Tuesday, July 10, 2007

The National Guideline Clearinghouse

Today I want to talk about another awesome site I found in my travels that I believe to be an invaluable source for not only social work students but practitioners as well. It can be found at http://www.guideline.gov/

This site is an invaluable medical science based resource. Here is a short description taken from the NGC page:

"In 1997, the Agency for Healthcare Research and Quality (AHRQ) launched its initiative to promote evidence-based practice in everyday care through establishment of 12 Evidence-based Practice Centers (EPCs). The EPCs develop evidence reports and technology assessments on clinical topics that are common, expensive, and/or are significant for the Medicare and Medicaid populations. With this program, AHRQ became a "science partner" with private and public organizations in their efforts to improve the quality, effectiveness, and appropriateness of clinical care by facilitating the translation of evidence-based research findings into clinical practice."

While as social workers we are not involved in the "clinical" care of patients I believe that this site offers us valuable assessment resources that we might use to recognize when a client needs to be referred to a physician or when a client has been referred to us for counseling. There are annotated bibliographies, bioterrorism links, discussion list links, EPC reports, guideline resources, hurricane resources and patient resources.
The one that I would like to talk about today is guideline resources. On this page you will find links to complimentary resources as well as sister sites. Halfway down on the left you will see a browse box complete with a search box where you can type in whatever disease, mental disorder or treatment you are looking for. I typed in social work just to see how it would narrow down my search. Out of over 4000 articles in the database it narrowed down to 449 so that might be a good way to start. Typing in social worker narrows it down to 93. There are articles on recommendations for chronic pain management, domestic violence, HIV/AIDS, reproductive health for homeless women, diabetes, chronic fatigue, protecting patients rights,spirituality and the older adult,asthma management, stress related conditions and other mental disorders just to name a few.
I have selected Adapting your practice: treatment and recommendations for homeless children with otitis media to break down for you today as an example of the offerings of the site.

The page first gives you the title then the bibliographic sources for the article which for this article are: Bonin E, Brammer S, Brehove T, Hale A, Hines L, Kline S, Kopydlowski MA, Misgen M, Obias ME, Olivet J, O'Sullivan A, Post P, Rabiner M, Reller C, Schulz B, Sherman P, Strehlow AJ, Yungman J. Adapting your practice: treatment and recommendations for homeless children with otitis media. Nashville (TN): Health Care for the Homeless Clinicians' Network, National Health Care for the Homeless Council, Inc.; 2003. 24 p. [27 references]

Then it gives you the status of the guideline. This is the current release of this guideline. Then you have the option of a brief summary of the contents which include: recommendations, evidence supporting the recommendations, identifying information and availability, disclaimer and the option to view the complete summary. Under recommendations you will find excellent questions to ask while doing your own assessment if needed. Questions about the child's housing and medical situation, exposures to smoke, viral illnesses, drugs while being brest fed, sleep disturbances, hearing difficulties, delayed speech, development, behavior, school attendance, prior infections and treatment and other history. The plan and management section gives good insight into suggestions for parental education ie signs and symptoms, prevention, risk of delayed or interrupted treatment, aids for adherance, emergency numbers, follow-up. there is also a list of associated problems/complications such as congregate living, parental smoking, lack of transportation, financial barriers, poor adherance and familial stress. Follow-up includes recheck, sharing information with patients primary care physician, referrals for further testing, specialists and case management.
The rest of the guideline centers around documentation of sources, release date, copyright information and the disclaimer.
I did check several other guidelines and found them to be as informative but much too long for my purpose here. There is also a box on the left side where you can have your own list of articles and also do comparisons of the articles you choose. I haven't tried that. I will let you know how it goes in this article when i do. :-) Have a Great Day and Happy Hunting!

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