The Importance of Guidelines in Hospitals

Synopsis

The Purpose of the study

This study sought to showcase the importance of developing and disseminating guidelines in hospitals regarding different hospital procedures. The discussion mainly focuses on Mechanical Ventilation (MV) guidelines (Eldh, Vogel, Soderberg, Blomqvist & Wengstrom, 2013).

Research Hypotheses

  1. There are no national guidelines for mechanical ventilation in Swedish.
  2. It is upon the discretion of health professionals to establish, interpret, and validate the contents of international documents.
  3. There is limited knowledge regarding MV usage in ICUs.

How the sample was obtained

The study was to be a national survey of all 64 ICUs in Sweden as all the general ICUs had been invited to participate (Eldh et al., 2013). However, the sample chosen was based on the hospitals that gave their permission and accepted to be part of the study. The sample was based on two groups the ICU’s head nurse and senior physician.

The inclusion or exclusion criteria used

The criteria that were used; all participants should be managers working in the ICU department; either an ICU head nurse or a senior physician.

Participants of the study

Out of the 65 ICU hospitals that had been invited to participate only 55 ICUs did participate (Eldh et al., 2013). They included ICUs, 55 head nurses, and 45 senior physicians. Furthermore, 51 ICUs submitted their guidelines that included their recommendations for Medical or Nursing MV actions. Only 11 ICUs that is 22% of 54 participants included references. Unfortunately, no participant presented patients’ experiences of MV. Most of the guidelines were based on professional advice (Eldh et al., 2013).

What methods were used to collect data?

The method used to collect data included telephone interviews, which consisted of semi-structured and open-ended questions (Eldh et al., 2013). A specific guide was made so that could guide the respondents on how to answer their questions.

Testing of the intervention /treatment /clinical protocol

Yes, the intervention was tested. The research was based on the recommendations of using MV in the ICU with the use of guidelines.

The main findings of the study

Despite their importance in the ICU department, many managers are not keen on MV guidelines. Several institutions stated that the duty of compiling MV guidelines is either a group responsibility or one person’s job. They find information about the MV guidelines through the internet, with a number of them sharing amongst themselves. They further stated that their MV guidelines are rarely revised by most institutions doing it once a year. The institutions that used MV guidelines stated that most of them seldom used the guidelines and relied on their personal experiences or instructions given.

Institutions that do not use MV guidelines considered them unnecessary since they have extensive experience among them, and there is no need for the guidelines.

Credibility

Whether the study is published in peer-reviewed journals

It cannot be established that the study has been published in a peer-reviewed journal. There was no evidence indicating such.

The research/experimental design

Yes, by having interview guidelines, the research was able to be controlled.

Data obtained and the data analyzed answered the research question

Yes, despite the difference in thought at the end of the day, it was concluded that ICUs are benefiting by using MV guidelines in their everyday practice (Eldh et al., 2013).

Reliability of the measuring instruments

Yes, the measuring instruments were reliable and valid. The results from the pilot test created room for further revision before being used and accepted for the study.

Control of important extraneous variables and potential bias

Yes, it was controlled. Since word of mouth could lead to bias and falsification of information, it was controlled by structuring guidelines for the interviews.

Was the study free from extraneous variables introduced?

NO. The research findings were based on the answers from the managers. It was impossible to compare the results since they did not manage to get patients’ views of the MV guideline.

Consistency of the study

Yes, the results are different. According to the research, MV guidelines are an important part of the ICUs and need to be part of their daily practice. According to the research, most respondents did not feel that they needed the guidelines and preferred to use their experience or instructions given.

Credibility of findings

Some of the evidence is credible. Since the evidence is based on the interview guidelines varied and did not have patients’ experiences for comparison. However, despite the control, it could be told if the results from respondents were right.

Conclusion

I partly agree with the research findings. On one hand, the study shows that MV guidelines are very paramount in ICUs. However, when the research is conducted there is evidence of the use of the MV guidelines, but most respondents state that they usually, use their experiences and instructions from superiors. Other respondents do not use MV guidelines and still are doing their work well. Therefore, it is clearly stated that despite the need for MV guidelines, they are not used in hospitals as they should.

Reference

Eldh, A. C., Vogel, G., Söderberg, A., Blomqvist, H., & Wengström, Y. (2013). Use of Evidence in Clinical Guidelines and Everyday Practice for Mechanical Ventilation in Swedish Intensive Care Units. Worldviews on Evidence‐Based Nursing, 10(4), 198-207.