Pediatric Audiology in North America: Current Clinical Practice and How It Relates to the American Academy of Audiology Pediatric Amplification Guideline

2016 ◽  
Vol 27 (03) ◽  
pp. 166-187 ◽  
Author(s):  
Sheila Moodie ◽  
Eileen Rall ◽  
Leisha Eiten ◽  
George Lindley ◽  
Dave Gordey ◽  
...  
Keyword(s):  
Clinical Practice ◽  
North America ◽  
Data Collection ◽  
Practice Guidelines ◽  
Best Practice ◽  
Intervention Program ◽  
Hearing Aid ◽  
Evidence Based ◽  
Pediatric Audiology ◽  
Family Centered

Background: There is broad consensus that screening and diagnosis of permanent hearing loss in children must be embedded within a comprehensive, evidence-based, family-centered intervention program. Clinical practice guidelines (CPGs) for pediatric hearing assessment and hearing aid verification aim to reduce variability in practice and increase the use of effective evidence-based diagnostic and treatment options so that optimal outcomes may be achieved. To be of value, guidelines must be translated and implemented into practice and ongoing monitoring of their use in practice should occur. Purpose: This paper provides the results of two studies that aim to examine current pediatric audiology and amplification practice in North America. Research Design: A concurrent embedded mixed methods design was used. Study Sample: An electronic survey was distributed to North American audiologists who delivered pediatric audiology services with 350 audiologists participating in study 1 and 63 audiologists participating in study 2. Data Collection and Analysis: A quantitative approach was the predominant method of data collection. Respondents were prompted to provide additional qualitative text and detail regarding their quantitative response choice. This qualitative text was used during the analysis phase and combined with quantitative results to assist understanding of respondents’ knowledge, skills, and barriers/facilitators to implement best practice in pediatric amplification. Results: Approximately 70% of audiologists reported using best-practice protocols for pediatric hearing aid fitting. Despite widespread knowledge and increased use of CPGs over the last 18 yrs, results of these studies show that variation in practice patterns continue to exist. Several examples of implementation challenges are discussed with recommendations provided. Conclusions: In order for audiologists working with children who are deaf or hard of hearing and their families to achieve the principles of family-centered early intervention, practice guidelines must continue to be developed, disseminated, and translated as they have a positive impact on the services provided. Researchers and clinical audiologists who deliver services must continue to collaborate to understand the “how” and “why” of implementing guidelines into practice and to identify the barriers/facilitators encountered in trying to do so.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

scholarly journals Ensuring Consistent European-Wide Urological Care by the Use of Evidence-Based Clinical Practice Guidelines: Can We Do Better

2017 ◽  
Vol 2 (Suppl. 1) ◽  
pp. 1-7
Author(s):  
Emma Jane Smith ◽  
Steven MacLennan ◽  
Anders Bjartell ◽  
Alberto Briganti ◽  
Thomas Knoll ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Best Practice ◽  
Scientific Evidence ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Evidence Based ◽  
Robust Methods ◽  
Practice Recommendations

The European Association of Urology (EAU) annually updates 21 clinical practice guidelines in which summaries of the evidence base and best practice recommendations are made. The methodology applied to achieve this and integrate stakeholder opinion is continuously improving. However, there is evidence to suggest wide variation in clinical practice indicating that many patients receive suboptimal and heterogeneous care. Studies from certain countries suggest that 2 out of 5 patients do not receive care according to the current scientific evidence, and in 1 out of 4 cases the care provided is potentially harmful. Clearly, the harmonisation of care in alignment with evidence-based best practice recommendations is something to strive for. Development of robust methods to disseminate and implement guideline recommendations and measure their impact is an objective the EAU is committed to improving. An important strategy for achieving harmonisation in urological care across Europe is to ensure the availability of high-quality clinical practice guidelines and to actively promote their implementation by clinicians and healthcare providers.

scholarly journals International Examination and Synthesis of the Primary and Secondary Surveys in Paramedicine

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Marc A Colbeck ◽  
Sonja Maria ◽  
Georgette Eaton ◽  
Craig B Campbell ◽  
Alan M Batt ◽  
...  
Keyword(s):  
South Africa ◽  
Clinical Practice ◽  
United Arab Emirates ◽  
Practice Guidelines ◽  
Best Practice ◽  
Evidence Based ◽  
Treatment Algorithms ◽  
Practice Recommendations ◽  
Assessment And Treatment ◽  
Secondary Survey

<p class="Pa2"><strong>Background</strong></p><p class="Pa2">To guide their care paramedics routinely rely upon two assessment and treatment algorithms, known as the primary survey and the secondary survey.  No clear consensus of the concepts (assessments and interventions) that are, or should be, included in these algorithms exist internationally. </p><p class="Pa2"><strong>Methods </strong></p><p class="Pa2">This paper evaluated Australasian paramedic clinical practice guidelines (CPGs), as well as six other international paramedic CPGs (USA, Ireland, UK, South Africa, Qatar, and the United Arab Emirates) in order to identify which concepts are currently described in best-practice recommendations for paramedics.  The authors also contributed concepts that they felt were important additions based on their experience as veteran paramedics and paramedic educators.</p><p class="Pa2"><strong>Results </strong></p><p class="Pa2">The resulting amalgamation of concepts identified in each term was then formed into two mnemonics which, together sequentially list approximately 100 specific clinical concepts that paramedics routinely consider in their care of patients. We describe these as the “International Paramedic Primary and Secondary Surveys”.</p><p class="Pa2"><strong>Conclusion </strong></p><p class="Pa2">The primary and secondary surveys presented in this paper represent an evidence-based guide to the best practice in conducting a primary and secondary survey in the paramedic context.  Findings will be of use to paramedics, paramedic students, and other clinicians working in remote or isolated practices.</p>

Evidence-Based Guidelines—An Introduction

Hematology ◽  
2008 ◽  
Vol 2008 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Wendy Lim ◽  
Donald M. Arnold ◽  
Veronika Bachanova ◽  
Richard L. Haspel ◽  
Rachel P. Rosovsky ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
North America ◽  
Practice Guidelines ◽  
Diagnostic Tests ◽  
Medical Literature ◽  
Evidence Based ◽  
Cooperative Groups ◽  
Professional Societies ◽  
Evidence Based Guidelines

Abstract Recommendations in the form of clinical practice guidelines are increasingly common. Clinical guidelines are systematically developed statements designed to help administrators, practitioners and patients make decisions about appropriate health care for specific circumstances. In North America, guidelines developed by professional societies, government panels and cooperative groups are frequently used to measure quality, to allocate resources and to determine how health care dollars are spent. For clinicians, guidelines provide a summary of the relevant medical literature and offer assistance in deciding which diagnostic tests to order, which treatments to use for specific conditions, when to discharge patients from the hospital, and many other aspects of clinical practice.

Clinical practice guidelines for comprehensive patient assessment in emergency care: A quality evaluation study

2021 ◽  
pp. 205715852110069
Author(s):  
Åsa Falchenberg ◽  
Ulf Andersson ◽  
Birgitta Wireklint Sundström ◽  
Anders Bremer ◽  
Henrik Andersson
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Emergency Care ◽  
Quality Evaluation ◽  
Evaluation Study ◽  
Evidence Based ◽  
Patient Assessment ◽  
Care Needs ◽  
Home Based

Emergency care nurses (ECNs) face several challenges when they assess patients with different symptoms, signs, and conditions to determine patients’ care needs. Patients’ care needs do not always originate from physical or biomedical dysfunctions. To provide effective patient-centred care, ECNs must be sensitive to patients’ unique medical, physical, psychological, social, and existential needs. Clinical practice guidelines (CPGs) provide guidance for ECNs in such assessments. The aim of this study was to evaluate the quality of CPGs for comprehensive patient assessments in emergency care. A quality evaluation study was conducted in Sweden in 2017. Managers from 97 organizations (25 emergency medical services and 72 emergency departments) were contacted, covering all 20 Swedish county councils. Fifteen guidelines were appraised using the validated Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. The results revealed that various CPGs are used in emergency care, but none of the CPGs support ECNs in performing a comprehensive patient assessment; rather, the CPGs address parts of the assessment primarily related to biomedical needs. The results also demonstrate that the foundation for evidence-based CPGs is weak and cannot confirm that an ECN has the prerequisites to assess patients and refer them to treatment, such as home-based self-care. This may indicate that Swedish emergency care services utilize non-evidence-based guidelines. This implies that ECN managers and educators should actively seek more effective ways of highlighting and safeguarding patients’ various care needs using more comprehensive guidelines.

scholarly journals Defining key questions for clinical practice guidelines: a novel approach for developing clinically relevant questions

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Samantha Chakraborty ◽  
Bianca Brijnath ◽  
Jacinta Dermentzis ◽  
Danielle Mazza
Keyword(s):  
Qualitative Research ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Best Practice ◽  
International Guideline ◽  
Novel Approach ◽  
Clinical Questions ◽  
Key Questions

Abstract Background There is no standardised protocol for developing clinically relevant guideline questions. We aimed to create such a protocol and to apply it to developing a new guideline. Methods We reviewed international guideline manuals and, through consensus, combined steps for developing clinical questions to produce a best-practice protocol that incorporated qualitative research. The protocol was applied to develop clinical questions for a guideline for general practitioners. Results A best-practice protocol incorporating qualitative research was created. Using the protocol, we developed 10 clinical questions that spanned diagnosis, management and follow-up. Conclusions Guideline developers can apply this protocol to develop clinically relevant guideline questions.

Sign in / Sign up

Export Citation Format

Share Document