Criterion 1.4.1 Evidence based practice
Our health service ensures that our approaches to common and serious conditions are consistent with best available evidence.
► A. Our health service can demonstrate that we have ready access to a range of current references relevant to primary care (including mental healthcare, drug withdrawal and opiate management guidelines and blood borne virus management) (direct observation).
► B. There is evidence in our patient health records that our health service provides care of common and serious conditions that is consistent with clinical practice based on best available evidence (health records review).
► C. Our medical and other clinical staff can describe how they ensure their approaches to common and serious conditions are broadly consistent with clinical practice based on best available evidence (interview).
► D. Our medical and other clinical staff can describe and access clinical practice guidelines used to assist in the management of serious and common conditions (interview).
E. Our health service staff can explain how they access guidelines for the specific clinical care of patients who are identified as Aboriginal or Torres Strait Islander (interview).
Contemporary practice is based on best available evidence in the current Australian context. This criterion recognises that, in the absence of well conducted clinical trials or other higher order evidence, the opinion of consensus panels of peers is an accepted level of evidence and may be the best available evidence at that time. Health service staff may consider conducting research to increase the evidence relevant to patient health status and outcomes in the prison setting.
Clinical practice guidelines must be up-to-date and may include recommendations from sources such as:
It may be helpful for medical staff – especially those undertaking procedural work and minor surgery – to use the Safety Every Time – Our General Practice Checklist (www.racgp.org.au/safety) or an equivalent protocol that incorporates the five safety steps. Compliance with the protocol reduces the risk of error for medical staff who perform procedures.
Medical and other clinical staff will find it valuable – both for treating patients and for their professional development – to have access to resources about a range of clinical issues, including care provided to patients in prisons. These resources may include paper based resources (eg. text books and peer reviewed journals) as well as electronic resources (eg. access via the internet or CD-ROM). Useful resources may relate to clinical matters (eg. infectious diseases or mental health), information about cultural beliefs, health practices of various cultural groups, and might not be limited to what the profession would generally consider to be references on ‘evidence based practice’.
This criterion does not necessarily require access to the most recent editions of texts, materials or publications, nor does it require those resources to be in electronic format. However, resources need to contain information that is consistent with current practice and not recommend management that is no longer applicable.