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Implementing Clinical Practice Guidelines for Improving Function in Cerebral Palsy: Development of a Fidelity Tool
Michelle Jackman1, Megan Thorley, Rachel Toovey
1The Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia (Dr Jackman, Mr Blatch-Williams, Prof Novak); John Hunter Children's Hospital, Newcastle, Australia (Dr Jackman); Queensland Paediatric Rehabilitation Service, Brisbane, Australia (Ms Thorley); Department of Physiotherapy, The University of Melbourne, Melbourne, Australia (Dr Toovey); Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland Child Health Research Centre, Brisbane, Australia (Dr Burgess, A/Prof Sakzewski, Prof Boyd).
A new 21-item fidelity tool was developed to guide the implementation of clinical practice guidelines for improving physical function in children with cerebral palsy. This tool aids clinicians and supervisors in self-reflection and planning practice changes.
Area of Science:
- Pediatric Rehabilitation
- Clinical Practice Guideline Implementation
- Cerebral Palsy Management
Background:
- Cerebral palsy (CP) significantly impacts physical function in children and young people.
- Effective implementation of clinical practice guidelines (CPGs) is crucial for optimizing care.
- A need exists for tools to support adherence to CPGs in pediatric CP rehabilitation.
Purpose of the Study:
- To develop a fidelity tool for supporting the implementation of CPGs.
- To enhance physical function outcomes for children and young people with CP.
- To provide a structured approach for evaluating adherence to best practices.
Main Methods:
- A 5-step development process was employed.
- Mixed-methods action research, including pilot studies, was utilized.
- Data collection involved focus groups, questionnaires, and field notes.
Main Results:
- A 21-item fidelity tool was successfully developed.
- The tool covers core CPG components: goal setting, intervention, and therapeutic elements.
- Clinicians and supervisors found the tool acceptable, feasible, and useful for self-reflection.
Conclusions:
- A validated fidelity tool is now available for use.
- Clinicians, supervisors, and organizations can use it for practice reflection.
- The tool supports aligning practice with CPGs to improve functional outcomes in pediatric CP.
