Paucity of Clinical Practice Guidelines for the Rehabilitation of Burn Survivors

Abstract

Clinical practice guidelines (CPGs) provide an efficient route from research to practice because they follow a prescribed, vetted process for evidence collection. CPGs offer underserved fields, such as burn rehabilitation, an accessible approach to reliable treatment. A literature search was performed using the terms “Burns AND CPGs AND Rehabilitation.” Three reviewers determined whether guideline development followed an established vetting process. “Rehabilitation” required evidence of treatment to improve, maintain, or restore human function and provide treatment to facilitate recovery. Only 160 articles were obtained and, after adding the term “functional outcome,” 62 remained for full-text review, of which 21 were eligible. When articles were scored for inclusion of both rehabilitation AND function or functional outcome AND guideline vetting, seven articles remained. One was community based. Nine articles had no recorded vetting process but addressed rehabilitation as an outcome. There is a paucity of CPGs relevant to clinical rehabilitation for burn survivors, likely a result of very few published intervention trials, rare randomized controlled trials addressing rehabilitation, absence of data to establish an evidence base for practice recommendations, an inadequate number of community-based intervention trials, and little patient input. It is likely that rehabilitation of burn survivors will improve if more people gain skills in meeting the needs of people with burn injury. An increase in trained professionals may lead to an increase in intervention trials and research to establish evidence for CPGs. People engaged in burn research have an opportunity to devise a systematic, generally agreed-upon approach toward evaluating burn patients and treatment outcomes that will permit data sharing across the world and assess patients throughout the acute and chronic phases of burn injury.

Access, Utilization, and Implementation of Research Among Rehabilitation Nurses: A Qualitative Study

“…Despite the recent increase in randomized controlled trials in clinical rehabilitation research, rigorous study designs may be less prevalent, leaving nurses with a smaller pool of literature from which to draw evidence for clinical practice ( Honkanen et al, 2019 ; Morris et al, 2020 ). With regard to content, studies that address issues most germane to rehabilitation, such as long-term functioning, complex social needs, return to independence, and vocational outcomes, are fewer in number, as are studies that include nursing home residents and participants with cognitive or functional impairments ( Camicia et al, 2021 ; Gerber et al, 2020 ; Rose et al, 2017 ; Sheehan et al, 2019 ). These and other qualities specific to the rehabilitation setting suggest that a better understanding of the research barriers experienced by rehabilitation nurses is warranted.…”