Evaluation of Post-Stroke Rehabilitation Clinical Practice Guideline

This study evaluates the healthcare practice guideline for post-stroke rehabilitation patients using the AGREE system. The guideline's scope, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence are analyzed. The study aims to improve the guideline's effectiveness and efficiency in treating depressed stroke patients.

POPULATION HEALTHCARE

Table of Contents
Abstract......................................................................................................................................2
Introduction................................................................................................................................2
Evaluation of the clinical practices guideline............................................................................3
Summary....................................................................................................................................6
Reference list..............................................................................................................................8
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Abstract
The study mainly comprises of the evaluation and the analysis of the healthcare practice
guideline for the post-stroke rehabilitation patient. The Post-stroke rehabilitation guideline
comprises of specific scope and objective that will be evaluated by the Appraisal of Guideline
for Research and Evaluation or the AGREED system("WHO | World Health Organization",
2018). Additionally, different components of the guideline like stakeholder's involvement,
rigor development, and assessment and management strategies will be analyzed in the study.
The AGREED system is used to analyze the different perspective of the clinical post-stroke
rehabilitation guideline for the Post-stroke rehabilitation patient. This analysis may help in
effective improvement of the guideline that may help the medical practitioners to implement
the action plan in an efficient manner.
Introduction
In the United States of America, more than 795,000 people suffer from stroke according to
the data of (National Institute of Neurological disorder). It is observed that most of the
patients in the post-stroke stage suffer from depression that enhances the physiological
problems in the body. Minimizing this condition is the responsibility of the Government.
Effective clinical practice guidelines are there those help in the implementation of a proper
action plan to reduce the depression in Stroke patients. The post-stroke rehabilitation clinical
practice guideline is developed by the health care and policy research institute. Subsequently,
with time, the post-stroke rehabilitation guideline has been upgraded according to the need.
This guideline is prepared mainly for the medical professionals that will help in enhancing
their quality of service. This study mainly focuses on the review of the clinical practice
guideline of Stroke rehabilitation patient in community service hospital setting of California.
Moreover, evaluation of the clinical practice guideline will be done by using the AGREE
system of evaluation. The AGREE system is the Appraisal of Guidelines For research and
Evaluation instrument that is developed with the purpose of holistic evaluation of the clinical
practice guideline system in the health care setting. Subsequently, the evaluation will be
followed by a summary that will include the analysis of the evaluation. The summary section
will represent a critical analysis of the results those are found in the evaluation.
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Evaluation of the clinical practices guideline
Assessment of the qualities of guidelines
Stroke is one of the most significant problems causing the huge rate of morbidity and
mortality throughout the world. According to the World Health organization Yearly about
15 million people suffer from a stroke. It is observed that there is a high tendency for post-
stroke patients to develop depression and disability ("WHO | World Health Organization",
2018). The Post-stroke rehabilitation clinical practice guideline aims at maximizing recovery
of the patient. Moreover, the Clinical practice health care guide is intended for the medical
practitioner’s responsible for the holistic treatment of the patient (Laur, Marcus, Ray &
Keller, 2016). According to the data in the MPHS hospital in California, it is stated that 395
patients have been admitted to the hospital with a hemorrhagic stroke and transient ischemic
stroke. It is seen that 2% out of the affected 395 patients have been selected for mental health
treatment. This step is mainly taken to analyze the holistic mental condition of the patient.
According to researchers symptoms of depressions are found in 33% of the stroke patients.
This depression has an overall negative effect on the health of the patient (Lea, 2014). The
Post-stroke rehabilitation clinical guideline suggests that effective steps should be taken to
mitigate depression in the post-stroke patient in healthcare. The effective steps in the clinical
guideline include a screening tool by which the mental state of the patient may be evaluated
by the medical practitioner in the healthcare (Laur, Marcus, Ray & Keller, 2016).
Subsequently, if any sign of depression and anxiety is seen in the patient then efficient
intervention must be planned according to the guideline.
According To the AGREE System of evaluation the scope and the purpose of the clinical
post-stroke rehabilitation guideline should be assessed. According to the AGREE system of
evaluation, there are 6 domains based on which the evaluation of the clinical guideline of
Post-stroke rehabilitation patient should be performed in an efficient manner.
Scope and Purpose evaluation
This part mainly deals with the evaluation of the overall objective of the clinical guideline,
the health questions covered under the described guidelines and the target population.
According to the Clinical guideline of Post-stroke rehabilitation patient, particular objectives
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are clearly mentioned (Stoodley, 2017). The health questions and aspects are mentioned in an
appropriate manner. Specific target population is mentioned in the guideline that may help in
implementing the quality treatment to the Post-stroke patient. The guideline includes different
assessment of the cognitive ability and mental state of the patient (Stoodley, 2017).
According to the AGREE method of evaluating, the scope and the purpose of the Clinical
post-stroke rehabilitation guideline in health care are efficient and effective. This plan
consists of specific screening techniques and the target population. According to
researchers, it might get a six score according to the AGREE system of evaluation. The
health care cost of a stroke patient with depression is 63% more than that of the normal stroke
patient (Stanley & Campos, 2015). Assessment and intervention according to the clinical
guideline to Post-stroke rehabilitation might help in the cost-effective treatment of the patient
in the MPHS hospital in California.
Stake Holders Involvement
The second important component that should be evaluated in the clinical health care practice
of Post Stroke rehabilitation patients is the stakeholder's involvement in the process. The
stakeholder's involvement process includes aspects like consultation of different stakeholders
group in formulating the clinical guideline for post-stroke rehabilitation in health care
(Bishwajit, 2016). The guideline should involve the views and preferences of the
stakeholders. Through the guideline, the target users must be clearly defined. According to
researchers, it is seen that suicidal tendencies in the post-stroke patient are 14%(Gagliardi,
2014). It is essential to develop a clinical guideline by effectively consulting with the
physician and the patients. Every stakeholder's opinion is valuable in implementing the
clinical guidelines in a prominent manner (Bishwajit, 2016). The panel members included in
the formulation of the clinical guideline for the post-stroke rehabilitation includes physician
and professors of different medical universities of the United States researchers, Managers
from the health administration, doctors of multidisciplinary subjects. This implies that a wide
variety of highly qualified stakeholders are involved in the formulation of this clinical health
care guideline for post-stroke rehabilitation patients (Bishwajit, 2016).
On the other hand opinions from the patient should be taken in the formulation or up
gradation of the post-stroke rehabilitation clinical health care guideline. This may help in
assessing the needs of the depressed stroke patient in MPHC California. The guideline
specifies the target population in an efficient manner (Tsima, Setlhare&Nkomazana,
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2016).According to the researchers in the stakeholder involvement parameter, the clinical
guideline for post-stroke rehabilitation may get 4 points. Additionally, the guideline needs to
be formulated including an opinion from the patient parties to have a holistic approach.
Rigor of Development
The Rigor of development component includes the evaluation of the systematic methods of
assessment those are mentioned in the clinical health care guideline for the Post-stroke
rehabilitation patients. This part comprises of the evidence-based methods to assess
depression in the stroke patient in an appropriate manner (Murphy, Sarris & Byrne, 2017).
According to the Clinical healthcare guideline, there are different scales to asses to
depression level in post-stroke patients. Geriatric depression scale, Hospital anxiety and
depression scale, Visual analogue mood Scale is a different assessment tool used to assess
post-stroke patients in an efficient manner (Murphy, Sarris & Byrne, 2017). A provision for
an update of the clinical health care guideline for a post-traumatic patient is also included. It
may help the medical practitioners of MPHC hospital to implement the assessment plan in an
efficient manner. According to the researchers, the clinical health care guideline may get 7
with respect to the rigor of development (Tsima, Setlhare&Nkomazana, 2016).
Clarity of presentation
The clarity of the presentation includes the specific recommendation provided in the clinical
health care guideline for the Post-stroke rehabilitation patients. The unambiguous
recommendation may help in improving the overall diagnosis and management of depressed
stroke patients in an effective and efficient manner (Murphy, Sarris & Byrne, 2017).
Moreover, the clinical healthcare guideline for post-stroke rehabilitation patient consists of a
management system for impaired cognition and perceptual deficit for the patients. This is
one of the essential components that provide clarity to the doctors of MPHC hospital in
implementing efficient diagnostic on depressed stroke patient (DAI, QU, LIU & YU, 2013).
According to the researchers, the Clinical health care guideline may get 7 points in the
AGREED rating mechanism.
Applicability
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The applicability part is concerned with the application of the recommendation in reality.
Besides that, different assessment and diagnosis techniques present in the clinical healthcare
guideline of post-stroke rehabilitation patient should be implemented effectively in practice
by the physicians (Kafri& Dickstein, 2016). The guideline must include monitoring and
auditing the criteria of the assessment and management techniques used to treat the depressed
ischemic stroke patient. According to the researchers, there is provision for improvement of
Assessment tools and diagnostic management in the health care guideline so it may get 6 in
the AGREED system of evaluation for applicability part (Kafri& Dickstein, 2016).
Editorial independence
The editorial independence suggests that the professional panel should make the appropriate
decision to formulate the health care guidelines in an effective manner. The funding body
must not influence the content that may decrease the effectiveness and efficiency of the
Guideline (Levitt, 2014). After proper analysis of the healthcare guideline for post-stroke
rehabilitation, it is seen that the formulation of the guideline is performed by expert panels.
According to researchers Health care guideline may get 6 points. This guideline may be
followed by the MPCH hospital to reduce the number of depressed stroke patient by a
significant margin (Levitt, 2014).
Summary
According to the AGREE system, there are six domains present on which the evaluation are
made. After the holistic evaluation of the healthcare guideline of post-stroke rehabilitation
patient, it is seen that the scope and the purpose of the guideline are perfect. The objectives
and the target audience of the guidelines are clear. In the stakeholder involvement section, the
guideline has included a multidisciplinary team of highly efficient professionals like doctors
and professors and administrators. On the other hand, public and patient's party's opinions
should be included in the guideline for the more holistic approach. In the clarity of
presentation, the proper management procedures to diagnose the depression in the post-stroke
patients (Gagliardi, 2014) are mentioned. Assessment and management are two most
significant components of the health care guideline. The assessment part comprises of the
different tools like hospital anxiety scale. This helps the physician to implement assessment
and effective diagnostic in the practical scenarios. Moreover, the applicability of the health
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care guideline may be prominently performed by individuals. In formulating the Healthcare
guideline for Post-stroke rehabilitation influence of funding authorities is avoided and
priorities are given to the ideas of the professional panel delegated for the job.
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Reference list
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