Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with ...

Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease (COPD)Pauwels, R. A., Buist, A. S., Jenkins, C. R., Hurd, S. S., & the GOLD Scientific Committee (2001). Globalstrategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease:National Heart, Lung, and Blood Institute and World Health Organization Global Initiative for ChronicObstructive Lung Disease (GOLD): Executive summary. Respiratory Care, 46(8), 798-825.Veterans Health Administration (2000). VHA/DOD clinical practice guideline for the management ofchronic obstructive pulmonary disease. Clinical Practice Guidelines Office of Quality andPerformance [Electronic version]. Available: http://www.oqp.med.va.gov/cpg/COPD/COPD_base.htmIt is acknowledged that nursing care of dyspnea in individuals with COPD needs to be studied in a moreclearly defined way, and that there are gaps in the research evidence. However, this guideline will enablenurses to apply the best available evidence to clinical practice, and to promote a more appropriate use ofhealthcare resources.The panel members divided into subgroups to undergo specific activities using the short-listed guidelines,other literature and additional resources for the purpose of drafting recommendations for nursinginterventions. This process yielded a draft set of recommendations. The panel members as a whole reviewedthe recommendations, discussed gaps, available evidence, and came to a consensus on a draft guideline.This draft was submitted to a set of external stakeholders for review and feedback of the content. It was alsocritiqued using the AGREE instrument. An acknowledgement of these reviewers is provided at the front ofthis document. Stakeholders represented healthcare consumers, various healthcare disciplines as well as aprofessional association. External stakeholders were provided with specific questions for comment, as wellas the opportunity to give overall feedback and general impressions. The results were compiled andreviewed by the development panel. Discussion and consensus resulted in revision to the draft documentprior to publication.Definition of TermsAn additional Glossary of Terms related to clinical aspects of the guideline is located in Appendix B.Clinical Practice Guidelines or Best Practice Guidelines: Systematically developedstatements (based on best available evidence) to assist practitioner and patient decisions aboutappropriate healthcare for specific clinical (practice) circumstances (Field & Lohr, 1990).Consensus: A process for making policy decisions, not a scientific method for creating newknowledge. At its best, consensus development merely makes the best use of available information,be that of scientific data or the collective wisdom of the participants (Black et al., 1999).16