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Assessment of Physical Function

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81. Assessment and Management of Foot Ulcers for People with Diabetes, Second Edition

to the recommendation as a result of the systematic review evidence. ? The recommendation and/or supporting evidence were updated as a result of the systematic review evidence. NEW A new recommendation was developed as a result of the systematic review evidence*. PRACTICE RECOMMENDATIONS G LEVEL OF EVIDENCE Assessment 1 . 0 Obtain a comprehensive health history and perform physical examination of affected limb(s) . Ib – IV ? 1 . 1 Identify the location and classification of foot ulcer(s) and measure length, width (...) REGISTERED NURSES’ ASSOCIATION OF ONTARIO BACKGROUND Assessment and Management of Foot Ulcers for People with Diabetes, Second Edition Laura M. Teague, RN, MN, NP Panel Chair Nurse Practitioner, St. Michael’s Hospital, Lecturer, University of T oronto, Faculty of Nursing Adjunct Faculty, Western University – Faculty of Physical Therapy (Master of Clinical Science, Wound Healing) T oronto, Ontario Karen Bruton, RN, BScN, CETN(C) Professional Practice Leader, Northumberland Hills Hospital Cobourg, Ontario

2013 Registered Nurses' Association of Ontario

82. Assessment and Management of Pain (Third Edition)

analgesics; and ¦ Prevention, assessment and management of opioid risk . Ib ? Recommendation 3 .2 Evaluate any non-pharmacological (physical and psychological) interventions for effectiveness and the potential for interactions G with pharmacological interventions . Ib ? Recommendation 3 .3 Teach the person, their family and caregivers about the pain management strategies in their plan of care and address known concerns and misbeliefs G . Ib ?9 BEST PRACTICE GUIDELINES • www.RNAO.ca BACKGROUND Assessment (...) , 2008; Institute for Clinical Systems Improvement [ICSI], 2009). Nurses are required to intervene within their scope of practice to a person’s self-reported pain, and work with the person toward managing the pain appropriately. That means nurses must have the competencies to assess and manage pain, including knowledge and skills in interviewing techniques, and the ability to physically assess and manage pain in people who are not able to self report (Herr, Coyne, McCaffery, Manworren, & Merkel, 2011

2013 Registered Nurses' Association of Ontario

83. Falls - risk assessment

not give specific information on what a falls service should offer a person identified to be at risk of falling. However, the guideline does state that a personalized intervention aimed at promoting independence and improving physical and psychological function should be offered. Strength and balance training, home hazard and vision assessment and intervention, and medication review are common components in successful multifactorial intervention programmes [ ]. A Cochrane systematic review (search date (...) , and smoking. For more information, see the CKS topic on . A longitudinal study that examined the consequences of falls in older men and women found that 68% of people who fell reported some injury, 24% required healthcare, 35% reported functional decline, and more than 15% of people reported impairment of social and physical activities [ ; ]. Other complications of falls include distress, pain, loss of self-confidence, reduced quality of life, and loss of independence [ ; ]. In addition, falls can trigger

2019 NICE Clinical Knowledge Summaries

84. CVD risk assessment and management

assessment, an assessment of alcohol consumption, physical activity, cholesterol level, body mass index (BMI), an assessment for dementia in those aged 65-74 years, and screening for diabetes mellitus and chronic kidney disease in those at increased risk of developing these conditions. A person's 10 year CVD risk should be assessed using the QRISK assessment tool every 5 years (apart from people who already have CVD or are at high risk of developing it, or people aged 85 years or over). People with type (...) , optimizing treatment of relevant comorbidities, and by drug treatment, if appropriate. All people who have had a CVD risk assessment, should be given lifestyle advice, regardless of their risk score. This should include advice about: Smoking cessation. Weight loss if overweight or obese. Eating a healthy diet. Keeping alcohol consumption within the recommended limits. Being physically active. Statin treatment should be offered for the primary prevention of CVD to people with an estimated 10 year CVD risk

2019 NICE Clinical Knowledge Summaries

85. Perfusion Assessment in Critical Limb Ischemia: Principles for Understanding and the Development of Evidence and Evaluation of Devices: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

on the reduction of tissue perfusion, which is the primary pathophysiological problem and treatment target in CLI. Direct assessment of skin perfusion can be performed with fluorescent imaging of indocyanine green (ICG) and application of various transit rate functions, as well as indirectly by postocclusive skin perfusion pressure. , Techniques have also been developed that are able to quantify limb skeletal muscle perfusion with kinetic modeling of contrast-enhanced magnetic resonance, contrast-enhanced (...) clinicians on the expected degree of clinical improvement. Implicit in this application is that perfusion imaging or assessment of oxygenation will be an important asset in the development of new arterial revascularization strategies (ie, new devices or selection of surgical versus endovascular approach) or new drug, gene, or cell-based therapies that are designed to improve microvascular function. Figure 1. Examples of noninvasive techniques that have been used to assess the effect of revascularization

2019 American Heart Association

86. Assessing Fitness to Drive

to be a substantial reduction in the driver’s visual fields and possibly their perceptual abilities, thus increasing the risks of missing important visual information when driving. Advanced age, in itself, is not a barrier to driving, and functional ability rather than chronological age should be the criterion used in assessing the fitness to drive of older people. Age-related physical and mental changes vary greatly between individuals but will eventually affect the ability to drive safely. Professional (...) Assessing Fitness to Drive 2016 Contents Part A: General information 1 1. About this publication 3 1.1 Purpose 3 1.2 Target audience 3 1.3 Scope 3 1.4 Content 4 1.5 Development and evidence base 5 2. Principles of assessing fitness to drive 6 2.1 The driving task 6 2.2 Medical conditions and driving 7 2.3 Assessing and supporting functional driver capacity 12 3. Roles and responsibilities 15 3.1 Roles and responsibilities of driver licensing authority 16 3.2 Roles and responsibilities of drivers 17 3.3

2016 Cardiac Society of Australia and New Zealand

87. Assessment and Device Selection for Vascular Access

of therapy – Level Ib; Physical assessment – Level IV; Client health history – Level IV; Support system/resources – Level IV; Device availability – Level IV; and Client preference – Level IV. Client Education3 3. Nurses will discuss the options for vascular access devices with the client and family caregivers. Device selection is a collaborative process between the nurse, client, physician and other members of the health care team, however, the nurse has a role to educate and advocate for clients (...) , organizational and administrative support, as well as appropriate facilitation. Organizations may wish to develop a plan for implementation that includes: An assessment of organizational readiness and barriers to education. Involvement of all members (whether in a direct or indirect supportive function) who will contribute to the implementation process. Dedication of a qualified individual to provide the support needed for the education and implementation process. Ongoing opportunities for discussion

2004 Registered Nurses' Association of Ontario

88. Diarrhoea - adult's assessment

, liver function tests, calcium, vitamin B 12 and red blood cell folate, ferritin, thyroid function tests, ESR and CRP, and testing for coeliac disease. People with diarrhoea may require admission to hospital, referral using a suspected cancer pathway, or routine referral for further assessment and management depending on their presentation and the certainty of the diagnosis. Have I got the right topic? Have I got the right topic? From age 18 years onwards. This CKS topic covers the assessment (...) [ ]: Weight loss and bleeding — less likely to be a feature of irritable bowel syndrome or functional diarrhoea. Fever, bleeding, abdominal pain — indicate possible underlying inflammation. Systemic symptoms (for example, fatigue, night sweats, fever, weight loss) — suggest lymphoma. Assessment for an underlying cause This recommendation is extrapolated from the causes of chronic diarrhoea in the BSG guideline for the investigation of chronic diarrhoea in adults [ ], expert opinion in review articles

2018 NICE Clinical Knowledge Summaries

89. Oral Health: Nursing Assessment and Intervention

program, utilizing a variety of quantitative and qualitative approaches. 21. Organizations develop a plan for implementation of best practice guideline recommendations that include: ¦ An assessment of organizational readiness and barriers/facilitators. ¦ Involvement of all members (whether in a direct or indirect supportive function) who will contribute to the implementation process. ¦ Ongoing opportunities for discussion and education to reinforce the importance of best practices. ¦ Dedication (...) Oral Health: Nursing Assessment and Intervention Nursing Best Practice Guideline Shaping the Future of Nursing Oral Health: Nursing Assessment and Interventions December 2008Greetings from Doris Grinspun Executive Director Registered Nurses’ Association of Ontario It is with great excitement that the Registered Nurses’ Association of Ontario (RNAO) presents this guideline, Oral Health: Nursing Assessment and Interventions to the health care community. Evidence-based practice supports

2008 Registered Nurses' Association of Ontario

90. Assessment and Management of Venous Leg Ulcers

. . . . . . . . . . . . . . . . . . . . . . . . . . . .110 Appendix L – Description of the Toolkit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111 9 Nursing Best Practice GuidelineSummary of Recommendations RECOMMENDATION *LEVEL OF EVIDENCE Practice A. ASSESSMENT Recommendations 1. Assessment and clinical investigations should be undertaken by healthcare C professional(s) trained and experienced in leg ulcer management. 2. A comprehensive clinical history and physical examination including blood C pressure measurement, weight (...) of ulcers, at regular intervals, to monitor B Recommendations progress. Maximum length and width, or tracings onto a transparency are useful methods. 6. The client’s estimate of the quality of life should be included in the initial C discussion of the treatment plan, throughout the course of treatment, and when the ulcer has healed. 7. Assess the functional, cognitive and emotional status of the client and C family to manage self-care. 8. Regular ulcer assessment is essential to monitor treatment

2004 Registered Nurses' Association of Ontario

91. Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour

and stigma that may be associated with suicidality, mental illness and addictions. 4. The nurse provides care in keeping with the principles of cultural safety/cultural competence. 5. The nurse assesses and manages factors that may impact the physical safety of both the client and the interdisciplinary team. 6. a) The nurse recognizes key indicators that put an individual at risk for suicidal behaviour, even in the absence of expressed suicidality. For individuals who exhibit risk indicators, the nurse (...) in mental health nursing. 25. Organizations support research initiatives related to suicide and other mental health issues. 26. Organizations develop a plan for the implementation of best practice guideline recommendations that include: ¦ An assessment of organizational readiness and barriers to education. ¦ Involvement of all members (whether in a direct or indirect supportive function) who will contribute to the implementation process. ¦ Ongoing opportunities for discussion and education to reinforce

2009 Registered Nurses' Association of Ontario

92. Assessment and Interventions for Perinatal Depression

Assessment and Interventions for Perinatal Depression Best Practice Guideline Assessment and Interventions for Perinatal Depression Second Edition OCTOBER 2018Disclaimer These guidelines are not binding on nurses or the organizations that employ them. The use of these guidelines should be flexible and based on individual needs and local circumstances. They neither constitute a liability nor discharge from liability. While every effort has been made to ensure the accuracy of the contents (...) , reproduced, and published in its entirety, without modification, in any form, including in electronic form, for educational or non-commercial purposes. Should any adaptation of the material be required for any reason, written permission must be obtained from RNAO. Appropriate credit or citation must appear on all copied materials as follows: Registered Nurses’ Association of Ontario. Assessment and Interventions for Perinatal Depression. 2nd ed. Toronto (ON): Registered Nurses’ Association of Ontario

2018 Registered Nurses' Association of Ontario

93. Knee pain - assessment

Knee pain - assessment Knee pain - assessment - NICE CKS Share Knee pain - assessment: Summary Knee pain is a common condition, particularly in older people. Possible causes include osteoarthritis of the knee, injuries (such as muscle strain and fractures), tumours, referred pain from the hip or lumbosacral spine, and bursitis. Risk factors for knee pain include increasing age, obesity, knee-straining work and participation in sport. A person presenting with knee pain should be: Asked about (...) a history of trauma. Asked to describe the history of the pain and/or injury (including, type and duration of pain, aggravating and relieving factors, history of swelling). An examination of the knee should be carried out. If there is a history of trauma, an assessment for injuries including fracture, tendon rupture, ligament tears, neurovascular damage, and septic arthritis is required. Red flags should be considered for: Infection (septic arthritis or osteomyelitis). Tumours (bone tumour, soft-tissue

2017 NICE Clinical Knowledge Summaries

94. Headache - assessment

function The NICE clinical guideline on Suspected cancer: recognition and referral [ ] recommends that: An urgent direct access MRI scan of the brain (or CT scan if MRI is contraindicated) (to be performed within 2 weeks) should be considered to assess for brain or central nervous system cancer in adults with progressive, sub-acute loss of central neurological function. A very urgent referral (for an appointment within 48 hours) should be considered to assess for suspected brain or central nervous (...) system cancer in young people (birth to 24 years of age) with newly abnormal cerebellar or other central neurological function. Progressive headache A headaches that worsens with time may be the result of a progressive intracranial lesion such as tumour, subdural hematoma, or hydrocephalus. As neurological examination may not always be abnormal, the Institute for Clinical Systems Improvement recommend neuroimaging to assess for serious underlying causes in such cases [ ]. New onset headache over

2017 NICE Clinical Knowledge Summaries

95. Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition

://rnao.ca/bpg/guidelines/risk- assessment-and-prevention-pressure-ulcers) clinical BPG. Members of the interprofessional team include but are not limited to nurses, physical therapists, occupational therapists, physicians, and dietitians. The interprofessional team should work in collaboration with the person G with the pressure injury/injuries and the person’s circle of care—that is, paid and unpaid caregivers (e.g., personal support worker [PSW], developmental support worker [DSW], primary caregiver (...) evidence. NEW A new recommendation was developed based on evidence from the systematic review. PRACTICE RECOMMENDATIONS LEVEL OF EVIDENCE STATUS 1.0 Assessment Recommendation 1.1: Conduct a health history, a psychosocial history, and a physical exam on initial examination and whenever there is a signi? cant change in the person’s medical status. V ? Recommendation 1.2: Assess the risk for developing additional pressure injuries on initial examination and if there is a signi? cant change in the person’s

2016 Registered Nurses' Association of Ontario

96. Delirium, Dementia, and Depression in Older Adults: Assessment and Care, Second Edition

Recommendation 4 .2: Use clinical assessments and validated tools to assess older adults at risk for delirium at least daily (where appropriate) and whenever changes in the person’s cognitive function, perception, physical function, or social behaviour are observed or reported . Ia & V Recommendation 4 .3: Continue to employ prevention strategies when caring for older adults at risk for delirium who have not been identified as having delirium . Ia & VBACKGROUND Delirium, Dementia, and Depression in Older (...) Recommendation 6 .1a: Assess older adults for possible dementia when changes in cognition, behaviour, mood, or function are observed or reported . Use validated, context-specific screening or assessment tools, and collaborate with the person, his/her family/ care partners, and the interprofessional team for a comprehensive assessment . Recommendation 6 .1b: Refer the person for further assessment/diagnosis if dementia is suspected . Ia & V Ia Recommendation 6 .2: Assess the physical, functional

2016 Registered Nurses' Association of Ontario

97. Cerebral palsy in under 25s: assessment and management

1 in 3 children have specific difficulties with speech and language. The more severe the child's physical, functional or cognitive impairment, the greater the likelihood of difficulties with speech and language. Uncontrolled epilepsy may be associated with difficulties with all forms of communication, including speech. A child with bilateral spastic, dyskinetic or ataxic cerebral palsy is more likely to have Cerebral palsy in under 25s: assessment and management (NG62) © NICE 2019. All rights (...) at the following approximate prevalences in children with cerebral palsy: white matter damage: 45% basal ganglia or deep grey matter damage: 13% congenital malformation: 10% focal infarcts: 7%. 1.2.2 When assessing the likely cause of cerebral palsy, recognise that white matter damage, including periventricular leukomalacia shown on neuroimaging: is more common in children born preterm than in those born at term may occur in children with any functional level or motor subtype, but is more common in spastic

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

98. Mental health problems in people with learning disabilities: prevention, assessment and management

and interventions for family members and carers 11 1.5 Social and physical environment interventions 11 1.6 Annual health check 12 1.7 Identification and referral 13 1.8 Assessment 14 1.9 Psychological interventions 20 1.10 Pharmacological interventions 22 1.11 Occupational interventions 25 T erms used in this guideline 26 Putting this guideline into practice 29 Context 31 More information 32 Recommendations for research 33 1 Develop case identification tools for common mental health problems 33 2 Psychological (...) of the mental health problem, and any physical health problems (including sensory impairments). Mental health problems in people with learning disabilities: prevention, assessment and management (NG54) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 7 of 381.2.8 All people with learning disabilities and a serious mental illness should have a key worker who: coordinates all aspects of care, including safeguarding concerns

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

99. Eye movement assessment protocol

the responses from each side equally (if at all) and therefore this would not affect any canal paresis measurement although it might affect interpretation of any results suggesting hyper / hypo function. Draft recommended procedure (for consultation) British Society of Audiology Eye movement assessment 2013 © BSA 2013 8 4.3. Room and recording conditions 198 4.3.1. Recording conditions 199 The optimal condition for recording eye movements in the absence of visual 200 fixation is with the eyes open (...) required for each ocular-motor function test. Light to dark and dark to light 370 adaptation is non-linear (Davson, 1962) and not always predictable. Therefore if 371 there is any doubt, recalibration is advisable. 372 373 374 Draft recommended procedure (for consultation) British Society of Audiology Eye movement assessment 2013 © BSA 2013 13 Ch1 Ch2 Common + - + - 375 376 377 378 Figure 1-A Binocular Eye Recordings. Ch1 Ch2 Common + - + - Ch1 Ch2 Common + - + - Figure 1-B Monocular Eye Recordings

2014 British Society of Audiology

100. Hyperhidrosis and bromhidrosis. A guide to assessment and management.

be considered for late onset, recent onset or very severe hyperhidrosis • Blood tests – full blood count – electrolytes and renal function tests – liver function tests – thyroid function tests – HIV serology – fasting blood glucose level • Testing for specific infectious diseases as suggested by the history (eg. tuberculosis) • 24 hour urinary catecholamines FOCUS Hyperhidrosis and bromhidrosis – a guide to assessment and management 268 Reprinted from AustRAliAn F Amily PhysiciAn Vol. 42, no. 5, mA y 2013 (...) Hyperhidrosis and bromhidrosis. A guide to assessment and management. Embarrassing problems 266 Reprinted from AustRAliAn F Amily PhysiciAn Vol. 42, no. 5, mA y 2013 Hyperhidrosis and bromhidrosis A guide to assessment and management Background Hyperhidrosis and bromhidrosis are two common conditions, which are troublesome for patients and carry a significant psychosocial burden. Objective This article details an approach to the assessment and management of hyperhidrosis and bromhidrosis

2013 Clinical Practice Guidelines Portal

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