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best practice guidelines

GLA:D® Back

Teaser: 

Brandyn Powelske, PhD Candidate, 1 Greg Kawchuk, 2 Ted Findlay,3

1 Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta.
2 Professor, Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta.
3Medical Staff, Calgary Chronic Pain Centre at Alberta Health Services, Calgary. Alberta.

CLINICAL TOOLS

Abstract: While low back pain is one of the most common clinical conditions seen in a family physician's office, there remains a lack of low or no cost initial treatment options that are concordant with recognized best practice guidelines. As a result, many patients are offered investigations and treatments that have limited value and/or significant risks but are readily available through publicly funded provincial health care systems. GLA:D® Back builds upon the successful GLA:D model (initially developed for hip and knee osteoarthritis patients) by using the same established methodology to deliver a patient education and targeted rehabilitation program for low back pain.
Key Words: low back pain; best practice; guidelines; education; rehabilitation.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

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Pre-test CME Quiz Post-test CME Quiz
1. Low Back Pain remains one of the most seen conditions in a family medical practice, and chronic low back pain the leading cause of ongoing disability
2. There are significant patient financial and access barriers to treatment modalities most consistently recommended in practice guidelines: education and activity/rehabilitation-based therapies.
3. GLA:D Back presents a validated option that can help close the gap between recommended treatments for low back pain and access through a primary care practice.
4. GLA:D Back is an extension of the well-recognized and widely used GLA:D program for hip and knee osteoarthritis.
In the absence of clinical "Red Flags", avoid ordering unnecessary imaging when the results are not needed for investigating an established clinical diagnosis or to initiate a therapeutic procedure.
When considering pharmacotherapeutic options, remember that the Institute for Safe Medical Practices (Canada Institute for Safe Medication Practices Canada notes that opioids should generally be avoided in the treatment of low back pain, headache and fibromyalgia.
The Covid-19 Pandemic has taught us that many group based education and rehabilitation-based programs can be effectively delivered in a virtual format.
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Related Terms: Back Health, low back pain, best practice guidelines, education, rehabilitation

The Experience of Implementing Nursing Best Practice Guidelines for the Screening of Delirium, Dementia and Depression in the Older Adult

The Experience of Implementing Nursing Best Practice Guidelines for the Screening of Delirium, Dementia and Depression in the Older Adult

Teaser: 

Rola Moghabghab, RN, MN,1 Lori Adler, RN, MHSc,2 Carol Banez, RN, MAN,1 Faith Boutcher RN, MSc,3 Athina Perivolaris, RN, MN,3 Donna-Michelle Rancoeur, RN, MSc(A),3 Donna Spevakow, RN, MSN,3 Sandra Tully, RN, MAEd,1 Susan Wallace, RN, MSc3 and Kevin Woo, RN, MSc.4

1Advanced Practice Nurse, University Health Network; 2Administrative Director, Regional Geriatric Program, Toronto Rehabilitation Institute; 3Advanced Practice Nurse, Toronto Rehabilitation Institute; 4Advanced Practice Nurse, Mount Sinai Hospital; Toronto, ON.

Confusion related to dementia, delirium and/or depression is a common concern in the older adult. The Registered Nurses Association of Ontario Best Practice Guideline (BPG),"Screening for Delirium, Dementia and Depression in the Older Adult", was implemented as a pilot project by Advanced Practice Nurses on eight different units at Toronto Rehabilitation Institute, University Health Network and Mount Sinai Hospital. This article describes the development of the BPG and its implementation, including the design of an education program and a screening process to assist nurses. Discussion focuses on the facilitators and barriers to BPG implementation and effecting sustainable change in practice.

Related Terms: Mental Health, best practice guidelines, delirium, dementia, depression, evidence-based medicine