 ADA clinical practice guidelines. Clinical practice guidelines promote health care interventions that have proven benefits and improve the consistency of care provided to patients. The greatest benefits of implementing clinical practice guidelines for patients with pre-diabetes are early diagnosis and aggressive disease management. This would improve patient outcomes and in the long run, decrease the cost of medical care.

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Cooper, Heather L. "Evidence-based practice and asthma guideline adherence and barriers a study of a university family practice clinic /." Laramie, Wyo. : University of Wyoming, 2007. http://proquest.umi.com/pqdweb?did=1400966251&sid=1&Fmt=2&clientId=18949&RQT=309&VName=PQD.

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4

Cantin, Christina. "Family Practice Nurses and Smoking Cessation Interventions for Pregnant Women." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/23953.

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PURPOSE: To describe 1) smoking cessation (SC) interventions by Family Practice Nurses (FPN) during prenatal visits, and 2) the predictors and barriers of FPN-provided SC counselling for pregnant women. DESIGN: Non-experimental, descriptive, correlational design. Onetime, cross-sectional questionnaire using a previously validated questionnaire, modified and converted to electronic format. METHODS: Descriptive and multivariable analysis. Predictors investigated included nurses’ age, beliefs about their role in SC, self-efficacy to provide effective counselling, SC training, and interest in updating SC knowledge. PARTICIPANTS: Eighty-nine members of the Ontario Family Practice Nurses’ interest group (18% response rate) working in primary care settings across Ontario. RESULTS: Nearly one quarter (21.5%) of respondents never offer SC counselling to pregnant women. Nurses with higher levels of self-efficacy were more likely to provide SC counselling. Nurses are less likely to provide concrete assistance in the quitting process or arrange follow-up. The most commonly cited barriers included lack of time and cost of medication. CONCLUSIONS: FPNs are not consistently providing evidence-based SC interventions for pregnant women. Training to enhance self-efficacy may increase the frequency, efficiency and quality of FPN-provided SC interventions.

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Kiessling, Anna. "Quality of care and quality of life in coronary artery disease /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-205-5/.

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6

Baker-Townsend, Julie Ann. "Quality Improvement Measures for Cervical Screening Guidelines in a Clinic for Uninsured Adults." UNF Digital Commons, 2014. http://digitalcommons.unf.edu/etd/510.

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Cervical cancer, a completely curable disease with early detection and management, is an international concern. Early identification allows for treatment of the disease, which prevents or slows progression, ultimately reducing morbidity and mortality. Due to the regressive nature of most cervical lesions, the duration between cervical cytology has been lengthened to prevent over diagnosis and treatment. This was reflected in the 2012 United States Preventative Services Task Force (USPSTF) clinical practice guideline for cervical cancer screening. The purpose of this project was to determine the effectiveness of a quality improvement initiative to increase adherence to the 2012 USPSTF guideline at a volunteer medical clinic for the working uninsured. In this retrospective, time series observational evaluation, data were collected via chart review regarding adherence to the guideline. The intervention consisted of the placement of a visual algorithm educational tool for clinical decision-making for cervical cytology screening in each exam room. Data were collected during three time periods: (1) the 3 months prior to initial education of clinic staff regarding the guideline; (2) the 3months between initial education and introduction of the algorithm; and (3) the 3 months post introduction of the algorithm. A total of 335 charts were reviewed. There was a significant difference in the proportion of appropriate screening among the three groups (Χ2= 6.83 p=.03). There was also a significant difference in appropriate screening rates between the new and established patients’ group, controlling for group (p<.0001). The use of the interventional algorithm is recommended to improve adherence to evidence-based practice guideline related to cervical screening as it decreases harm(s) to the patient by reduction of fear, cost to the patient, and overtreatment of benign regressive lesions.

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7

English, Thomas MacAndrew. "Impact of an electronic medical record on adherence to current diabetes guidelines in a family medical center." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2008p/english.pdf.

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8

Marshall, Ashley M. "Development of a Practice Guideline for DNP Prepared Nurse Practitoners Working in Long-Term Care Facilities." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2093.

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Clinical evidence-based practice guidelines providing recommendations for health care decision making have become vital components of long-term health care practice in the United States. Frequently changing guidelines have complicated nurse practitioners' (NPs) efforts to implement evidence-based practice into the daily care that they provide to patients. The purpose of this project was to develop an evidence-based practice guideline for doctoral-prepared NPs working in long-term care facilities. This project is important because practitioners use practice guidelines to provide patients with the most appropriate, evidence-based care. Kolcaba's comfort theory was used to guide this project. Kolcaba's theory holds that comfort exists in 3 forms: relief, ease, and transcendence. Comfort theory, with its emphasis on physical, psychospiritual, sociocultural, and environmental aspects of comfort, will lead to a proactive, diverse, and multifaceted approach to providing patient care. A complete practice guideline was developed for doctoral-prepared NPs. For the review of the scholarly evidence, an electronic search that yielded 34 articles was completed. Twenty-six of these articles were excluded because the articles were more than 20 years old and/or focused on a specialty. Findings from the 8 articles were used to develop the practice guideline, which was reviewed by an advisory committee of 7 experts. The AGREE tool was used by the advisory committee to provide feedback on the quality of the practice guideline. Implementation of the practice guideline will take place in a facility in Indiana that currently uses 3 NPs. A doctoral-prepared NP will evaluate the practice guideline annually for patient trends including hospital readmission and infection rates.

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9

Fhärm, Eva. "Treatment of cardiovascular risk factors in type 2 diabetes time trends and clinical practice /." Umeå : Department of Public Health and Clinical Medicine, Umeå university, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-30686.

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10

Shultz, A. K., and Jodi Polaha. "Examining Current Practices in Relation to Recommended ADHD Guidelines." Digital Commons @ East Tennessee State University, 2009. https://dc.etsu.edu/etsu-works/6643.

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11

Humbert, Xavier. "Détection et pronostic de l'effet blouse blanche en médecine générale Office white-coat effect tail and long-term cardiovascular risks in the Gubbio residential cohort study Impact of Sex on Office White Coat Effect Tail: Investigating Two Italian Residential Cohorts Office white-coat effect tail: a useful tool in family practice? White-coat hypertension: management and adherence to guidelines by European and Canadian GPs : a cross-sectional clinical vignette study." Thesis, Normandie, 2020. http://www.theses.fr/2020NORMC403.

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L’effet blouse blanche (EBB) est un phénomène connu depuis de nombreuses années. Son diagnostic est rendu difficile par les mesures multiples de pression artérielle à réaliser (en consultation et en ambulatoire). De plus, son influence cardio-vasculaire est mal connue. Dans ce contexte, nous avons développé un concept d’effet blouse blanche résiduel (EBBR), permettant de diminuer le nombre de mesures de pression artérielle à réaliser (en consultation seulement). Il est bien corrélé à l’EBB et moins à l’hypertension blouse blanche. Son impact cardio-vasculaire est important notamment chez la femme, faisant de l’EBBR, un facteur de risque cardio-vasculaire à part entière. Les recommandations doivent mieux appréhender l’EBB afin d’améliorer sa prise en charge en soins courants
The white coat effect (WCE) has been known for many years. Its diagnosis is made difficult by the multiple blood pressure measurements to be carried out (in clinic and outpatient). In addition, its cardiovascular influence is poorly understood. In this context, we have developed a concept of office white coat effect tail (OWCET), making it possible to reduce the number of blood pressure measurements to be carried out (in clinic only). It is well correlated with the WCE and less with white coat hypertension. Its cardiovascular impact is significant, especially in women, making EBBR a full-blown cardiovascular risk factor. The recommendations should better understand the WCE to improve its management in clinical practice

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Agbeli, Martha Ofeibea. "Reducing Antipsychotic Medication Use in Long-Term Care Settings." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7454.

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The prescription rate of antipsychotics in patients with dementia varies between 20% and 50% for the common and troubling neuropsychiatric symptoms experienced by patients with dementia. The use of these antipsychotic medications has been linked with increased risk of morbidity and mortality due to associated Parkinsonism, over sedation, gait disturbances, cognitive decline, and cardiovascular adverse events. The purpose of this project was to assess whether development of an evidence-based clinical practice guideline (CPG) for a long-term care facility would increase awareness about issues that govern the safe use of antipsychotic medications. The conceptual framework for the project was Watson's model of caring. The Fineout-Overholt tool was used to rank and score information retrieved following an extensive literature review. An expert panel made up of 2 medical doctors and 4 nurse practitioners had 100% agreement that objectives were clear; content was relevant and easy to understand; the CPG was well-organized and easy to follow; and knowledge learned would be used in practice. From 66.6% to 83.3% agreed that the CGP led to an improved understanding of dementia, neuropsychiatric symptoms, medication adverse events, and nonpharmacologic interventions. The expert panel agreed to launch the CPG upon implementation of an educational program for frontline nursing staff and a behavioral log to track occurrence and frequency of behaviors and the use of nonpharmacologic interventions and their effectiveness in managing behaviors. Safe implementation of this CPG might be adapted to other long-term facilities to optimize dementia care, which would bring about a positive social change.

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13

Weijden, Trudy van der. "Evaluation of cholesterol guidelines in general practice." [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Maastricht University [Host], 1997. http://arno.unimaas.nl/show.cgi?fid=5829.

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14

Remenyi, D. "Strategic information systems : current practice and guidelines." Thesis, Henley Business School, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.280667.

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15

Hendricks, Estelle. "Good practice guidelines for improving educator morale." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/1247.

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The morale of educators in certain schools is very low. From the literature review I concluded that not all schools experience low morale in the same way. There are different factors impacting on the morale of educators at different schools. In this study, the causes of low educator morale, indicators of low morale, the importance of high morale and how low morale can be dealt with were addressed in order to provide guidelines to improve low morale. An empirical study was conducted and 2 schools in the Northern Areas of Port Elizabeth were used in this case study to establish to what measure the educators are exposed to the abovementioned variables. The data was analysed qualitatively and quantitatively. South Africa is divided into different demographic areas. The majority of people living in the communities where these schools are located are poor, unskilled, unemployed and the crime levels are very high. The socio-economic context within which these schools are located also has an impact on the morale of the educators at these schools and it affects their working lives. Educators, SMTs and principals took part in the empirical study so that their views can be compared and to facilitate the researcher to make recommendations on improving low educator morale. The research outcomes were analysed and deductions, recommendations and a need for further research were given. The empirical and literature study emphasised that the morale of educators is low in the schools and this morale status impacts on learners’ achievements, the health of the educators and the health of the institution. The educators in this study ranked their own morale status as low and some of the causes of the low morale according to the empirical study are lack of resources, ill-disciplined learners, uninvolved parents and an ineffective management style of the principal.

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16

Blackwelder, Reid B. "Alternative Medicine Family Practice." Digital Commons @ East Tennessee State University, 2002. https://dc.etsu.edu/etsu-works/6997.

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17

Bayard, Max, Cathy Peoples, Jim Holt, and David Daniel. "An Interactive Approach to Teaching Practice Management to Family Practice Residents." Digital Commons @ East Tennessee State University, 2003. https://dc.etsu.edu/etsu-works/6492.

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Three years ago, our residency program began a new approach to teaching practice management to our second- and third-year residents. The underlying principles for the new curriculum involved a realization that our residents lacked basic business understanding and that they would likely learn more effectively through a hands-on approach.The newcurriculum, which we describe in this article, is in large part built around the establishment of a mockpractice during thesecond year ofresidency. Although the curriculum is still evolving, initial response and evaluation have been encouraging.

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18

Goliath, Veonna. "Practice guidelines for culturally sensitive drug prevention interventions." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/d1017193.

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South Africa has experienced a notable increase in adolescent drug use during the country’s transition from apartheid to democracy (Central Drug Authority [CDA], 2006). These findings are verified by epidemiological studies and two national youth risk behaviour surveys, highlighting the need for effective drug prevention interventions. Whilst drug use spans across age, gender and social strata, the rapid increase in both legal and illicit drug use among adolescents in the Northern Areas communities of Port Elizabeth has been particularly pronounced. The South African Community Epidemiology Network on Drug Use (SACENDU) statistics, which reflects on racial demographics in accordance with the Population Registration Act of 1950 (South Africa, 1950), reports that, in the year 2011, the ‘Coloured’ population constituted 62 percent of those individuals seeking treatment for drug abuse, compared to 15 percent ‘African’ treatment seekers in Port Elizabeth (Dada, Plüddemann, Parry, Bhana, Vawda & Fourie, 2012:44). Furthermore, methamphetamine use by persons under the age of 20 years in Port Elizabeth increased fivefold in a three-year period, i.e. from 7 percent in 2008 to 39 percent in 2011 (Dada et al., 2012), with the ‘Coloured’ population group accounting for the majority of methamphetamine users. These statistics reinforce a long-standing racial stereotype that associates ‘Coloured’ racial identity with an enhanced susceptibility to drug use. The National Drug Master Plan (South Africa, 2012a), and the Prevention of and Treatment for Substance Abuse Act (Act no 70 of 2008) propose that drug prevention programmes should address the values, perceptions, expectations and beliefs that the community associates with drug abuse (South Africa, 2008b). This view emphasises the importance of drug preventions interventions that are culturally sensitive and contextually relevant. The current study was guided by two conceptual frameworks, i.e. the Social Constructionist Framework and the Ecological Risk/Protective Resilience Framework, and focused on the Northern Areas of Port Elizabeth, a historically marginalised community inhabited by a predominantly ‘Coloured’ indigenous/ethnic group. The goal of the study was to enhance understanding of the socio-cultural meaning attributed to cultural identity, drug use, non-use and drug prevention in the Northern Areas of Port Elizabeth, with the view to developing guidelines for drug prevention interventions that are culturally sensitive and contextually relevant. The following objectives were formulated in order to achieve the goal of the study: • To explore adolescent narratives regarding the constructs ‘Coloured’, drug use, non-use and drug prevention programmes of three distinct groups of adolescents (drug users, non-users, and TADA peer mentors) from the Northern Areas. • To explore and describe the social service practitioners’ (social workers and social auxiliary workers’) constructions of drug use, non-use and drug abuse prevention in relation to adolescents from the Northern Areas, and how such constructions inform the drug prevention services rendered to adolescents from these communities. • To review the data collected from the adolescent narratives and the social service practitioners’ reflections on their drug prevention programmes against existing theory and models for drug prevention. • To synthesise the above information with a view to developing guidelines for culturally sensitive drug prevention programmes relevant and responsive to the specific social constructions of adolescents from the Northern Areas. A qualitative research approach, located in a narrative tradition of inquiry research design, was employed to achieve the goal of the study (Riessman, 2008). The study was conducted in two phases. The first phase involved an empirical study with the four sample groups (i.e. adolescent drug users, adolescent non-drug users, Teenagers against Drug Abuse [TADA] peer mentors and social service professionals (i.e. social workers and social auxiliary workers)). Phase two involved the co-construction of the practice guidelines for culturally sensitive and contextually relevant drug prevention interventions. Phase one started with the informal exploration of community stakeholders’ views on the identified research problem and the process of gaining access to the research population. Several gatekeepers (i.e. teachers, social workers, the Families Against Drugs [FAD] Support Group representatives, a minister of religion and a community stakeholder) were engaged to assist in recruiting participants from the four sample groups. A non-probability purposive sampling method was employed to purposively recruit 29 adolescent non-drug users and ten adolescent peer mentors (via the TADA Programme at one school). The same sampling method, followed by a snowball sampling technique, was employed to recruit the two remaining sample groups of ten adolescent drug users (in the recovery process) and nine social workers and social auxiliary workers respectively. The sample sizes were determined by the principle of data saturation.The data generation method used in respect of the non-users took the form of semi-structured written narratives, administered in a group context during school time, followed by a second round of data generation. The life-grid (Wilson, Cunningham-Burley, Bancroft, Backett-Milburn & Masters, 2007:144), a qualitative visual tool for mapping important life events, was employed to guide the co-construction of the biographical narratives generated during the individual semi-structured interviews with the sample of adolescent drug users. Focus group interviews were used to enhance an understanding of the peer mentors and social service practitioners’ views on the construct ‘Coloured’ and their existing drug prevention programmes. Each of the individual and focus group interviews was audio-recorded, transcribed and complemented by the field notes. Informal data gathering occurred through participant observation of two drug prevention programmes, attendance of a FAD Support Group meeting, and interviews with community volunteers and the South African Police Services (SAPS) Youth Development Forum. Both the content and the context of the narratives were analysed to arrive at the research themes, sub-themes and categories. The content of the narratives was analysed by employing categorical content analysis, whilst the form of the narratives (i.e. how the stories were told) was analysed by using the socio-cultural approach to narrative analysis (Grbich, 2007:130). The journey metaphor emerged from the adolescent drug users’ narratives, depicting a prototypical storyline of a drug use journey, starting with experimentation and culminating in abuse and dependence for some and an early exit from the journey for others. The conclusions that can be drawn from these findings illuminate key protective factors and processes at a multisystemic level that can be strengthened to enhance the adolescents’ resistance to drug use and/or delay the onset of use. Embedded in the participants’ narration of the drug use journey were nuances relating to internalised stereotypes of ‘White’ supremacy and ‘Coloured’ inferiority as an explanatory framework for venturing onto and prolonging the journey.The two themes that emerged during the process of content and narrative analysis of the qualitative data (from both adolescent drug users and non-users) were as follows: Constructing drug use as a ‘Coloured’ phenomenon and reconstructing ‘Coloured’ identity; Risk and protective factors located at individual, family, peer, school, community and societal domains. The four themes that emerged during the data analysis of the peer mentors and social service practitioners’ narratives were as follows: Construction of ‘Coloured’ identity; socio-cultural meaning construction about the reasons for drug use amongst adolescents from the Northern Areas; description of drug prevention services rendered in the Northern Areas; and reflection on barriers to rendering drug prevention interventions.

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19

Taylor, Michael Dennis. "Prostate cancer clinical practice guidelines clinical and economic outcomes /." [Gainesville, Fla.] : University of Florida, 2005. http://purl.fcla.edu/fcla/etd/UFE0010098.

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Thesis (Ph.D.)--University of Florida, 2005.
Typescript. Title from title page of source document. Document formatted into pages; contains 99 pages. Includes Vita. Includes bibliographical references.

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20

Christie, Petter Tobias Grindstad. "Best practice for Games Design : Guidelines for ensuring quality." Thesis, Norwegian University of Science and Technology, Department of Electronics and Telecommunications, 2009. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-9036.

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The gaming industry is getting bigger for each year and new games hit the market almost every week. But what makes a game a success or a flop? In the end it is the users, gamers, that have decide if they think a game is good or not. But what do a gamer want form a game? This thesis looks mainly into what the game players like when it comes to communication in multiplayer games. It also looks at players preferences for using the graphic settings to control the flow in the game (the frames per second), and preferences when it comes to music and sound in the game. A questionnaire was used to collect the quantitative data, while user testing was used to get qualitative data on the effect of using voice over IP (VoIP) when playing a multiplayer game. The game used for testing is Age of Conan from Funcom. The data collected are analyzed to get results. These results are used to make guidelines that can be used by game producers and developers when making new games. These guidelines are what are deemed best practices based on the data collected. The research concludes that VoIP has an important role in multiplayer games and that game producers should be conscious on the use of VoIP when making multiplayer games. For the use of graphic settings to control the flow the conclusion is that this is common to do and important for the game experience. Lastly it concludes that music is very important for the mood of the game.

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21

Aboiralor, Ruth Airiohuomo. "Developing Staff Education Regarding Colorectal Cancer Screening Practice Guidelines." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7578.

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Colorectal rectal cancer (CRC) is the 3rd most common cancer in men, the 2nd most common cancer in women, and the 4th leading cause of cancer death. Lack of screening or delayed screening for CRC is the major cause of undiagnosed cancers that become malignant and eventually become fatal. Nurses at the project site are not in compliance with CRC screening guidelines due to inadequate knowledge of the screening guidelines recommended by the American Cancer Society, which creates a gap in practice. The purpose of this project was to develop staff education on CRC screening guidelines. The practice focused question addressed if evidence-based education regarding CRC screening could be an effective means for nurse education, according to a panel of local experts. A pre-test evaluation of knowledge regarding CRC screening was administered to nursing staff from the site. The John Hopkins evidence-based practice model guided the development of the staff education program, using the results of the pre-test, evidence-based practice literature and guidelines. The project team, consisting of a physician and medical support staff, evaluated the education program, plan for delivery, and plan for evaluation of learning through an anonymous Likert-style evaluation survey. The 3 team members also completed program evaluation surveys, and 100% agreed or strongly agreed that the program objectives were met. The project was limited to planning only and the education program materials, along with plans for later implementation and evaluation of learning through pre- and post-tests, were handed over to the project site for delivery at a later date. The CRC screening education will become part of the yearly staff competencies, leading to appropriate screening of the site’s patient population. This education project has the potential to promote positive social change by saving lives and improving the quality of those lives.

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22

Msosa, Yamiko Joseph. "Modelling evolving clinical practice guidelines: a case of Malawi." Thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/28388.

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Electronic medical record (EMR) systems are increasingly being adopted in low- and middle-income countries. This provides an opportunity to support task-shifted health workers with guideline-based clinical decision support to improve the quality of healthcare delivery. However, the formalization of clinical practice guidelines (CPGs) into computer-interpretable guidelines (CIGs) for clinical decision support in such a setting is a very challenging task due to the evolving nature of CPGs and limited healthcare budgets. This study proposed that a CIG modelling language that considers CPG change requirements in their representation models could enable semi-automated support of CPG change operations thereby reducing the burden of maintaining CIGs. Characteristics of CPG changes were investigated to elucidate CPG change requirements using CPG documents from Malawi where EMR systems are routinely used. Thereafter, a model-driven engineering approach was taken to design a CIG modelling framework that has a novel domain-speciﬁc modelling language called FCIG for the modelling of evolving CIGs. The CIG modelling framework was implemented using the Xtext framework. The national antiretroviral therapy EMR system for Malawi was extended into a prototype with FCIG support for experimentation. Further studies were conducted with CIG modellers. The evaluations were conducted to answer the following research questions: i) What are the CPG change requirements for modelling an evolving CIG? ii) Can a model-driven engineering approach adequately support the modelling of an evolving CIG? iii) What is the eﬀect of modelling an evolving CIG using FCIG in comparison with the Health Level Seven (HL7) standard for modelling CIGs? Data was collected using questionnaires, logs and observations. The results indicated that ﬁnegrained components of a CPG are aﬀected by CPG changes and that those components are not included explicitly in current executable CIG language models. The results also showed that by including explicit semantics for elements that are aﬀected by CPG changes in a language model, smart-editing features for supporting CPG change operations can be enabled in a language-aware code editor. The results further showed that both experienced and CIG modellers perceived FCIG as highly usable. Furthermore, the results suggested that FCIG performs signiﬁcantly better at CIG modelling tasks as compared to the HL7 standard, Arden Syntax. This study provides empirical evidence that a model-driven engineering approach to clinical guideline formalization supports the authoring and maintenance of evolving CIGs to provide up-to-date clinical decision support in low- and middle-income countries.

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Bayard, Max, Jim Holt, Cathy Peoples, and Bendik Clark. "An Innovative Practice Management Curriculum." Digital Commons @ East Tennessee State University, 2002. https://dc.etsu.edu/etsu-works/6504.

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24

McKechnie, Joanne. "Physician characteristics and compliance with thyroid function testing practice guidelines." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68219.

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This study uses daims data from a provincial health care insurance plan to examine the ability of certain physician and practice characteristics to predict compliance with thyroid function testing (TFT) guidelines. The characteristics examined are the practitioner's gender, year of birth, university or country of graduation, type of practlce (solo or clinic), location of practice (metropolitan, urban, or rural), geographical area of practice (census division). CCFP certification, patient caseload, and proportion of patient caseload tested for thydroi functioning. This study found significant variation in the degree of compliance wlth TFT guidelines. On average, physician-ordered thyroid function tests complied wlth guidelines only 37% of the time. Very little of the variation (approximately 7%) was explained by the characteristics examined. Although the explanatory power of this model was low, oertain characteristics appear to contribute to better compliance. They are: being male, practicing in the southern third of the province, practicing in an urban location, having CCFP certification, and testing proportionately more of one's patient caseload for thyroid functioning. The results of this study suggest that physicians require better training regarding TFT and that further research should be done to understand the marked differences in compliance by gender and geographic location.

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Chan, 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.

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26

Taylor, Rosemary. "Clinical Practice Guidelines for Home Management of Intravenous Immunoglobulin Therapy." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7342.

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The infusion of intravenous immunoglobulin therapy in the home setting requires a critical nursing assessment and interventions aimed at managing and preventing the escalation of adverse events. Some patients experience side effects that necessitate a rapid response by field nurses, requiring standing orders for nursing administration and the availability of essential medications to alleviate symptoms in the patient's home. The clinical practice issue was that the home health agency did not have a uniform clinical practice nursing guideline to assist field nurses in providing rapid responses for managing infusion-related reactions. The purpose of this project was to develop an evidence-based clinical practice guideline using standing orders for the comprehensive management of immunoglobulin side effects in the patient's home. The practice-focused question centered on whether the use of a nursing practice guideline based on interprofessional collaboration could manage the side effects of patients in the home by decreasing the use of emergent care and improved quality of care for those patients susceptible to significant side effects. An interdisciplinary expert panel experience in IVIG l used Newman's system theory and the reach, effectiveness, adoption, implementation, maintenance framework for interprofessional collaboration in developing a clinical nursing guideline with a standing order for rating side effects. Panelists used the appraisal of guidelines, research, and evaluation II tool to appraise the evidence for the guideline. The use of clinical guideline with standing orders to address the needs of patients in the home setting may lead to positive social change by enabling more rapid management of symptoms, more effective care in the home, and improved patient outcomes

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Hays, Katherine. "Advanced Practice Nurses Knowledge and Use of Fall Prevention Guidelines." Otterbein University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1428416895.

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Miller, Melina Rose, and Melina Rose Miller. "Best practice guidelines for skin-to-skin contact following birth." Thesis, The University of Arizona, 2017. http://hdl.handle.net/10150/626827.

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The purpose of this thesis was to develop an educational pamphlet with best practice guidelines for expectant parents and nurses about skin-to-skin contact. The research conducted for this thesis focused on the benefits of skin-to-skin contact for mothers, pre-term infants, and term infants following both vaginal and cesarean deliveries. Skin-to-skin contact has been referred to as the optimal form of care for a newborn (Erlandsson, Dsilna, Fagerberg, & Christensson, 2007). When skin-to-skin contact does not occur following birth, the most common reasons are lack of education among parents and lack of collaboration of the healthcare team (Zwedberg, Blomquist, & Sigestad, 2013). Some of the benefits skin-to-skin contact has to offer for mothers is as a reduction in anxiety, depression, and postpartum hemorrhage (Moore, Anderson, & Bergmen, 2009). Some of the benefits of skin-to-skin contact for infants is a reduction in sepsis, infection, and hypothermia. Pre-term infants are also more likely to breastfeed and gain more weight daily if they engage in skin-to-skin contact (Conde-Agudelo & Díaz-Rossello, 2016). Implementing an educational pamphlet within the setting of a childbirth class would provide expecting parents with evidence-based information on the benefits and feasibility of skin-to-skin contact.

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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.

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This was the first study undertaken in the United Arab Emirates, to investigate clinical practice guidelines. There were three parts to the investigation, 1. A survey of the knowledge, attitude and beliefs about clinical practice guidelines among General Practitioners; 2. A research enquiry into the effects of the guidelines of the Royal College of Radiologists' of the United Kingdom, on the request behaviour of General Practitioners; 3. A further enquiry into the effect of introducing information regarding the cost of radiograph ordered, on the 'request' behaviour of General Practitioners. The study took place among General Practitioners employed within the Al-Ain Medical District, in the United Arab Emirates. Important recommendations derived from this research were - The high percentage of inappropriate radiological referrals in the Practices studied is an alarming indication of substandard care provision, to counteract which, clinical practice guidelines are still highly recommended; Educational programmes are required which should be directed towards improving the knowledge of General Practitioners of the concept of clinical practice guidelines; Implementation of clinical practice guidelines requires an inclusive approach in planning. The strategy should be directed towards doctors, patients, the setting, administration and appropriate guidelines; how they are developed, evaluated and presented. The planning should ensure continuous reinforcement of the guidelines and appropriate marketing and public persuasion. In addition, a continuous evaluation system is essential to assess performance which could then be improved; Strategies which are more likely to be effective are those which involve the end user; in this case, the General Practitioner and those operating directly upon the consultation between the doctor and the patient. Examples of such strategies include, feedback on practice, opinion leaders, patient specific reminders and educational outreach visits; the guidelines adopted by a respected 'organisation' ensure a greater acceptance.

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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.

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Using evidence-based practice (EBP) to deliver patient care in a hospital setting improves patients' care and their outcomes. The use of clinical practice guidelines (CPG) enables nurses and other healthcare professionals to translate current evidence into bedside care. However, there continue to be barriers for hospitals in adopting and implementing evidence-based care using CPGs, including a lack of understanding about EBP by nursing staff. The purpose of this project was to explore readiness of registered nurses in a tertiary hospital to use EBP and provide recommendations for a plan to implement CPGs successfully. Melnyk's research identified EBP as an approach to care, and the concept of using CPGs to shape patient care served as a foundation for the project. In addition, Kotter's theory of change was used to guide the recommendations to promote implementation. The Academic Center for Evidence-Based Practice-Readiness Inventory (ACE-ERI) created by Stevens was used to survey nurses' EBP readiness and knowledge at one Florida tertiary hospital. Data were analyzed using descriptive and inferential statistics. Survey results revealed the nurses' overall moderate level of confidence in using EBP, but limited EBP knowledge. Therefore, recommendations to develop education programs for EBP as well as guidance on follow-up assessments were proposed to nursing leadership. Educating the nurses will increase the likelihood of adoption of the CPGs, which will promote positive social change by improving the bedside care delivered by hospital nurses, which will result in better patient outcomes.

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Rew, Meera. "Family centred social work practice with stepfamilies." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ62833.pdf.

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Wilson, Barbara Dian. "'Careful disorderliness' : writing about family mediation practice." Thesis, University of Portsmouth, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.500347.

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This thesis comprises fifteen papers and a commentary on their contribution to the field of academic and practitioner knowledge about family mediation, reflecting the author's interest in the theoretical frameworks surrounding this subject. Written over a seven-year period (2000-2007), they reflect the author's evolution as a family mediator and Professional Practice Consultant, and were published against a turbulent background of ongoing political and practice discourses.

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Kohler, Levi R. "Vaccination Policies of Utah Family Practice Clinics." BYU ScholarsArchive, 2015. https://scholarsarchive.byu.edu/etd/5980.

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The purpose of this study was to collect information regarding healthcare worker (HCW) vaccination policies in Utah family practice clinics. Data sources: The study was conducted in Utah family practice clinics in the most densely populated counties in the state and was a cross-sectional descriptive design. Data were collected from 155 family practice clinic managers. Analyses included frequencies and percentages for quantitative items and a content analysis for open-ended items. Conclusions: HCWs are employed in environments where infectious diseases can be easily spread from person to person, thus, vaccinations can be instrumental in protecting the health of HCWs and patients alike. In Utah, 56.8% of family practice clinics had either no vaccination policy for HCWs or had a policy with no consequences for noncompliance. Utah family practice clinics need to implement changes to create and maintain HCW vaccination policies. Implications for practice: Nurse practitioners can be leaders and change agents by working with their county and state health departments to create state-wide policies that mirror the position statements from the American Nurses Association and the American Association of Nurse Practitioners.

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Polaha, Jodi. "Practice Transformation in Pediatric Primary Care." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/6665.

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This session will describe the evolution of the Pediatric Primary Behavioral Health Model in one clinic including the integration of behavioral health and social services into a residency training clinic. The implementation strategy used to develop this model will be described.

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Holt, Jim. "Addressing Childhood Obesity in Primary Care Practice." Digital Commons @ East Tennessee State University, 2002. https://dc.etsu.edu/etsu-works/6508.

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Gaines, 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.

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The spectrum of acute pancreatitis (AP) affects between 4.9 and 73.4 patients out of 100,000 worldwide annually (Tenner, Baillie, DeWitt, & Vege, 2013). AP uses the Atlanta classification system to establish a diagnosis of mild, moderate, or severe. The American College of Gastroenterology (ACG) has established comprehensive clinical practice guidelines (CPG) for the management of AP, the most recent version published in 2013 (Tenner et al., 2013). There have been similar CPGs published internationally that integrate current evidence-based research into recommendations for practice. These guidelines along with the ACG's guidelines recommend initiating a diet for mild acute pancreatitis patients due to research findings of improved patient outcomes (i.e. reduced length of hospital stay, decreased rate of infections, and reduced mortality) (Horibe et al., 2015; Lariño-Noia et al., 2014). There is an international awareness of the need for increased CPG nutrition recommendation compliance in the practice setting as many studies have found providers prefer to keep patients nil per os (NPO) and do not adhere to CPGs (Andersson, Andrén-Sandberg, Nilsson, & Andersson, 2012; Greenberg et al., 2016; Sun et al., 2013). The purpose of this doctor of nursing practice (DNP) project is to assess providers' current nutrition therapy practice and knowledge of the ACG’s CPG nutrition recommendations for mild AP patients. The researcher conducted the assessment with a hospitalist practice at Banner University Medical Center in Phoenix, Arizona. The results of the project contribute to the current body of research on national adherence to CPGs for AP and act as a needs assessment for future projects where a nutrition protocol order set may be established. The investigation of nutrition therapy for AP patients seeks to improve and standardize the care this patient population receives while in the acute care setting.

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Calhoun, McKenzie L. "Advancing Pharmacy Practice Expert Panel." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/6883.

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Polaha, Jodi. "Gun Violence Prevention in Pediatric Practice." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/6658.

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Polaha, Jodi. "Gun Violence Prevention in Pediatric Practice." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6662.

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Calhoun, McKenzie L. "Discussion on Interprofessional Education and Practice." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6886.

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Elinson, Lynn. "Implementation of practice guidelines, a case study of hormone replacement therapy." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ27640.pdf.

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Gravas, 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.

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Dawtrey, Chantal. "Coaching supervision in South Africa : comparing current practice against COMENSA guidelines." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97420.

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Thesis (MPhil)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: The Coach and Mentors of South Africa (COMENSA) coach/mentor supervision policy of 2010, which was updated in 2013, aims to convey COMENSA’s official position on coaching supervision as well as inform members about this practice. The policy offers a framework for best practice for coaching supervision and serves as a benchmark against which to compare the goals and competencies of coach supervisors in South Africa. COMENSA’s policy on supervision includes a list of seven goals. The policy further recommends that, throughout the supervisory relationship, the supervisor must be able to demonstrate a range of behaviours and competencies, as well as be able “to pay attention to, work with and balance” the three functions of supervision, namely: developmental, resourcing, and qualitative. Currently it is unknown whether the coach supervisors offering supervision in South Africa actually meet these behaviours, competencies and goals. In addition, it is unknown what qualifications and experience the coach supervisors have and whether their supervision meets the supervisees’ expectations. This study assessed whether coach supervisors in South Africa actually meet the COMENSA supervision policies’ competency requirements and supervision goals and whether these goals and requirements are necessary and sufficient for quality coaching supervision sessions. The study also explored whether coaching supervision met the supervisees’ expectations. The research design was an empirical qualitative study using a multi-method approach involving interviews and documents. The study was interpretive and exploratory in nature. Primary data was sourced through semi-structured interviews with 23 participants comprising five supervisors and 18 supervisees from three regions in South Africa. Secondary data came from the two COMENSA coach/mentor supervision policies (2010 and 2013). The data was analysed using ATLAS.ti. It was found that supervisors focused their goals on learning and support first, then relational dynamics and professional practice issues. In the COMENSA coach/mentor supervision policy the emphasis differs. The policy focuses predominantly on relational dynamics, then learning and professional practice. Supervision as support was mentioned only briefly in two goals. According to the perspective of their supervisees, supervisors were competent in terms of the requirements set out in the COMENSA coach/mentor policies (2010 and 2013) and supervision largely met their expectations. Supervisees identified areas for improvement in supervisor facilitation skills, providing a safe space and stronger contracting. A surprising result emerged with 11 of the 18 supervisees either already using supervision to discuss the business of coaching or wanting this to be an added element of the process. The business of coaching covers topics such as marketing and how to run a practice and is not typically included in coaching supervision. The competency of raising cultural awareness and respecting diversity and difference was not mentioned by any of the participants, a surprising omission given the diverse socio-political environment of South Africa.

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Watson, Margaret C. "The development, implementation and evaluation of prescribing guidelines in general practice." Thesis, University of Bristol, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265364.

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Soji, Zoleka. "Practice guidelines for supporting youth-headed families to enhance their resilience." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1016381.

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The topic of the research is derived from the researcher‟s own interest as a social worker and observations of reality within youth-headed families. Over the past few years the number of published studies on child and youth-headed households has grown out of the realisation that this multi-faceted phenomenon is growing in numbers and complexity. Most of these studies and reports concentrate on the issue of scale and the severity of the crisis of child and youth-headed households (UNICEF, 2002; Maqoko & Dryer, 2007 & Kuhanen, Shemeikka, Notkola & Nghixulifwa, 2008). These studies reveal the complex nature of the phenomenon of child and youth-headed families and the challenges that face young people within these families which impact on their growth and development. In most of the studies, the phenomenon of child and youth-headed households has been reported to have an impact on societal framework as a result of its complexity (UNICEF, 2002, 2008; van Dijk, 2008; Kuhanen et al., 2008; Evans, 2010). Over the past years there has been a steady increase in studies that has focussed on coping and resilience of children and young people. Many of these studies have identified resilience-related factors through quantitative ecological approaches to research. To date, there seems to be very few qualitative studies that have been undertaken to delineate the construct of resilience in child and youth-headed families within the South African context from the perspectives of children and young people growing up in these families (Beeka, 2008; Nkomo, 2008; Leatham, 2005). McCubbin (1999, in Smith 2006:48) argues that qualitative research is well suited to understanding processes and strategies in the study of resilience. This study therefore corresponds to McCubbin‟ calling by employing a qualitative research to the study of resilience in youth-headed families. The first goal of this study was to gain a deeper understanding of the experiences and needs of youth-headed families in Port Elizabeth, South Africa, as well as to enhance understanding of the protective factors and processes within youth-headed families and their environment that enable them to cope with their circumstances. The secondary goal of this study was to formulate practice guidelines for supporting members of youth-headed families that could be used by social workers and other service providers rendering services to these families in order to enhance their coping and resilience. The following objectives were formulated to guide the research process: - To explore and describe the experiences and needs of youth-headed families; - To explore the perceptions of community members regarding the needs of youth-headed families, as well as their perceptions regarding how these needs are addressed at community level; - To identify and describe the protective factors and/or processes within individual members of youth-headed families, their families and community context that promote the coping and resilience of youth-headed families; - To explore the views of service providers rendering services to youth-headed families regarding the nature of interventions and programmes rendered to these families; - To review the literature on existing family support programmes in order to identify good practice examples to inform the formulation of practice guidelines for supporting members of youth-headed families.

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Holt, Jim. "New Payment Models Within a Virtual Practice." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6452.

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Blackwelder, Reid B. "Review of Complementary Medicine and Clinical Practice." Digital Commons @ East Tennessee State University, 2007. https://dc.etsu.edu/etsu-works/6912.

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Reviews the book, Complementary medicine and clinical practice edited by David P. Rakel and Nancy Faass (2006). Complementary and alternative medicine, or CAM, as it is known, has been an important and controversial topic for allopathic medicine. Although the majority of the patients in this country will use one or more forms of complementary medicine, and spend more out-of-pocket money on CAM techniques and practitioners than on allopathic ones, there is still a great deal of uncertainty among practicing physicians about what exactly CAM consists of. This book goes a long way toward helping to clarify this diverse and changing topic. Overall, each of the topics in the book emphasizes a refreshing focus on health compared with the antidisease focus of many more traditional medical articles and books. Each of the chapters integrates the technique and philosophy of the topic explored into an overall health-oriented approach to patient care. Rakel and Faass's book creates a template for a new model of medicine. Given its broad scope, it is ideal for family physicians to consider as we envision the evolution of our practices.

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Toms, Gill. "Applications of family-centred care in clinical practice." Thesis, Bangor University, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540738.

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Tse, Chow Sau-wan Wendy, and 周秀雲. "Towards a practice model of family life education." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1986. http://hub.hku.hk/bib/B31247714.

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Tse, Chow Sau-wan Wendy. "Towards a practice model of family life education /." [Hong Kong : University of Hong Kong], 1986. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12325934.

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