In their daily work, nurses are guided by well-researched and documented evidence. These recommendations are published in a document known as the Clinical Practice Guidelines (CPGs). The paper is essential for any practicing nurse because it comprises countless cases and symptoms that various patients exhibit (Jcaho, 2011). The rules provide advice on how to handle clients and make key judgments. This is especially useful when a nurse is unsure how to continue, eliminate old recommendations, and provide knowledgeable recommendations on a specific patient. Additionally, the guidelines enhance uniformity and consistency in the patient's medical care as well as reassure the appropriateness of the treatment policy (DiCenso, Guyatt, & Ciliska, 2005). The CPG's have scientific research supported with clinical data to reinforce the methods of critical appraisal and draw attention to ineffective and harmful practices.
Nurses worldwide handle a tremendous number of surgical procedures; it is approximated that approximately 200 million surgical procedures are carried out annually. The procedures remain one of the most sensitive areas for any practicing nurse. There myriad of challenges that come along with performing a surgical procedure on a patient (Berwick, 2008). The major challenge is the risk of the patient acquiring secondary infections after the surgical procedure. The nosocomial infections are highly likely in any hospital setting; to avoid these infections, the nurses and the caregivers must stick to strict guidelines articulated in the CPG document. Statics from the Center for Disease Control indicates 75% of surgical procedures are likely to become infected unless great hygiene is maintained during the procedure as well as the healing process (Wenberg, 2017). The majority of the infections are critical, and the patients may even end up in Intensive Care Unit (ICU). This report shows how grave the nosocomial infections can become. It is, therefore, necessary that the nurses and all caregivers, who interact with the patient, both during and after the surgical procedure take necessary precautions to avoid such occurrences.
Scope and Purpose
The Clinical Practice Guidelines has numerous benefits for both the patients and healthcare professionals. The patients are assured of realistic diagnostic procedures as well as treatment. They are guaranteed of current treatment methods which ultimately gives the best health outcome (Eddy, 2005). As a result, the guidelines play a significant role in reducing the mortality and morbidity rates. The healthcare professionals benefit from the guidelines since they are able of authoritatively decide on the medication for the patients. It gives them reference point where they can get an evidence-based analysis of the conditions of the patients (Berwick, 2008). The nurses learn the benefits of hygiene especially during surgical operations to avoid dangerous infections. The CPG's were developed for the sole purpose of improving the quality of healthcare and applying the correct methods in the analysis of the patient and the subsequent treatment.
Stakeholders Involvement
The process of developing the Clinical Practice Guidelines is vigorous and thorough. The document is a sensitive one, and no errors should be allowed (Schünemann, Fretheim, & Oxman, 2008). Any mistakes in the document are akin to gambling with the patient's life. Due to the high level of sensitivity, the content is developed by several categories of professionals. They thoroughly research on the various possibilities and then settle for the best. Their interest is primarily to ensure that the patients get the best services in the hospitals. The professionals involved include;
Government Agencies
Several government agencies involved in the research and development are key contributors to the development of the guidelines. This group offers both intellectual and financial support in the process of research to acquire the data necessary in making certain decisions. These institutions include Centre for Disease Control (CDC), USPSTF as well as NIH (Jcaho, 2011). The CDC has systematic review of the literature to come up with evidence-based guidelines. It also possesses well-equipped laboratories with sufficient pool of qualified professionals who contribute heavily to the development of guidelines on surgery of other prevalent diseases. On the other hand, USPSTF is a body formed under a Public Health Act bringing together a pool of professional healthcare providers with experience and expertise in the medical field (Wenberg, 2017). It primarily offers guidelines on the preventive measures such as the best methods that nurses should use to prevent nosocomial infections successfully.
The hospital-based health care providers
This is a crucial group of professionals and contributors to the process of developing the guidelines (DiCenso, Guyatt, & Ciliska, 2005). They interact directly with the patients making them very resourceful when documenting the systematic symptoms that lead to a definite diagnosis.
Allied Health Professionals
Institutions that may be involved in formulating policies allied to the health professionals are vital in the process of developing the operational guidelines. These may include Non-Governmental Organizations (NGO's), International Organizations as well as organizations that deal with specific conditions (Eddy, 2005). These organizations are primarily vital in the financing of the process of developing the guidelines. They also have professionals who contribute to the knowledge pool during the drafting and documenting of the evidence and recommendations.
Rigor of Development
The process of developing the CPG is rigorous since it involves rigorous research and consultations among the key stakeholders. In the initial stage of development, the stakeholders carry out extensive research on the different publications as well as electronic databases to gather information on the condition they choose to concentrate on. Once different groups of professionals come up with the suggested CPG, it is scrutinized using Appraisal of Guideline Research and Evaluation Tool (A.G.R.E.E) (DiCenso, Guyatt, & Ciliska, 2005). Once the guidelines pass the test, it means there are no controversial recommendations. This enables the CPG to move to the next level of scrutiny. The CPG is then subjected to scrutiny by various research and development bodies. This stage is meant to ascertain the efficacy of the CPG about alternative possibilities. The institutions will then document their findings which will be discussed by an independent panel of professionals. This is aimed at confirming that there are no errors in the work. The document is then subjected to another panel of professional that run it through electronic databases such as MedLine, Embase, Database of abstract reviews as well as the health technology assessment database (Wenberg, 2017). Different methods assess the quality of the evidence to be used in the document. The most accurate method used is the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). This is the last process that the guidelines are subjected to. Passing the test at this stage is a sure way of passing it as of impeccable quality.
Recommendations
The CPG on the surgical procedures make recommendations on how the nurses and other caregivers should handle the patient, the surroundings as well as their bodies during and after the operation procedure (Berwick, 2008). This is aimed at ensuring that there is no contamination of the wound that would lead to infections which could turn out to be fatal. The recommendations include;
The choice of Preoperative antiseptics
The microbes are found on every surface. This includes the hospital bed and the skin of human beings. As a result, any opening on the skin will lead to infection of the wound by the surrounding microbes (Jcaho, 2011). This calls for thorough skin sterilization before an opening is made; the choice of the antiseptic to use is crucial, the more effective the antiseptic is against all form of microbes, the better. The skin is sterilized using the antiseptic making it safe to operate on the patient using sterile equipment. To avoid situations where the patient sneezes and contaminate the site of operation, there are nasal antiseptic which the nurses should carefully select and use the best.
Use of Antibiotic Prophylaxis
The antibiotics are meant to fight systemic infection in case it happens (Schünemann, Fretheim, & Oxman, 2008). This is meant to be protective because when thorough sterilization is done during the operation, there exist minimal chances of infection.
Availability of enough blood banks
Operative procedures may lead to excessive bleeding and the consequent need to infuse blood into the patient (DiCenso, Guyatt, & Ciliska, 2005). Compatible blood type should be available in the bank
Prevention of complications from anesthesia
The anesthetic products may lead to complications in some patients. Due diligence should be conducted before the operation. The nurse should also examine the patient before the procedure to ensure that the patient maintains the standard body temperature and that cardiovascular complications do not occur (Berwick, 2008) during the procedure.
A nurse taking care of a patient before and after a surgical operation should always prioritize on the ensuring that the patient will be safe, affordability, quality of scientific data available and the patient's overall welfare. Frequent training and refreshers should be conducted among the nurses and caregivers to update themselves on the guidelines.
Implementation
For the set guidelines to be helpful to the patient, it is necessary that full implementation is done. The healthcare professionals should ensure that the guidelines provided in the CPG on surgical operations are upheld. This data and analysis are conclusive, and the evidence is provided to the recommendations (Wenberg, 2017). If the guidelines are fully implemented, there is a likelihood that the infections will be eliminated from the patients. Every healthcare provider would want the best for their patients, and this gives us, even more, reasons to implement the guidelines.
Conclusion
The quality of health care in any given state is dependent on the professionalism of the health care professionals. A Lot of effort has been put into ensuring that the patients get the best healthcare services. The quality of the healthcare service should never be compromised. There are massive numbers of infections that occur every year; it should be the goal of every healthcare provider to reduce this number significantly. The reduction and even elimination of the cases are possible with just a little care and caution. Let us all endeavor to achieve this mission together.
References
Berwick, D. M. (2008). Broadening the view of evidence-based medicine. Quality and Safety in Health Care. PubMed.
DiCenso, A., Guyatt, G., & Ciliska, D. (2005). Evidence-based Nursing: A Guide to Clinical Practice. Elsevier Health Sciences.
Eddy, D. M. (2005). Evidence-based medicine: A unified approach. Health Affairs. PubMed, 25.
Jcaho. (2011). Selecting and Implementing Clinical Practice Guidelines in Hospitals. Joint Commission Resources.
Schünemann, H. J., Fretheim, A., & Oxman, A. D. (2008). Improving the use of research evidence in guideline development: Guidelines for guidelines. Health Research Policy and Systems. PMC, 34.
Wenberg, H. (2017, May 10). CDC Wonder: CDC prevention guidelines. Retrieved from Centre for Disease Control and Prevention: http://wonder.cdc.gov/wonder/prevguid/library/library.asp
