The Journal and Guidelines

Excerpt

How often do you use a guideline when deciding on the best practice in your patient? I would certainly hope you do frequently. There are those who argue there is limited success of clinical practice guidelines in changing decision making—or even changing an attitude. In the extreme position, guidelines are considered to create uncertainty where certainty supposedly existed before and it may determine policy. And then of course the question begs who is the expert panel and on the bases of what qualifications? Interpretation of a guideline as an undisputed directive or even standard of care is part of the problem. Guidelines are provided as an educational service to practicing neurointensivists and adherence to guidelines remains voluntary. …