Clinical Guidelines (pedoman pelayanan klinis/medis)
Sari
alam sepuluh tahun terakhir, pedoman
klinis telah menjadi sesuatu alat yang sangat
erat dengan praktek klinis kedokteran.
Hampir setiap hari, keputusan klinis di
kamar praktek, standar operasi di rumah sakit dan
klinik, serta kebijakan kesehatan pemerintah dan
perusahaan asuransi mendapat pengaruh atau asupan
dari pedoman klinis yang ada.
Clinical guidelines didefinisikan sebagai aturan yang
dibuat secara sistematis untuk membantu para praktisi
dalam penanganan pasien, untuk pelayanan kesehatan
yang tepat dalam situasi yang spesifik. Pedoman ini
dapat berisi tentang cara pemilihan prosedur diagnostik
maupun skrining, cara memberikan pelayanan medis
maupun bedah, seberapa lama pasien harus dirawat,
dan rincian lainnya
Kata Kunci
Teks Lengkap:
PDFReferensi
Shekele PG, Woolf SH, Eccles M, Grimshaw JM. Developing
guidelines. BMJ 1999; 318:593-6.
Feder G, Eccles M, Grol R, Griffiths C and Grimshaw
JM. Using clinical guidelines. BMJ 1999;318:728-30.
Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw
JM. Potential benefits, limitations, and harms of clinical
guidelines. BMJ 1999; 318:527-30.
NZGG Guidelines Handbook. Dikutip dari http://
www.nzgg.org.nz/development/documents/nzgg_guideline_
handbook.pdf , tanggal 5 Mei 2003.
Harbour R, Miller J. A new system for grading recommendations
in evidence based guidelines. BMJ 2001;
:334-6.
Shekele PG, Eccles M, Grimshaw JM, Woolf SH. When
should clinical guidelines be updated? BMJ 2001;
:155-7.
Are the recommendations in this guideline valid?
Were all important decision options and outcomes
clearly specified?
Was the evidence relevant to each decision option
identified, validated, and combined in a sensible and
explicit way?
Are the relative preferences that key stakeholders attach
to the outcomes of decisions (including benefits, risks
and costs) identified and explicitly considered?
Is the guideline resistant to clinically sensible variations
in practice ?
Is this valid guideline or strategy potentially useful?
Does this guideline offer an opportunity for significant
improvement in the quality of health care practice?
Is there a large variation in current practice?
Does the guideline contain new evidence (or old
evidence not yet acted upon) that could have an
important impact on management? Would the guideline
affect the management of so many people, or concern
individuals at such high risk, or involve such high costs
that even small changes in practice could have major
impacts on health outcomes or resources (including
opportunity costs)?
Should this guideline or strategy be applied in yourpractice?
What barriers exist to its implementation? Can they be
overcome?
Can you enlist the collaboration of key colleagues?
Can you meet the educational, administrative, and
economic conditions that are likely to determine the
success or failure of implementing the strategy?
a. credible synthesis of the evidence by a respected
body
b. respected, influential local exemplars already
implementing the strategy
c. consistent information from all relevant sources
d. opportunity for individual discussions about the
strategy with an authority
e. user-friendly format for guidelines
f. implementable within target group of clinicians
(without the need for extensive outside collaboration)
g. freedom from conflict with economic incentives,
administrative incentives, patient expectations, and
community expectations.
GUIDELINES
DOI: http://dx.doi.org/10.14238/sp4.4.2003.204-6
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