This assignment is focused on a schizophrenia clinical guideline. According to NICE (2009) Clinical guidelines are “recommendations on the appropriate treatment and care of people with specific diseases and conditions within the NHS in England and Wales”. Clinical guidelines are based on the best available evidence. Guidelines help healthcare professionals in their work, but they do not replace their knowledge and skills. The chosen guideline is called core interventions of schizophrenia in adults in primary and secondary care (March 2009). This guideline is from NICE it was the most up to date schizophrenia guideline in Britain. This assignment has been divided into three parts. The first part the assignment analysis and briefly summaries the chosen clinical guideline schizophrenia. Part two will focus on one chosen aspect of schizophrenia treatment. Cognitive behavioural treatment (CBT) will be the main focus. CBT will be critically discussed and this will be done through evidence based practice experience and literature evidence. Finally Part three of the assignment will focus on how the schizophrenia guideline can be implemented in practice by nurses, and discuss the benefits and limitations of clinical guideline schizophrenia.
The two main clinical guideline developers in the UK are the National Institute for Health and Clinical Excellence (NICE) guideline over the Scottish Intercollegiate Guidelines Network (SIGN). Both NICE and SIGN are members of the Appraisal of guidelines, Research and Evaluation (AGREE). Therefore the two developers use the same basic principles to develop recommendations based on a systematic review appraisal of the evidence. The difference between the two is that NICE develops guidance through Diagnostic Assessment programme where as a SIGN develops guidance in methodology way. However they both aim to provide the highest quality guidance to the National Health Services (NHS) The author’s main advantage for choosing a NICE guideline over SIGN is that it provided the most up to date clinical guideline of schizophrenia. Therefore the people who will use the guideline will have improved knowledge and skills based on current new evidence. Another main point is that NICE provides authoritative clinical guidance for the national health services in England and Wales whereas Sign only develops clinical guideline for Scotland.
Schizophrenia is a major psychiatric disorder, or cluster of disorders, characterised by psychotic symptoms that alter a person perception, thought, affect, and behaviour “NICE clinical guideline 82- schizophrenia 03-2009”. Schizophrenia has been described as “a mental illness which occurs when the parts of the brain responsible for emotion and sensation stop working properly” (Rethink 2011). However each person with schizophrenia disorder will experience a mixture of unique symptoms. Schizophrenia symptoms are grouped into positive or psychotic and negative symptoms (mental health foundation 2012). Negative symptoms include memory loss, lack of concentration, unusual behaviours and ideas, problems with communication, social withdrawal and reduced interest in daily activities. According to Barker (2008) positive symptoms include delusions. Delusions are linked to a fixed belief associated with the person changed perception of reality. Therefore this suggests that a person with schizophrenia may believe he or she is being chased by someone or something when it’s not really happening in reality. Another positive symptom is hallucinations. Hallucinations are linked to experiences that are not based in reality (Pilgrim, 2009). They can experience hearing voices that other people don’t hear usually saying negative, critical, or frightening things. ‘The core interventions of schizophrenia in adults in primary and secondary care guideline’ this guideline covers the treatment and management of schizophrenia in adults between the age...
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