PHECC’s Education and Training Standards (2007) identified six clinical levels all of which required CPGs to inform practice. The Realignment project was established within PHECC to manage the process of developing and updating the 3rd Edition CPGs.
CPG development and approval process
The initial drafting of each CPG is completed by a PHECC Programme Development Officer. This initial draft CPG is then subject to review by the clinical staff within PHECC and updated accordingly. These draft CPGs are then presented to the Medical Advisory Group (MAG) for review. Feedback is received from the MAG and the CPGs are updated to reflect this. Each draft CPG is then subject to a Delphi process. This process enables MAG members to consider each draft CPG and to vote on each by choosing one of five voting options (see Delphi Score below). If a MAG member ‘strongly disagrees’ or ‘disagrees’ with a draft CPG he/she is required to outline why. These results are then presented at a further MAG meeting with each reason for disagreement being discussed. The MAG agree changes based on evidence presented and discussions on the Delphi process.
The draft CPGs are then aligned to ensure wording and layout are compatible across all the clinical levels. This alignment is completed externally by a 3rd party not previously involved in the CPG development process.
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The draft CPGs are at this stage sent for external review by a Medical Practitioner and an Advanced Paramedic who practice outside the state and are both acquainted with the Irish pre-hospital emergency care system. The external review feedback is further presented to a sub-group of MAG consisting of a Medical Practitioner, an Advanced Paramedic and a PHECC Programme Development Officer.
This sub-group report any issues identified directly to the Chairman of MAG. The Chairman of MAG decides if these issues require further debate within MAG. The MAG then recommends the CPG to the Clinical Care Committee. The Clinical Care Committee ratifies the CPG which is then presented to the PHECC Council for sign-off. The CPG now becomes the standard of care for Ireland.
In December 2007 PHECC published 9 CPGs for Cardiac First Response level.
The 3rd Edition CPGs will include:
- 9 CPGs for Cardiac First Response
- 19 CPGs for Occupational First Aid
- 27 CPGs for Emergency First Response
- 56 CPGs for Emergency Medical Technician
- 71 CPGs for Paramedic
- 73 CPGs for Advanced Paramedic
PHECC maintains the current edition of CPGs on its website www.phecc.ie
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