Facilitating Implementation of Evidence-Based Guidelines in Hospital Settings: Learning From Trauma Centers

2006 ◽  
Author(s):  
Artemis March
Keyword(s):  
Evidence Based ◽  
Trauma Centers ◽  
Evidence Based Guidelines

Pediatric evidence-based imaging guidelines for adult trauma providers significantly reduces radiation exposure to children

Trauma ◽  
2021 ◽  
pp. 146040862110284
Author(s):  
Anna Wu ◽  
Mary J Edwards ◽  
Rachel Le ◽  
Ashar Ata ◽  
Jasmine Adderly ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Guideline Implementation ◽  
Skull Fracture ◽  
Pediatric Trauma ◽  
Evidence Based ◽  
Trauma Centers ◽  
Trauma Service ◽  
Number Of Patients ◽  
Evidence Based Guidelines ◽  
The Impact

Introduction Evidence suggests that stand-alone pediatric trauma centers outperform adult and combined adult/pediatric trauma centers in limiting radiation exposure to injured children. We sought to determine the impact of implementing evidence-based guidelines for pediatric imaging at a combined adult (level 1) and pediatric (level 2) center. The initiative focused on trauma/critical care surgeons as the pediatric surgeons did not participate in the resuscitation and initial evaluation of injured children. Methods Imaging guidelines were developed from existing clinical studies. After 3 months of education, guidelines were implemented, and regular feedback was given to providers regarding compliance. Data were collected from the trauma registry for all pediatric patients (aged less than 15 years), in calendar years 2017 (pre-guideline) and 2019 (post-guideline). All admissions were analyzed, with subgroup analysis of children with multisystem trauma admitted to the trauma surgery service. Results Following guideline implementation, mean computed tomography (CT) scans per injured child fell by over 50% (.93 vs .45). For patients admitted to the trauma service, the mean fell by 58% (1.82 vs 0.76). The number of patients receiving more than 1 CT significantly decreased for all children (26% vs 10%), and particularly those admitted to the trauma service (52% vs 17%). During this time, there was only one injury missed at the initial admission, which was clinically insignificant (non-displaced skull fracture). Conclusions Implementation of evidence-based guidelines for imaging eliminates disparity in practices between a combined adult/pediatric trauma center and stand-alone pediatric trauma centers.

scholarly journals PIN156 Knowledge of Intensive Care Nurses about the Evidence-Based Guidelines of Preventing Centralvenous Catheter Related Infection

2020 ◽  
Vol 23 ◽  
pp. S569-S570
Author(s):  
V. Pacsai ◽  
B. Szabó ◽  
E. Kalamár-Birinyi ◽  
L. Horváth ◽  
I. Boncz ◽  
...  
Keyword(s):  
Intensive Care ◽  
Evidence Based ◽  
Catheter Related Infection ◽  
Intensive Care Nurses ◽  
Evidence Based Guidelines

scholarly journals Eye Protection in ENT Practice During the COVID-19 Pandemic

OTO Open ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 2473974X2110104
Author(s):  
Jia Hui Ng ◽  
Dan Daniel ◽  
Anton Sadovoy ◽  
Constance Ee Hoon Teo
Keyword(s):  
Health Care ◽  
Protective Equipment ◽  
Evidence Based ◽  
Clinical Scenario ◽  
Degree Of Contamination ◽  
Eye Protection ◽  
Fluorescent Microscope ◽  
Set Up ◽  
Evidence Based Guidelines ◽  
Care Worker

Objectives There is a lack of evidence-based guidelines with regard to eye protection for aerosol-generating procedures in otolaryngology practice. In addition, some recommended personal protective equipment (PPE) is not compatible with commonly used ENT equipment. This study aims to investigate the degree of eye protection that commonly used PPE gives. Study Design Simulation model. Setting Simulation laboratory. Methods A custom-built setup was utilized to simulate the clinical scenario of a patient cough in proximity of a health care worker. A system that sprays a xanthan-fluorescein mixture was set up and calibrated to simulate a human cough. A mannequin with cellulose paper placed on its forehead, eyes, and mouth was fitted with various PPE combinations and exposed to the simulated cough. The degree of contamination on the cellulose papers was quantified with a fluorescent microscope able to detect aerosols ≥10 µm. Results When no eye protection was worn, 278 droplets/aerosols reached the eye area. The use of the surgical mask with an attached upward-facing shield alone resulted in only 2 droplets/aerosols reaching the eye area. In this experiment, safety glasses and goggles performed equally, as the addition of either brought the number of droplets/aerosols reaching the eye down to 0. Conclusion When used with an upward-facing face shield, there was no difference in the eye protection rendered by safety goggles or glasses in this study. Safety glasses may be considered a viable alternative to safety goggles in aerosol-generating procedures.

scholarly journals Young Adult Cancer Survivorship: Recommendations for Patient Follow-up, Exercise Therapy, and Research

2020 ◽  
Author(s):  
Scott C Adams ◽  
Jennifer Herman ◽  
Iliana C Lega ◽  
Laura Mitchell ◽  
David Hodgson ◽  
...  
Keyword(s):  
Young Adult ◽  
Late Effects ◽  
Adolescent And Young Adult ◽  
Future Research ◽  
Evidence Based ◽  
Pediatric Cancer Survivors ◽  
Increased Risk ◽  
Care Guidelines ◽  
Young Adult Cancer ◽  
Evidence Based Guidelines

Abstract Survivors of adolescent and young adult cancers (AYAs) often live 50 to 60 years beyond their diagnosis. This rapidly growing cohort is at increased risk for cancer- and treatment-related late effects that persist for decades into survivorship. Recognition of similar issues in pediatric cancer survivors has prompted the development of evidence-based guidelines for late effects screening and care. However, corresponding evidence-based guidelines for AYAs have not been developed. We hosted an AYA survivorship symposium for a large group of multidisciplinary AYA stakeholders (approximately 200 were in attendance) at Princess Margaret Cancer Centre (Toronto, ON) to begin addressing this disparity. The following overview briefly summarizes and discusses the symposium’s stakeholder-identified high-priority targets for late effects screening and care, and highlights knowledge gaps to direct future research in the field of AYA survivorship. This overview, while not exhaustive, is intended to stimulate clinicians to consider these high-priority screening and care targets when seeing survivors in clinical settings and, ultimately, support the development of evidence-based ‘late effects’ screening and care guidelines for AYAs.

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