4. Intended users The intended users for the guidance in the first instance are health and rehabilitation professionals (including rehabilitation physicians, medical practitioners, nurses and allied health professionals, prosthetists, and prosthetic technicians), service providers, funders of prostheses and rehabilitation services (e.g. insurers), and insurance scheme regulators (e.g. the State Insurance Regulatory Authority [SIRA]). The guidance also provides information that can be empowering for the person with an amputation, their family and carers, whether they access all or only parts of the guidance.
experiential knowledge (knowledge gained through lived experience, including from people with an amputation and service users, and their families and advocates) [1-5].
6.1 Overview of methods Mixed research methods were used to develop this guidance. Guideline development involved two stages:
Preparatory stage • A scoping review of national and international
rehabilitation and care pathway approaches and guidelines
5. Use of the guidance
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Retrospective file reviews of a sample of 20 icare participants injured in the last 5 years
The guidance is intended to inform and guide the user. The guidance does not replace the need for education, supervision or judgment, and careful consideration of the context of the person with the limb amputation. The guidance complements but does not replace process or procedural guidelines, or guidelines relating to policy or statutory obligations.
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Semi-structured one-to-one interviews with 15 people with lived experience of amputation (who were participants of Lifetime Care and Support or Workers Insurance, or Workers Care)
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Semi-structured interviews with 14 sector stakeholders, including service providers, by an independent researcher
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Insurer consultation.
Throughout the guidance, there are recommendations (typically indicating a ‘must’ or ‘should’ action), best practice notes (indicating ‘optimal’ actions), lists of resources (blue colour for the person and teal for health professionals) and tools, definitions, and links to relevant online resources. Section 14 includes resources for the person with an amputation and health professionals. The guidance does not attempt to provide the only, nor all possible, resources and tools that can be used for the best practice care pathway for people with an amputation.
Development stage • Consultation with people with lived experience and advocates throughout the guideline development
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Multiple systematic searches of peer-reviewed journal databases for research literature on each topic. The literature was searched from 2010 to 2020; literature was assessed for relevance (over 300 research papers, guidelines and reports) and subsequently for the quality of the research.
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A working party of 23 experts including those with lived experience, who met eight times (for a total of 28 hours) over 10 months to develop recommendations and consensus using a facilitated nominal group technique
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Knowledge, documents and reports from reputable key organisational websites (national and international)
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Several rounds of drafting the document, including revision after critical review by the members of the working party, followed by another round of critical review by national and international expert peer reviewers and people with lived experience.
LC0063_Guidance_on_the_support_pathway_v10
6. Guidance development The topic and issues covered by this guidance are complex and concern the real world rather than controlled clinical settings. The scientific knowledge used to inform the appropriate content of this guidance was obtained from all relevant sources: experimental and observational research evidence (research from the literature searches); contextual knowledge (e.g. demographics, systems, history); expert knowledge (formal or tacit knowledge from expert health and rehabilitation professionals and funders); and © icareTM | Insurance and Care NSW 2021
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icare Guidance for people with a limb amputation 2021
