The interventions in the Primary Clinical Care Manual (PCCM) are based on the best available evidence and information on best practice from experienced health professionals working in rural and isolated practice areas and Sexual and Reproductive Health Programs throughout Queensland and New South Wales. The contents are not an exhaustive list of situations that may confront Registered Nurses, Indigenous Health Workers and Paramedics, but rather, those they most commonly encounter.
The importance of the balance between clinical expertise and the evidence base for clinical decision making is explored in the following extract of an editorial from the British Medical Journal:
| Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients. …External clinical evidence can inform, but can never replace, individual clinical expertise, and it is this expertise that decides whether the external evidence applies to the individual patient at all and, if so, how it should be integrated into a clinical decision. Similarly, any external guideline must be integrated with individual clinical expertise in deciding whether and how it matches the patient's clinical state, predicament, and preferences, and thus whether it should be applied. (From an editorial in the British Medical Journal on 13th January 1996 (BMJ 1996; 312: 71-2 written by Rosenberg WMC, Richardson WS, Haynes RB, Sackett DL.) |
The Therapeutic Guidelines1 were used extensively to review the PCCM. The Therapeutic Guidelines are disease-oriented guidelines for prescribing that provide clear, practical, succinct and up-to-date recommendations for therapy. Non-drug options are given where appropriate. The Therapeutic Guidelines are based on the latest international literature, interpreted by some of Australia’s most eminent and respected experts, with input from an extensive network of general practitioners and other users. The Therapeutic Guidelines are characterised by their:
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We welcome your comments on this edition and your contribution to future editions.
Please write or e-mail to:
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Director |
Director of Medical Services, RFDS | |
| Workforce Directorate - | or | 12 Casuarina Street |
| Northern Area Health Service | Brisbane Airport, 4007 | |
| PO Box 902 | rfds_bne@rfdsqld.com.au | |
| Cairns 4870 |
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