Rankin Jane, Morris Kay, Reilly Aoife
Clinical Lead for the Lymphoedema Network Northern Ireland, Health and Social Care.
Project Manager Lymphoedema Services, Health Service Executive.
Br J Community Nurs. 2022 Oct 1;27(Sup10):S22-S26. doi: 10.12968/bjcn.2022.27.Sup10.S22.
The last decade has produced a plethora of lymphoedema-based research. As such, a new All-Ireland Guideline for lymphoedema diagnosis, assessment and management was required to replace the 2008 CREST Guideline. A research team was commissioned to work with healthcare staff and service users following international research standards practice. An evidence-based clinical practice guideline was developed to aid clinicians in the diagnosis, assessment, and management of lymphoedema. Recommendations were formulated based on the evidence available to answer each clinical question and were assigned a grade based on the strength of the evidence. In the absence of sufficient evidence and in an effort to maximise clinical applicability, recommendations were also based on expert opinion, which was gathered via guideline member consensus. The recommendations from the guideline, which aim to provide healthcare professionals with clear, evidence-based guidance on the diagnosis, assessment and management of patients with all types of lymphoedema, should be communicated at all levels regarding responsibility for implementation in clinical care and service development. Audit should be a core component of the implementation. A budget impact analysis should be completed to determine additional costs required to fully implement the guideline.
过去十年间涌现出了大量基于淋巴水肿的研究。因此,需要一份新的全爱尔兰淋巴水肿诊断、评估及管理指南来取代2008年的CREST指南。一个研究团队受委托按照国际研究标准做法与医护人员及服务使用者合作。制定了一份循证临床实践指南,以帮助临床医生对淋巴水肿进行诊断、评估和管理。根据现有证据制定建议以回答每个临床问题,并根据证据强度赋予等级。在缺乏充分证据的情况下,为了最大限度地提高临床适用性,建议还基于通过指南成员共识收集的专家意见。该指南的建议旨在为医疗专业人员提供关于各类淋巴水肿患者诊断、评估和管理的清晰循证指导,应在临床护理和服务发展实施责任的各个层面进行传达。审核应是实施的核心组成部分。应完成预算影响分析,以确定全面实施该指南所需的额外成本。