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41. Workplace health: long-term sickness absence and capability to work

not currently employ yed ed 1.8.1 Commission an integrated programme to help people receiving benefits who have a health condition or disability to enter or return to work (paid or unpaid). The programme should include a combination of interventions such as: an interview with a trained adviser to discuss the help they need to return to work vocational training (for example help producing a CV, interview training and help to find a job or a work placement) a condition management component run by local health (...) and disability). However, fit notes are currently only completed by medical practitioners and the recommendation reflects the situation at the time of publication (November 2019). There was evidence from a small number of UK studies that showed there can be challenges for GPs in completing fit notes. GPs may feel that they do not have the occupational health experience or the knowledge of the workplace needed to make suggestions about workplace adjustments. The committee discussed that other medical

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

42. Depression in children and young people: identification and management

1.1.21 Healthcare professionals specialising in depression in children and young people should work with local child and adolescent mental health services (CAMHS) [1] to enhance specialist knowledge and skills regarding depression in these existing services. This work should include providing training and help with guideline implementation. [2005] [2005] 1.1.22 CAMHS and local healthcare commissioning organisations should consider introducing a primary mental health worker (or CAMHS link worker (...) or young person's depression, CAMHS, primary care and educational professionals should work collaboratively to prevent bullying and to develop effective antibullying strategies. [2005] [2005] 1.1.29 Psychological therapies used in the treatment of children and young people with depression should be provided by therapists who are also trained in child and adolescent mental health. [2005] [2005] 1.1.30 Psychological therapies used in the treatment of children and young people with Depression in children

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

43. Crohn’s disease: management

and Harvey-Bradshaw Index, healthcare professionals should take into account any physical, sensory or learning disabilities, or communication difficulties that could affect the scores and make any adjustments they consider appropriate. [2010] [2010] 1.2.20 Treatment with infliximab or adalimumab should only be started and reviewed by clinicians with experience of TNF inhibitors and of managing Crohn's disease. [2010] [2010] Ustekinumab and v Ustekinumab and vedolizumab edolizumab 1.2.21 For guidance (...) with any concerns about the disease and its treatment, including concerns about body image, living with a chronic illness, and attending school and higher education. [2012] [2012] 1.2 Inducing remission in Crohn's disease Monother Monotherap apy y 1.2.1 Offer monotherapy with a conventional glucocorticosteroid (prednisolone, methylprednisolone or intravenous hydrocortisone) to induce remission in people with a first presentation or a single inflammatory exacerbation of Crohn's disease in a 12-month

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

44. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management

to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 38Contents Contents Overview 4 Who is it for? 4 Recommendations 5 1.1 Rapid recognition of symptoms and diagnosis 5 1.2 Imaging for people who have had a suspected TIA or acute non-disabling stroke 6 1.3 Specialist care for people with acute stroke 7 1.4 Pharmacological treatments and thrombectomy for people with acute stroke 8 1.5 Maintenance or restoration of homeostasis 12 1.6 Nutrition and hydration 14 (...) or acute non-disabling stroke 24 Thrombectomy for people with acute ischaemic stroke 25 Blood pressure control for people with acute intracerebral haemorrhage 28 Optimal positioning for people with acute stroke 30 Early mobilisation for people with acute stroke 30 Decompressive hemicraniectomy for people with acute stroke 31 Context 34 Finding more information and resources 36 Update information 37 Stroke and transient ischaemic attack in over 16s: diagnosis and initial management (NG128) © NICE 2019

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

45. Suspected neurological conditions: recognition and referral

with training and experience in the use of this test is available. 1.2.3 For adults with sudden-onset acute vestibular syndrome who have had a HINTS test: be aware that a negative HINTS test makes a diagnosis of stroke very unlikely refer immediately for neuroimaging if the HINTS test shows indications of stroke (a normal head impulse test, direction-changing nystagmus or skew deviation). 1.2.4 Refer immediately adults with sudden-onset acute vestibular syndrome in whom benign paroxysmal positional vertigo (...) or postural hypotension do not account for the presentation, in line with local stroke pathways, if a healthcare professional with training and experience in the use of the HINTS test is not available. Sudden-onset dizziness with no imbalance or focal neurological deficit Sudden-onset dizziness with no imbalance or focal neurological deficit 1.2.5 Be aware that dizziness in adults with no imbalance or other focal neurological deficit is unlikely to indicate a serious neurological condition. V Vertigo

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

46. Intrapartum care for women with existing medical conditions or obstetric complications and their babies

monitoring of fluid input and output (with at least 4-hourly assessment by a senior clinician), blood pressure, pulse, respiratory rate and oxygen saturation continuous electrocardiogram (ECG) and pulse oximetry with interpretation by trained staff continuous intra-arterial blood pressure monitoring cardiac output monitoring with non-invasive techniques, or serial echocardiography by trained staff. Advise women who need intensive monitoring that this may have to be carried out in an intensive care unit (...) a chest X-ray. 1.3.28 If clinical suspicion of heart failure in the intrapartum period cannot be ruled out by the investigations in recommendation 1.3.27, arrange: review by a cardiologist (with interim review by a healthcare professional with expertise in this area if a cardiologist is not immediately available) a transthoracic echocardiogram by a trained technician or cardiologist measurement of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. 1.3.29 Consider early birth for women

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

47. Cerebral palsy in adults

that allow adults with cerebral palsy access to a local network of care that includes: advocacy support learning disability services mental health services orthopaedic surgery (and post-surgery rehabilitation) rehabilitation engineering services rehabilitation medicine or specialist neurology services Cerebral palsy in adults (NG119) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 64secondary care expertise (...) needs (such as Gross Motor Function Classification System [GMFCS] levels IV and V) and any of the following: communication difficulties learning disabilities living in long-term care settings living in the community without sufficient practical and social support (for example, being cared for by elderly, frail parents) multiple comorbidities. 1.1.14 Discuss with the person with cerebral palsy (and their family and carers, if agreed) what information should inform the regular or annual review

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

48. Fever in under 5s: assessment and initial management

with feverish illness for the presence or absence of symptoms and signs that can be used to predict the risk of serious illness using the traffic light system (see table 1). [2013] [2013] 1.2.4 When assessing children with learning disabilities, take the individual child's learning disability into account when interpreting the traffic light table. [2013] [2013] 1.2.5 Recognise that children with any of the following symptoms or signs are in a high-risk group for serious illness: pale/mottled/ashen/blue skin (...) practitioner is defined as a healthcare professional who has not had specific training or who does not have expertise in the assessment and treatment of children and their illnesses. This term includes healthcare professionals working in primary care, but it may also apply to many healthcare professionals in general emergency departments. Clinical assessment Clinical assessment 1.4.1 Management by a non-paediatric practitioner should start with a clinical assessment as described in section 1.2. Healthcare

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

49. End of life care for adults: service delivery

reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 351.4 1.4 Pro Providing information viding information 1.4.1 For advice on communication, information and shared decision making, see the NICE guidelines on patient experience in adult NHS services and people's experience in adult social care services. Apply the same principles for communication and information giving to carers of all ages. 1.4.2 For people with learning disabilities, use (...) this guideline alongside the recommendations on end of life care in the NICE guideline on care and support of people growing older with learning disabilities. 1.4.3 Support and enable adults approaching the end of their life to actively participate in decision making by having in place: processes to establish the amount and type of information they would prefer systems to provide information in a way that meets their communication needs and preferences, for example, how it is given (verbally, on paper

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

50. Specialist neonatal respiratory care for babies born preterm

need invasive ventilation for stabilisation in the early postnatal period. 1.2.3 When giving surfactant [1] to a preterm baby who does not need invasive ventilation, use a minimally invasive administration technique. If this is not possible, for example, in units without the facilities or trained staff to carry out these techniques, use endotracheal intubation to give surfactant, with early extubation afterwards. T o find out why the committee made the recommendations on giving surfactant and how (...) psychological support from a professional who is trained to deliver this type of help and advice. Specialist neonatal respiratory care for babies born preterm (NG124) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 16 of 53Pro Providing information to parents and carers while their preterm bab viding information to parents and carers while their preterm baby is on y is on respir respiratory support atory support 1.6.9 Ask

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

51. Canadian Stroke Best Practice recommendations: rehabilitation, recovery, and community participation following stroke. Part one: rehabilitation and recovery following stroke; 6th edition update 2019

education, training, and access to resources to assist the patient with ADL and increase the patient’s level of independence (Evidence Level B). (xi) Patients in stroke rehabilitation should be considered for referral to transition planners (such as stroke navigators) where these roles are available (Evidence Level B). Refer to Transitions and Community Participation module for additional information 20 International Journal of Stroke, 0(0) 8 International Journal of Stroke 0(0)continuingrehabilitation (...) (Evidence Level: Early-Level C; Late-Level C). (xiii) Retraining trunk control should accompany functional training of the affected upper extremity (Evidence Level C). C. Adaptive devices (i) Adaptive devices designed to improve safety and function may be considered if other methods of performing specific functional tasks are not available or tasks cannot be learned (Evidence Level C). (ii) Functional dynamic orthoses may be offered to patients to facilitate repetitive task-specific training (Evidence

2020 CPG Infobase

52. Promoting patient utilization of outpatient cardiac rehabilitation: ajoint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement

Health, The University of British Columbia, Vancouver, British Columbia, Canada (Dr Sarrafzadegan); Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran (Dr Sarrafzadegan); Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India (Dr Babu); Department of Physiotherapy, Kathmandu University, Dhulikhel Hospital, Dhulikhel, Nepal (Ms Baidya); University Centre (...) , Gregorio Marañón Health Research Institute, Madrid, Spain (Dr Supervia); Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota (Dr Supervia); Philippine Heart Association, Pasig City, Philippines (Dr Trani); Cardiology Department, Hospital Santa Maria, CHLN, Lisbon, Portugal (Dr Abreu); Medical School of University of Lisbon, Lisbon, Portugal (Dr Abreu); Public Education and Special Projects, Cardiac Health Foundation of Canada, Toronto, Ontario

2020 CPG Infobase

53. Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience

housing services for specific marginalized populations, for example, Indigenous people, women and families, youth, those who identify as LGBTQ2+, those with disabilities, refugees and migrants. Strong recommendation Recommendation 2: A homeless or vulnerably housed person with experience of poverty, income instability or living in a low-income household Low certainty ???? • Identify income insecurity. • Assist individuals with income insecurity to identify income-support resources and access income (...) . Clinical considerations: Consult poverty screening tools when needed (e.g., https://cep.health/clinical-products /poverty-a-clinical-tool-for-primary-care-providers). Conditional recommendation Recommendation 3: A homeless or vulnerably housed person with multiple comorbid or complex health needs (including mental illness and/or substance use) Low certainty ???? • Identify history of severe mental illness, such as psychotic or mood and anxiety disorders, associated with substantial disability

2020 CPG Infobase

54. Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement Full Text available with Trip Pro

Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement - ScienceDirect JavaScript is disabled on your browser. Please enable JavaScript to use all the features on this page (...) translated into implementable recommendations, using best practices. • Implementation tools include an online course to educate inpatient care providers. • Patient preferences and barriers should be considered to optimize use. Abstract Background Cardiac Rehabilitation (CR) is a recommendation in international clinical practice guidelines given its' benefits, however use is suboptimal. The purpose of this position statement was to translate evidence on interventions that increase CR enrolment

2020 CPG Infobase

55. Decision-making and mental capacity

decisions, for example, about their personal welfare, medical treatment, property or affairs facilitating their involvement in decisions that may be made, or are being made under the Mental Capacity Act 2005. 1.1.8 As a minimum, independent advocacy must be offered by local authorities as described in the Care Act 2014, Mental Capacity Act 2005 and Mental Health Act 2007. [This recommendation is adapted from the NICE guideline on learning disabilities and behaviour that challenges: service design (...) investment in training for statutory independent mental capacity and other statutory advocates in key areas, in order to ensure they are able to support: Decision-making and mental capacity (NG108) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 10 of 41people who have communication difficulties and and Independent Mental Capacity Advocates to have expertise in specific areas that require additional skills and knowledge

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

56. Flu vaccination: increasing uptake

such as oncology or antenatal. Social care staff who may have contact with carers and other eligible groups, such as people with learning disabilities. This may include during home visits, individual needs assessments and carers' assessments. Flu vaccination: increasing uptake (NG103) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 731.2.2 Provide information on the following as part of an education programme on flu (...) of health and social care staff and support workers – there are national minimum standards for these groups (see national minimum standards and core curriculum for immunisation training for registered healthcare practitioners, the Royal College of Nursing's Immunisation knowledge and skills competence assessment tool, and Immunisation training of healthcare support workers: national minimum standards and core curriculum). Health Education England's eLearning for Healthcare platform has produced

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

57. Pancreatitis

with acute, chronic or hereditary pancreatitis welfare benefits, education and employment support, and disability services. 1.1.4 For more guidance on giving information, including providing an individualised approach and helping people to actively participate in their care, see the NICE guideline on patient experience in adult NHS services. 1.1.5 Explain to people with severe acute pancreatitis, and their family members or carers (as appropriate), that: a hospital stay lasting several months (...) on diagnosing and managing diabetes in children and young people NICE's technology appraisal guidance on continuous subcutaneous insulin infusion for the treatment of diabetes mellitus. 1.3.18 For guidance on education and information for people with pancreatitis and type 3c diabetes requiring insulin, see the recommendations on education and information in the NICE guideline on diagnosing and managing type 1 diabetes in adults, and education and information in the NICE guideline on diagnosing and managing

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

58. Preventing suicide in community and custodial settings

initiatives can be reintroduced. 1.2.6 Oversee provision and delivery of training and evaluate effectiveness. Multi-agency partnerships in the community Multi-agency partnerships in the community 1.2.7 Consider collaborating with neighbouring local authorities to deliver a single strategy. 1.2.8 Consider advising local institutions and organisations on what to include in their contingency plans for responding to a suicide. This includes: schools, universities, further and higher education institutions (...) (this includes providing details of where they can get this help) take into account socioeconomic deprivation, disability, physical and mental health status, and cultural, religious and social norms about suicide and help-seeking behaviour, particularly among groups at high suicide risk. T o find out why the committee made the recommendations on training by suicide prevention partnerships and how they might affect practice, see rationale and impact. 1.8 Supporting people bereaved or affected by a suspected

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

59. Community pharmacies: promoting health and wellbeing

the professional characteristics of pharmacy staff affect the effectiveness and cost effectiveness of delivering information, advice, education or behavioural support to underserved groups and the general population? (Characteristics include, for example, job roles such as health champion, as well as competencies and level of training.) T o find out why the committee made the research recommendation on the characteristics of a person delivering an intervention, see rationale and impact. More details about how (...) behaviour change training may be available, for example from Health Education England and the Centre for Pharmacy Postgraduate Education. Full details of the evidence and the committee's discussion are in the evidence discussion for sections 1.1 and 1.2. Return to recommendations Awareness raising and providing information Recommendations 1.3.1 and 1.3.2 Community pharmacies: promoting health and wellbeing (NG102) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

60. Attention deficit hyperactivity disorder: diagnosis and management

, including any learning disabilities, sight or hearing problems, delays in language development or social communication difficulties takes into account any coexisting neurodevelopmental and mental health conditions is tailored to their individual needs and circumstances, including age, gender, educational level and life stage. [2018] [2018] Supporting families and carers Supporting families and carers 1.4.6 Ask families or carers of people with ADHD how the ADHD affects themselves and other family (...) , as well as group-based ADHD-focused support. [2018] [2018] 1.5.12 Consider individual parent-training programmes for parents and carers of children and young people with ADHD and symptoms of oppositional defiant disorder or conduct disorder when: there are particular difficulties for families in attending group sessions (for example, because of disability, needs related to diversity such as language differences, learning disability [intellectual disability], parental ill-health, problems

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

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