何謂臨床服務指引?
What is Clinical Practice Guideline?
如何建立臨床服務指引?
How to develop
CPG?
何謂臨床服務指引?
臨床服務指引是由專業人士根據理論及實踐經驗有系統地制定的指引，指引目的是協助員工就長者的個別情況(如老人痴呆症及抑鬱症)而選擇適當的介入手法。指引內容一般包括服務評估、介入手法的原則，步驟及服務成効評估。
我們可將臨床服務指引與現時的運作比較，以了解我們應如何進行最有效的臨床服務，以達到改善服務成效(如臨床服務表現，服務使用者滿足感等)。
What
is Clinical Practice Guideline?
Clinical Practice Guidelines
(CPGs) are systematically developed statements to provide guidance
in decision making for appropriate health and disability care for
specific circumstance. It is a tools to close the gap between how we
existing practice and how we might optimally practice which resulted
in the improvement in healthcare outcomes - clinical outcomes/health
status, client satisfaction, level of support and utilization.
CPGs describe the boundaries of practice or general
practice direction under usual circumstances, which requires clinical
judgment in their application.
Protocol is the term reserved for the subset
of guidelines at the more rigid end of the spectrum. They are very specific
guidelines which are expected to be followed in detail, with little
scope of variation.
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如何建立臨床服務指引?
以協商方式建立(Consensus Method of Guideline
Development)
專業人士跟據以往的經驗協議大套臨床服的程序指引。
以實證為本建立(Evidence Based Guideline
Development)
有系統地審閱有關的文獻及學術研究，以此方法建立的服指引需有客觀的證據，以證明該護理程序能有較佳的服務成効。
明確的實證為本 (Explicit Evidence Based
Guideline Development)
這與實證為本的臨床服指引的建立方法，但需清楚地指出根據此指引運作所出現的効果 (如獲益之處、成本及售處)。
How to Develop CPG?
Consensus Method of Guideline Development
It is developed by the consensus among a group of experts on the clinical
care of a condition.
Evidence Based Guideline Development
Evidence based methods include a process for systematically obtaining
and critically appraising information from the medical/academic literature.It
is not just saying which option is better but quantifying the absolute
difference in outcome in different practice.
Explicit Evidence Based Guideline Development
This method uses the same evidence based methods to obtain, critically
appraise and synthesize information about the effect of health practices,
but also projects the healthcare outcomes (benefit, harm and cost) of
the change in practice.
Reference: Web site of New Zealand Guidelines Group www.nzgg.org.nz
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