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Introduction
Rhinosinusitis is among the most concerning conditions in the healthcare field. The average annual number of diagnoses exceeds 30 million, which results in $11 billion in costs for the respective treatment (Rosenfeld et al., 2015). The economic costs are further increased by personal consequences of quality of life, productivity, and job effectiveness reduction.
Discussion
Despite the troubling statistical evidence, specific approaches in its treatment significantly vary across different disciplines. Thus, it is vital for a family nurse practitioner (FNP) to be concerned with understanding the rhinosinusitis treatment guidelines, as its various forms (bacterial, viral) require unique treatment. In this context, an assembled sinusitis guideline update group (GUG) represents a multidisciplinary collective. From otolaryngology to infectious diseases, allergies, and immunology, it spans several disciplines concerned with rhinosinusitis. In general, I agree with the group composition; however, the addition of a consumer advocate was not explicitly defined in the article (Rosenfeld et al., 2015). It could have been motivated by considering the service quality, but it raises concerns about the advocate’s fluency in the matter.
The distinction between acute and chronic rhinosinusitis lies in its duration. For acute, GUG agreed that the duration should be less than four weeks, whereas for chronic, it has to be longer than 12 weeks, regardless of exacerbations (Rosenfeld et al., 2015). Acute bacterial rhinosinusitis (ABRS) and acute viral rhinosinusitis (VRS) can then be distinguished by the illness pattern. In the former case, symptoms (nasal drainage and obstruction, facial pressure, fullness, or pain) either remain unchanged or worsen after a slight improvement within ten days (Rosenfeld et al., 2015). Lastly, if a person experiences four or more rhinosinusitis occurrences annually, which are not persistently connected, the condition is considered recurrent ARS.
For ABRS, GUG provided evidence with Grade B aggregated quality. It implies systematic reviews and observational and cross-sectional studies with minor limitations. GUG recommends offering seven days of watchful waiting as the ABRS initial management (Rosenfeld et al., 2015). This way, practitioners can determine whether the condition is bacterial or viral. For example, if a person experiences ABRS symptoms for less than two weeks, a practitioner can offer watchful waiting and prescribe respective antibiotics if symptoms worsen (Rosenfeld et al., 2015).
Conclusion
Overall, the guidelines can successfully generalize the treatment; however, they should never supersede professional judgment (Rosenfeld et al., 2015). This statement confirmed my attitude toward evidence-based practice (EVB) – EVB should not be taken as the ultimate truth applicable in every situation.
Reference
Rosenfeld, R. M., Piccirillo, J. F., Chandrasekhar, S. S., Brook, I., Ashok Kumar, K., Kramper, M., Orlandi R. R., Palmer, J. N., Patel, Z. M., Peters, A., Walsh, S. A., & Corrigan, M. D. (2015). Clinical practice guideline (update): Adult sinusitis. Otolaryngology–Head and Neck Surgery, 152(2S), S1-S39.
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