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EPOC guidelines

Gerd Flodgren, Amanda M Hall, Lucy Goulding, Martin P Eccles, Jeremy M Grimshaw, Gillian C Leng, Sasha Shepperd
BACKGROUND: The uptake of clinical practice guidelines (CPGs) is inconsistent, despite their potential to improve the quality of health care and patient outcomes. Some guideline producers have addressed this problem by developing tools to encourage faster adoption of new guidelines. This review focuses on the effectiveness of tools developed and disseminated by guideline producers to improve the uptake of their CPGs. OBJECTIVES: To evaluate the effectiveness of implementation tools developed and disseminated by guideline producers, which accompany or follow the publication of a CPG, to promote uptake...
2016: Cochrane Database of Systematic Reviews
Christopher Plishka, Thomas Rotter, Leigh Kinsman, Mohammed Rashaad Hansia, Adegboyega Lawal, Donna Goodridge, Erika Penz, Darcy D Marciniuk
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a respiratory syndrome characterized by progressive, partially reversible airway obstruction and lung hyperinflation. COPD has a substantial burden which is seen in both patient quality of life and healthcare costs. One proposed method of minimizing this burden is the implementation of clinical pathways (CPWs). CPWs aim to guide evidence-based practice and improve the interaction between health services. They bring the best available evidence to a range of healthcare professionals by adapting evidence-based clinical guidelines to a local context and detailing the essential steps in the assessment and care of patients...
2016: Systematic Reviews
Heinz Diehl, Birgitte Graverholt, Birgitte Espehaug, Hans Lund
BACKGROUND: Research on guideline implementation strategies has mostly been conducted in settings which differ significantly from a nursing home setting and its transferability to the nursing home setting is therefore limited. The objective of this study was to systematically review the effects of interventions to improve the implementation of guidelines in nursing homes. METHODS: A systematic literature search was conducted in the Cochrane Library, CINAHL, Embase, MEDLINE, DARE, HTA, CENTRAL, SveMed + and ISI Web of Science from their inception until August 2015...
2016: BMC Health Services Research
David Bardell, Eleanor West, J Mark Senior
OBJECTIVES: To determine whether the Enterprise point-of-care blood analysis system (EPOC) produces results in agreement with two other blood gas analysers in regular clinical use (i-STAT and Radiometer ABL77) and to investigate the precision of the new machine when used with equine whole blood. STUDY DESIGN: Prospective, randomized, non-blinded, comparative laboratory analyser study. ANIMALS: Horses admitted to a university teaching hospital requiring arterial or venous blood gas analysis as part of their routine clinical management...
July 7, 2016: Veterinary Anaesthesia and Analgesia
Zhicheng Wang, Susan L Norris, Lisa Bero
BACKGROUND: The implementation of high-quality guidelines is essential to improve clinical practice and public health. The World Health Organisation (WHO) develops evidence-based public health and other guidelines that are used or adapted by countries around the world. Detailed implementation plans are often necessary for local policymakers to properly use the guidelines developed by WHO. This paper describes the plans for guideline implementation reported in WHO guidelines and indicates which of these plans are evidence-based...
2016: Implementation Science: IS
Victoria Tzortziou Brown, Martin Underwood, Noman Mohamed, Olwyn Westwood, Dylan Morrissey
BACKGROUND: Musculoskeletal conditions require particular management skills. Identification of interventions which are effective in equipping general practitioners (GPs) with such necessary skills could translate to improved health outcomes for patients and reduced healthcare and societal costs. OBJECTIVES: To determine the effectiveness of professional interventions for GPs that aim to improve the management of musculoskeletal conditions in primary care.  SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), 2010, Issue 2; MEDLINE, Ovid (1950 - October 2013); EMBASE, Ovid (1980 - Ocotber 2013); CINAHL, EbscoHost (1980 - November 2013), and the EPOC Specialised Register...
2016: Cochrane Database of Systematic Reviews
Christine L Paul, Annika Ryan, Shiho Rose, John R Attia, Erin Kerr, Claudia Koller, Christopher R Levi
BACKGROUND: Thrombolysis using intravenous (IV) tissue plasminogen activator (tPA) is one of few evidence-based acute stroke treatments, yet achieving high rates of IV tPA delivery has been problematic. The 4.5-h treatment window, the complexity of determining eligibility criteria and the availability of expertise and required resources may impact on treatment rates, with barriers encountered at the levels of the individual clinician, the social context and the health system itself. The review aimed to describe health system factors associated with higher rates of IV tPA administration for ischemic stroke and to identify whether system-focussed interventions increased tPA rates for ischemic stroke...
2016: Implementation Science: IS
Sharon L Cadogan, John P Browne, Colin P Bradley, Mary R Cahill
BACKGROUND: Laboratory testing is an integral part of day-to-day primary care practice, with approximately 30 % of patient encounters resulting in a request. However, research suggests that a large proportion of requests does not benefit patient care and is avoidable. The aim of this systematic review was to comprehensively search the literature for studies evaluating the effectiveness of interventions to improve primary care physician use of laboratory tests. METHODS: A search of PubMed, Cochrane Library, Embase and Scopus (from inception to 09/02/14) was conducted...
2015: Implementation Science: IS
Kim Watkins, Helen Wood, Carl R Schneider, Rhonda Clifford
BACKGROUND: The clinical role of community pharmacists is expanding, as is the use of clinical guidelines in this setting. However, it is unclear which strategies are successful in implementing clinical guidelines and what outcomes can be achieved. The aim of this systematic review is to synthesise the literature on the implementation of clinical guidelines to community pharmacy. The objectives are to describe the implementation strategies used, describe the resulting outcomes and to assess the effectiveness of the strategies...
2015: Implementation Science: IS
Xuanyue Mao, Pengli Jia, Longhao Zhang, Pujing Zhao, Ying Chen, Mingming Zhang
BACKGROUND: From the viewpoint of human factors and ergonomics (HFE), errors often occur because of the mismatch between the system, technique and characteristics of the human body. HFE is a scientific discipline concerned with understanding interactions between human behavior, system design and safety. OBJECTIVE: To evaluate the effectiveness of HFE interventions in improving health care workers' outcomes and patient safety and to assess the quality of the available evidence...
2015: PloS One
Benedikt Schoser, Pascal Laforêt, Michelle E Kruijshaar, Antonio Toscano, Pieter A van Doorn, Ans T van der Ploeg
No abstract text is available yet for this article.
August 2015: Neuromuscular Disorders: NMD
Catherine M Algie, Robert K Mahar, Jason Wasiak, Lachlan Batty, Russell L Gruen, Patrick D Mahar
BACKGROUND: Specific clinical interventions are needed to reduce wrong-site surgery, which is a rare but potentially disastrous clinical error. Risk factors contributing to wrong-site surgery are variable and complex. The introduction of organisational and professional clinical strategies have a role in minimising wrong-site surgery. OBJECTIVES: To evaluate the effectiveness of organisational and professional interventions for reducing wrong-site surgery (including wrong-side, wrong-procedure and wrong-patient surgery), including non-surgical invasive clinical procedures such as regional blocks, dermatological, obstetric and dental procedures and emergency surgical procedures not undertaken within the operating theatre...
2015: Cochrane Database of Systematic Reviews
Bernardino Alcázar Navarrete, Ciro Casanova, Marc Miravitlles, Pilar de Lucas, Juan Antonio Riesco, José Miguel Rodríguez González-Moro
INTRODUCTION: Indications for inhaled corticosteroids (IC) in combination with long-acting bronchodilators (LABD) are well defined in clinical practice guidelines. However, there are some doubts about their efficacy and safety. The aim of this document is to establish an expert consensus to clarify these issues. METHOD: A coordinator group was formed, which systematically reviewed the scientific evidence with the aim of identifying areas of uncertainty about the efficacy of ICs, the adverse effects associated with their use and criteria for withdrawal...
April 2015: Archivos de Bronconeumología
Ulugbek B Nurmatov, Siew H Lee, Bright I Nwaru, Mome Mukherjee, Liz Grant, Claudia Pagliari
INTRODUCTION: Rates of maternal, newborn and child (MNCH) mortality and morbidity are vastly greater in low- than in high-income countries and represent a major source of global health inequity. A host of systemic, economic, geopolitical and sociocultural factors have been implicated. Mobile information and communication technologies hold potential to ameliorate several of these challenges by supporting coordinated and evidence-based care, facilitating community based health services and enabling citizens to access health information and support...
June 2014: Journal of Global Health
Lisa Maria Pfadenhauer, Jacob Burns, Anke Rohwer, Eva Annette Rehfuess
BACKGROUND: The toxic heavy metal lead continues to be a leading environmental risk factor, with the number of attributable deaths having doubled between 1990 and 2010. Although major sources of lead exposure, in particular lead in petrol, have been significantly reduced in recent decades, lead is still used in a wide range of processes and objects, with developing countries disproportionally affected. The objective of this systematic review is to assess the effectiveness of regulatory, environmental and educational interventions for reducing blood lead levels and associated health outcomes in children, pregnant women and the general population...
2014: Systematic Reviews
Helga E Breimaier, Ruud J G Halfens, Doris Wilborn, Esther Meesterberends, Gunnar Haase Nielsen, Christa Lohrmann
Translating guidelines into nursing practice remains a considerable challenge. Until now, little attention has been paid to which interventions are used in practice to implement guidelines on changing clinical nursing practice. This cross-sectional study determined the current ranges and rates of implementation-related interventions in Austria, Germany, and The Netherlands and explored possible differences between these countries. An online questionnaire based on the conceptual framework of implementation interventions (professional, organizational, financial, and regulatory) from the Cochrane Effective Practice and Organization of Care (EPOC) data collection checklist was used to gather data from nursing homes and hospitals...
2013: ISRN Nursing
Debra de Silva, Sukhmeet S Panesar, Sundeep Thusu, Tamara Rader, Thomas Werfel, Antonella Muraro, Karin Hoffmann-Sommergruber, Graham Roberts, Aziz Sheikh
BACKGROUND: Allergic reactions to plant and animal derived food allergens can have serious consequences for sufferers and their families. The associated social, emotional and financial costs make it a priority to understand the best ways of managing such immune-mediated hypersensitivity responses. Conceptually, there are two main approaches to managing food allergy: those targeting immediate symptoms and those aiming to support long-term management of the condition. The European Academy of Allergy and Clinical Immunology is developing guidelines about what constitutes an effective treatment for food allergies...
2013: Clinical and Translational Allergy
Gerd Flodgren, Lucieni O Conterno, Alain Mayhew, Omar Omar, Cresio Romeu Pereira, Sasha Shepperd
BACKGROUND: Healthcare-associated infections (HAIs) are a major threat to patient safety, and are associated with mortality rates varying from 5% to 35%. Important risk factors associated with HAIs are the use of invasive medical devices (e.g. central lines, urinary catheters and mechanical ventilators), and poor staff adherence to infection prevention practices during insertion and care for the devices when in place. There are specific risk profiles for each device, but in general, the breakdown of aseptic technique during insertion and care for the device, as well as the duration of device use, are important factors for the development of these serious and costly infections...
2013: Cochrane Database of Systematic Reviews
Danielle Mazza, Phillip Bairstow, Heather Buchan, Samantha Paubrey Chakraborty, Oliver Van Hecke, Cathy Grech, Ilkka Kunnamo
BACKGROUND: To better understand the efficacy of various implementation strategies, improved methods for describing and classifying the nature of these strategies are urgently required. The aim of this study was to develop and pilot the feasibility of a taxonomy to classify the nature and content of implementation strategies. METHODS: A draft implementation taxonomy was developed based on the Cochrane Effective Practice and Organisation of Care (EPOC) data collection checklist...
2013: Implementation Science: IS
Marc Miravitlles, Juan José Soler-Cataluña, Myriam Calle, Jesús Molina, Pere Almagro, José Antonio Quintano, Juan Antonio Trigueros, Pascual Piñera, Adolfo Simón, Juan Antonio Riesco, Julio Ancochea, Joan B Soriano
After the development of the COPD Strategy of the National Health Service in Spain, all scientific societies, patient organisations, and central and regional governments formed a partnership to enhance care and research in COPD. At the same time, the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) took the initiative to convene the various scientific societies involved in the National COPD Strategy and invited them to participate in the development of the new Spanish guidelines for COPD (Guía Española de la EPOC; GesEPOC)...
March 2013: Primary Care Respiratory Journal: Journal of the General Practice Airways Group
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