FNP 591 Wk 1 Discussion 2

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United States University *

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591

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Nursing

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Apr 29, 2024

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Uploaded by BrigadierQuetzal2508

Clinical Guideline Importance The purpose of clinical guidelines is to guarantee that patients receive the right care and treatment. Guidelines constitute a component of an evidence-based practice tool that, when converted into practice recommendations, can enhance patient outcomes and the process of care meticulously synthesized by skilled clinicians (Pereira et al., 2022). Increased guideline adherence has been linked to better outcomes in patients with different illnesses and reduced morbidity or mortality. Patient care is inconsistent when current practice recommendations are not fully followed, which can lead to the adoption of interventions that have little or no value. Clinical guidelines play a crucial role in recognizing challenges, selecting, and executing focused therapies, and enabling the tracking and evaluation of patient outcomes. 5 different governing bodies for Clinical Practice Guidelines and discussion of a health condition that can be managed by the clinical practice guideline. Examples of five different governing bodies for clinical practice guidelines include the American Academy of Family Physicians (AAFP), the National Institute for Health and Care Excellence (NICE), the American College of Cardiology and American Heart Association (ACC/AHH), the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO). As an example of a clinical practice guideline, the American Academy of Family Physicians (AAFP) provides evidence-based tools for family medicine to treat important disease processes, such as diabetes. According to AAFP, adults between the ages of 40 and 70 who are overweight or obese should get screened for type 2 diabetes (AAFP, 2023). The National Institute for Health and Care Excellence (NICE) offers recommendations and guidelines at the federal level to enhance health and social services. An example is that NICE offers clinical practice guidelines for the management of gestational hypertension which includes

assessing for proteinuria, managing chronic hypertension, managing preeclampsia, and treatment during the postnatal period (NICE, 2019). An example of clinical practice guideline I used during this program was the management of hypertension under the American College of Cardiology and American Heart Association (ACC/AHH). The clinical guideline of ACC/AHH is tailored to race-specific treatment management in patients with hypertension. These guidelines offer thorough guidance on the management, diagnosis, assessment, and prevention of high blood pressure. The Centers for Disease Control and Prevention (CDC) is the focal point for creating and implementing programs related to environmental health, health promotion, and disease prevention and control to enhance the health of Americans. An example of a clinical practice guideline that the CDC recommends is the management of Covid-19. CDC recommends those who test positive for COVID-19 should isolate themselves for at least five days as the first five days are the highest to be contagious (CDC, 2023). Lastly, the World Health Organization (WHO) aims to protect the vulnerable, advance global health, and maintain global security. An example of a clinical practice guideline that WHO provides is the non-surgical management of chronic low back pain in adults. WHO advises healthcare providers to prescribe planned exercise regimens that include a series of targeted movements meant to increase a patient's physical capability, along with instructions and supervision (WHO, 2023). Elaboration of Clinical Practice Guidelines Clinical practice guidelines provide detailed recommendations on how to care for patients with specific medical conditions. Clinical practice guideline begins with the background section that includes a detailed discussion of the purpose and dimensions of the disease or medical condition being treated, as well as data on its prevalence, personal impacts, and systemic implications (National Library of Medicine [NIH], 2020). There is a methodology section that

details the structured process of crafting a clinical practice guideline that considers expertise considerations with disclosure of potential conflicts of interest. This segment of the methodology may cover search tactics, criteria for study selection, and techniques for assessing evidence quality and relevance (NIH, 2020). There is a recommendation portion where specific suggestions for patient care encompass diagnosis, intervention, subsequent follow-up, and monitoring (NIH, 2020). There is evidence supporting the recommendations in the clinical practice guidelines referenced by systematic reviews, meta-analyses, and relevant studies or trials (NIH, 2020). Recurrent evaluation is encouraged by clinical practice guidelines to make sure they are current and applicable to clinical practices. Clinical Practice Guidelines for Sexually Transmitted infections in management for Syphilis and Chlamydia Clinical practice guidelines that would be used to manage sexually transmitted infection visits will be the Centers for Disease Control and Prevention (CDC). CDC offers the focal point for creating and implementing programs related to health promotion, disease prevention and control, and health education that aim to enhance the health of Americans (CDC, 2023). Screening for high-risk populations and pregnant individuals is part of the CDC's clinical practice guidelines for managing patients who present with Syphilis. Diagnosis and staging should be confirmed with two laboratory tests, the rapid plasma reagin and treponemal-specific tests (CDC, 2021). Penicillin G is the recommended medication for treating people with syphilis in all phases when given parenterally (CDC, 2021). The CDC advises screening for chlamydia in high-risk populations, pregnant women, and all sexually active people (CDC, 2021). Laboratory testing, including as specimen collection and nucleic acid amplification tests, is used to confirm the diagnosis of chlamydia (CDC, 2021). Treatment for Chlamydia includes an antibiotic such as

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doxycycline for 7 days to be prescribed (CDC, 2021). Partners should be notified of infection to prevent co-infections. Both syphilis and chlamydia need to be followed up to ensure treatment is successful and identify potential reinfection. Mammogram Screening differences between American College of Gynecology (ACOG), United States Prevention Services Task Force (USPSTF), and the American Cancer Society (ACS) There are specific guidelines that differ for mammogram screening between the American College of Gynecology (ACOG), the United States Prevention Services Task Force (USPSTF), and the American Cancer Society (ACS). The ACOG mammogram screening suggests should be initiated with women in their 40s and no later than when they turn 50 years old. Additionally, mammogram screening should be continued for one to two years until at least 75 years old (ACOG, 2023). According to the USPSTF, women between the ages of 40 and 74 should get screened for mammograms every two years (USPSTF, 2023). If a woman has dense breasts or has a negative screening mammography, she should also have further screening for ultrasound or magnetic resonance imaging (USPSTF, 2023). Under the American Cancer Society (ACS), women should start having mammograms at age 40 to 44, have them every year from age 45 to 54, and transition to every two years at age 55 and beyond. (ACS, 2023). Clinical Case Scenario Seasonal Allergic Rhinitis Seasonal allergic rhinitis triggers an inflammatory response of the upper respiratory tract in reaction to airborne allergens. Based on American Academy of Family Physicians (AAFP) clinical practice guidelines, treatment for seasonal allergic rhinitis includes a trial for intranasal corticosteroids such as beclomethasone dipropionate nasal one to two sprays in each nostril twice a day (Weaver-Agostoni, 2023). An oral antihistamine such as cetirizine 5 to 10 mg orally once

daily may be prescribed (Weaver-Agostoni, 2023). Education should be implemented for patients to reduce airborne allergen exposure such as dust, pollen, cat dander, and dogs. When compared to no treatment, non-pharmacological nasal saline irrigation has been demonstrated to lessen the intensity of allergy symptoms for up to eight weeks (Weaver-Agostoni, 2023). References American Academy of Family Physicians (AAFP). (2021, April 24). Diabetes screening, adults. https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all- clinical-recommendations/diabetes-screening-adults.html American Cancer Society (ACS). (2023). American cancer society guidelines for the early detection of cancer. https://www.cancer.org/cancer/screening/american-cancer-society- guidelines-for-the-early-detection-of-cancer.html American College of Gynecology (ACOG). (2023). Reducing your risk of cancer: Lifestyle changes and screening tests. https://www.acog.org/womens-health/faqs/reducing-your- risk-of-cancer-lifestyle-changes-and-screening-tests#:~:text=Finding%20breast %20cancer%20early%20makes,years%20until%20at%20least%2075. Centers for Disease Control and Prevention (CDC). (2021). Syphilis . https://www.cdc.gov/std/treatment-guidelines/syphilis.htm Centers for Disease Control and Prevention (CDC). (2021). Chlamydia infections . https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm Centers for Disease Control and Prevention (CDC). (2023, May 11). Isolation and precautions for people with covid-19 . https://www.cdc.gov/coronavirus/2019-ncov/your-health/isolation.html

National Institute for Health and Care Excellence (NICE). (2019, June 25). Hypertension in pregnancy: diagnosis and management . https://www.nice.org.uk/guidance/ng133 National Library of Medicine (NIH). (2020). What are clinical practice guidelines? https://www.ncbi.nlm.nih.gov/books/NBK390308/#:~:text=Guidelines%20summarize %20the%20current%20medical,scientific%20evidence%20supporting%20those %20recommendations. Pereira, V. C., Silva, S. N., Carvalho, V. K., Zanghelini, F., & Barreto, J. O. (2022). Strategies for the implementation of clinical practice guidelines in public health: An overview of Systematic Reviews. Health Research Policy and Systems , 20 (1). https://doi.org/10.1186/s12961-022-00815-4 United States Prevention Services Task Force (USPSTF). (2023). Screening for breast cancer. https://www.uspreventiveservicestaskforce.org/files/breastcancer/Breast_Cancer_DRS_C onsumer_Guide.pdf Weaver-Agostoni, J., Kosak, Z., & Bartlett, S. (2023). Allergic rhinitis: Rapid evidence review. American Family Physician, 107(5), 466-473. https://www.aafp.org/pubs/afp/issues/2023/0500/allergic-rhinitis.html World Health Organization (WHO). (2023, December 7). WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings . https://www.who.int/publications/i/item/9789240081789

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FNP 591 Wk 1 Discussion 2

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