Clinical Practice Guideline

							                              CLINICAL PRACTICE GUIDELINE

                                        DOCUMENT TITLE

1.      INTRODUCTION (Mandatory)
This section may include a background to the Clinical Practice Guideline and why is has come about.

2.       PURPOSE (Mandatory)
Lists the aims of the procedure.

3.      DEFINITIONS
Includes definitions of terms used in the Clinical Practice Guideline.

4.       RELATED POLICIES/ CLINICAL PRACTICE GUIDELINES (Mandatory)
List here for cross referencing to other current policies or Clinical Practice Guidelines.

5.       RESPONSIBILITIES
5.1.     Employer - Details the responsibilities for ensuring that the Clinical Practice Guideline is adhered
         to.
5.2.     Departmental - Details the responsibilities of the Department/Unit involved, eg assisting
         Department Heads to enforce the Clinical Practice Guideline.
5.3.     Department Head/Manager - Details the responsibilities of Managers/Supervisors in            relation to
the Clinical Practice Guideline.
5.4.     Employee - Details the responsibilities of all employees in relation to the Clinical Practice Guideline,
         including compliance with the Policies and Clinical Practice Guidelines.

6.         INDICATIONS AND CONTRAINDICATIONS

7.         CLINICAL CONSIDERATIONS

8.         REQUIREMENTS

9.         CLINICAL PRACTICE GUIDELINE (Mandatory)

10.        COMPLICATIONS

11.     EVALUATION
A range of tools will be used to evaluate procedure compliance. Feedback systems such as incident reports,
complaints, performance indicators and specific audit will be used to facilitate evaluation of compliance.
Feedback should be linked with the Clinical Practice Guideline review process.

12.      REFERENCES (Mandatory)
All relevant material utilised in developing the procedure must be referenced here including evidence to
support best practice, eg relevant legislation, professional standards, other policies etc.

13.      PROCEDURE HISTORY (Mandatory if name of document is changed)
All previous versions of this procedure are to be highlighted here.

14.        KEY PERFORMANCE INDICATORS/ OUTCOME


     Page Number                Page 1 of 1
     Date Created / Revised     9/2008
     Next Revision              Month Year
     Executive Sponsor          Executive Director of
     Coordinator                Expert Owner
     Approved by                Approval Body/ Committee