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According to the National Safety and Quality Health Standards, low back pain can be defined as one of the most common disability among the individuals living worldwide and hence it had become one of the major challenges to the International Health systems. In the context of the scenario, the same have been accessed by Bade (2017), found that the patients instead of taking the pain killers were searching for the non-pharmacological treatment. Hence as per the Australian clinical guidelines, one of the practical guideline for the patients can be the treatment with the superficial heat (moderate-quality evidences) long with frequent massages, acupuncture as well as the spinal manipulation. NSQHS outlines that instead of using the painkillers to treat the patients, they can also make the proper usage of the anti-inflammatory drugs which will be having no side effects for the patients and those can be treated as one of the skeletal muscle relaxants (Kamper, 2020).
This particular clinical practice guideline that is the superficial heat as per the National Safety and Quality Health Standards have been found as one of the effective non pharmacological treatment since certain evidences shows that this particular treatment have helped the patients in leading the quality life. As being highlighted by Traeger (2019), the reduction in the work disability have also been outlined through this particular clinical effectiveness. In addition to this, there had also existed global improvement along with the satisfaction among the patients (NCCIH, 2020). According to the ACP’s clinical guideline policies, the above treatments can be considered as one of the effective non pharmacological treatment through which both the practitioners as well as the patients can get easily assisted towards both of the informed and sound decision making system. Van Dieën (2019) outlines that the clinicians in this regard should be informed enough and also need to go through certain trainings which will ultimately help them in treating the patients suffering from acute low back pain. In this, the moderate evidences gets reflected where a single high quality randomized controlled trial should be performed by the clinician’s for the better treatment of the patients and for their aster recovery (NCCIH, 2020).
One of the effective aspect that needed to be highlighted in this context at the time making the treatment of the patients with the acute low back pain are the ethical principle that needed to be kept in mind by the clinicians. The four ethical principles highlights autonomy, non-maleficence, beneficence and the justice. The current practice to treat the patients that is the application of compressor, acupuncture that is the use of the superficial heat as per the Australian National Statement on Ethical Conduct in the Human Resources is fair enough. In this situation , the ethical principle on justice is getting fulfilled since both the patients and the medical practitioners through the mutual decision making perspectives is taking care of the patients by respecting the value and the decisions of the patients. As per the Australian clinical guidelines, Kamper (2020) outlines that the autonomy is the one which states that the patient should be having the entire control over their body (NPS MEDICINEWISE, 2020). Hence in this situation, any kind of decisions undertaken by the healthcare professionals should be there after taking into considerations the patient’s consent regarding that. It cannot be forceful for the patient. This principle should be followed where the patient should be aware regarding the treatment which they will be getting from the medical practitioners. Here it have been highlighted by Van Dieën (2019), that through this, the better patient care can get objectified and hence the doctor-patient relationship can also get uplifted through this easily. Again at the time of considering the non-maleficence principle of ethics, it have been argued by the authors like Traeger (2019), non –maleficence means to do no harm. Through this principle, the clinical practitioners should be aware regarding the fact that at the time of treatment they make no harm to the patients. This point have been critically argued by Kamper (2020), where it have been stated that in many times it can be seen that the use of the superficial heat for the patients suffering from the low back pain actually making them more unstable and the patients are often getting harmed with this treatment which is actually affecting the informed decision making practice of the clinical practitioners. Hence in this context, it have been highlighted by Traeger (2019), that the course of action which will be needed in this place is to motivate the patients in performing daily physical exercises which will help them to regarding their both of the metal and the physical support. This decision will be actually complied with the principle of non-maleficence (NPS MEDICINEWISE, 2020).
The explanation of beneficence states that as per the Australian medical guidelines and National Health and Safety Standards, the practitioners will perform only that clinical practice which will be all beneficial for the patients as a whole. In doing this as per Van Dieën (2019) the practitioners should be knowledgeable and skilful enough to check which treatment is ultimately benefiting the health prospect of the patients. Hence as a whole, it can be stated that before performing any form of the non-pharmacological practices, the medical practitioners should be ethically sound enough that whether those practices are really good enough for the benefit for the patients or not as per the Australian Health Standards by using the evidence-based practices and policies.
After conducting an adequate research on certain evidences and after exploring the ethical standards to treat the patients with lower back pain, four recommendations will be presented below. Traeger (2019), emphasised on the first recommendation where diagnostic tests needs to be performed by the clinical practitioners where in order to check the condition of the acute back pain of the patients , X-rays of the lumbar spine needs to be conducted with the help of sophisticated diagnostic imaging. This will actually help for the better stability and the stenosis. Next it have been recommended by Van Dieën (2019), that the laboratory testing is must where any kind of infections present in the blood which need to be conducted with the appropriate blood test reports. Thirdly, the patients need to be motivated to undergo through the physical exercises where the justification lies in the fact that through this, the patient themselves can manage their body and can also be able to tackle their chronic diseases through the development of the chronic disease management programmes. However, this particular exercise needs to be verified by an experience consultant from whom, the patient could learn the proper posture of the yoga. Last one as being recommended by Kamper (2020) highlights that the patient in the relation to the case scenario should also be having acquainted themselves with the active rehabilitation programmes like the proper education regarding the principles on the back pain along with the self-management programming. Through this, the patients will be knowledgeable enough regarding the core nursing practices and should also know that which course of medical treatment is actually better for them and which is not.
Bade, M. (2017). Effects of manual therapy and exercise targeting the hips in patients with low‐back pain—A randomized controlled trial. Journal of Evaluation in Clinical Practice, 23(4), 734-740. doi:https://doi.org/10.1111/jep.12705
Briggs, J. P. (2017). New ACP Clinical Practice Guidelines on Nonpharmacologic Treatment for Low-Back Pain. Retrieved from https://www.nccih.nih.gov/research/blog/new-acp-clinical-practice-guidelines-on-nonpharmacologic-treatment-for-low-back-pain
Kamper, S. J. (2020). What is usual care for low back pain? A systematic review of health care provided to patients with low back pain in family practice and emergency departments. Pain, 161(4), 694-702. doi:10.1097/j.pain.0000000000001751
NCCIH. (2020). Low-Back Pain and Complementary Health Approaches: What You Need To Know. Retrieved from https://www.nccih.nih.gov/health/low-back-pain-and-complementary-health-approaches-what-you-need-to-know
NPS MEDICINEWISE. (2020). The non-pharmacological treatment of back pain. Retrieved from https://www.nps.org.au/australian-prescriber/articles/the-non-pharmacological-treatment-of-back-pain
Qaseem, A. (2017). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Retrieved from https://www.acpjournals.org/doi/full/10.7326/M16-2367
Traeger, A. C. (2019). Care for low back pain: Can health systems deliver? Bull World Health Organ., 97(6), 423–433.
Van Dieën, J. H. (2019). Analysis of motor control in patients with low back pain: A key to personalized care? Journal of Orthopaedic & Sports Physical Therapy, 49(6), 380-388. doi:https://www.jospt.org/doi/10.2519/jospt.2019.7916
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