RNAO (Registered Nurses Association of Ontario) best practice guidelines for woman abuse: Screening, identification and initial response

Este editorial junto con algunos de los artículos de la edición 17(3) de la revista MedUNAB está dedicado a visualizar la transformación sistematizada de la profesión de Enfermería a través del uso continuo de evidencia científica en la práctica clínica del día a día. Un reto que puede parecer inalcanzable pero que ya se está dando en 450 organizaciones de servicios de salud y entidades académicas en diversos países del mundo incluyendo algunos de habla hispana. El eje organizador de este esfuerzo es la Asociación Profesional de Enfermeras y Enfermeros de Ontario (Registered Nurses’ Association of Ontario, RNAO), la cual con financiación del Gobierno Provincial de Ontario, lanzó en el año 1998 el Programa de Guías Clínicas (Best Practice Guidelines) basadas en la evidencia. Este programa fue ampliado en el año 2003, por solicitud del mismo gobierno, para incluir también guías de entorno laboral.Las metas trazadas por RNAO se dirigen a apoyar a los organismos de salud y educación junto con sus enfermeras (os) y estudiantes, además de optimizar los servicios de atención basándose en evidencia actualizada. Metas que no solo se han alcanzado sino sobrepasado ampliamente. Actualmente estas guías son utilizadas por equipos interdisciplinarios tanto en áreas preventivas (por ejemplo en atención primaria), como también en el ámbito comunitario y hospitalario en todos sus niveles de complejidad. El programa permite a las organizaciones y a los sistemas de salud centrarse en la atención al paciente y la excelencia clínica, utilizando en forma sistematizada las últimas investigaciones para informar la práctica y optimizar los resultados a pacientes, organizaciones de salud y sistemas locales y nacionales.

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Opioid crisis in primary care? An audit of high-dose opioid prescribing at Bangholm GP Practice

British Journal of General Practice ◽

10.3399/bjgp20x711581 ◽

2020 ◽

Vol 70 (suppl 1) ◽

pp. bjgp20X711581

Author(s):

Charlotte Greene ◽

Alice Pearson

Keyword(s):

Chronic Pain ◽

Back Pain ◽

Practice Guidelines ◽

Best Practice ◽

Evidence Base ◽

High Dose ◽

Opioid Prescription ◽

Opioid Prescribing ◽

Best Practice Guidelines

BackgroundOpioids are effective analgesics for acute and palliative pain, but there is no evidence base for long-term pain relief. They also carry considerable risks such as overdose and dependence. Despite this, they are increasingly prescribed for chronic pain. In the UK, opioid prescribing more than doubled between 1998 and 2018.AimAn audit at Bangholm GP Practice to understand the scale of high-strength opioid prescribing. The aim of the audit was to find out if indications, length of prescription, discussion, and documentation at initial consultation and review process were consistent with best-practice guidelines.MethodA search on Scottish Therapeutics Utility for patients prescribed an average daily dose of opioid equivalent ≥50 mg morphine between 1 July 2019 and 1 October 2019, excluding methadone, cancer pain, or palliative prescriptions. The Faculty of Pain Medicine’s best-practice guidelines were used.ResultsDemographics: 60 patients (37 females), average age 62, 28% registered with repeat opioid prescription, 38% comorbid depression. Length of prescription: average 6 years, 57% >5 years, 22% >10 years. Opioid: 52% tramadol, 23% on two opioids. Indications: back pain (42%), osteoarthritis (12%), fibromyalgia (10%). Initial consultation: 7% agreed outcomes, 35% follow-up documented. Review: 56% 4-week, 70% past year.ConclusionOpioid prescribing guidelines are not followed. The significant issues are: long-term prescriptions for chronic pain, especially back pain; new patients registering with repeat prescriptions; and no outcomes of treatment agreed, a crucial message is the goal is pain management rather than relief. Changes have been introduced at the practice: a patient information sheet, compulsory 1-month review for new patients on opioids, and in-surgery pain referrals.

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Smart community infrastructures. Best practice guidelines for transportation

10.3403/30337981u ◽

2017 ◽

Keyword(s):

Practice Guidelines ◽

Best Practice ◽

Best Practice Guidelines ◽

Smart Community

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Faculty Opinions recommendation of Urologist compliance with AUA best practice guidelines for benign prostatic hyperplasia in Medicare population.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.11874959.12977057 ◽

2011 ◽

Author(s):

Stavros Gravas

Keyword(s):

Benign Prostatic Hyperplasia ◽

Practice Guidelines ◽

Best Practice ◽

Prostatic Hyperplasia ◽

Medicare Population ◽

Best Practice Guidelines

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Introducing New Guidelines on Geoheritage Conservation in Protected and Conserved Areas

Geoheritage ◽

10.1007/s12371-021-00552-0 ◽

2021 ◽

Vol 13 (2) ◽

Author(s):

Roger Crofts ◽

Dan Tormey ◽

John E. Gordon

Keyword(s):

Practice Guidelines ◽

Best Practice ◽

Communication To The Public ◽

The Public ◽

Best Practice Guidelines ◽

The World ◽

New Guidelines ◽

The Many ◽

Ethical Basis ◽

Improve Practice

AbstractThis paper introduces newly published guidelines on geoheritage conservation in protected and conserved areas within the “IUCN WCPA Best Practice Guidelines” series. It explains the need for the guidelines and outlines the ethical basis of geoheritage values and geoconservation principles as the fundamental framework within which to advance geoheritage conservation. Best practice in establishing and managing protected and conserved areas for geoconservation is described with examples from around the world. Particular emphasis is given to the methodology and practice for dealing with the many threats to geoheritage, highlighting in particular how to improve practice for areas with caves and karst, glacial and periglacial, and volcanic features and processes, and for palaeontology and mineral sites. Guidance to improve education and communication to the public through modern and conventional means is also highlighted as a key stage in delivering effective geoconservation. A request is made to geoconservation experts to continue to share best practice examples of developing methodologies and best practice in management to guide non-experts in their work. Finally, a number of suggestions are made on how geoconservation can be further promoted.

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Antibiotic stewardship in direct-to-consumer telemedicine consultations leads to high adherence to best practice guidelines and a low prescription rate

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2021.02.020 ◽

2021 ◽

Vol 105 ◽

pp. 130-134

Author(s):

Carlos H.S. Pedrotti ◽

Tarso A.D. Accorsi ◽

Karine De Amicis Lima ◽

Ary Serpa Neto ◽

Maria T.S. de S. Lira ◽

...

Keyword(s):

Practice Guidelines ◽

Antibiotic Stewardship ◽

Best Practice ◽

Prescription Rate ◽

Direct To Consumer ◽

Best Practice Guidelines ◽

High Adherence

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Development of the “Hamburg Best Practice Guidelines for ICV−Enzyme Replacement therapy (ERT) in CLN2 Disease” Based on 6 Years Treatment Experience in 48 Patients

Journal of Child Neurology ◽

10.1177/0883073821989154 ◽

2021 ◽

pp. 088307382198915

Author(s):

Christoph Schwering ◽

Gertrud Kammler ◽

Eva Wibbeler ◽

Martin Christner ◽

Johannes K.-M. Knobloch ◽

...

Keyword(s):

Patient Safety ◽

Adverse Events ◽

Enzyme Replacement Therapy ◽

Replacement Therapy ◽

Practice Guidelines ◽

Best Practice ◽

Vision Loss ◽

Neuronal Ceroid Lipofuscinosis ◽

Enzyme Replacement ◽

Best Practice Guidelines

Intracerebroventricular enzyme replacement therapy (ICV-ERT) for CLN2 disease represents the first approved treatment for neuronal ceroid lipofuscinosis (NCL) diseases. It is the first treatment where a recombinant lysosomal enzyme, cerliponase alfa, is administered into the lateral cerebral ventricles to reach the central nervous system, the organ affected in CLN2 disease. If untreated, CLN2 children show first symptoms such as epilepsy and language developmental delay at 2-4 years followed by rapid loss of motor and language function, vision loss, and early death. Treatment with cerliponase alfa has shown to slow the rapid neurologic decline. However, the mode of administration by 4 hour-long intracerebroventricular infusions every 14 days represents a potentially greater risk of infection compared to intravenous enzyme replacement therapies. The Hamburg NCL Specialty Clinic was the first site worldwide to perform intracerebroventricular enzyme replacement therapy in children with CLN2 disease. In order to ensure maximum patient safety, we analysed data from our center from more than 3000 intracerebroventricular enzyme replacement therapies in 48 patients over 6 years with regard to the occurrence of device-related adverse events and device infections. Since starting intracerebroventricular enzyme replacement therapy, we have also developed and continuously improved the “Hamburg Best Practice Guidelines for ICV–Enzyme Replacement Therapy (ERT) in CLN2 Disease.” Results from this study showed low rates for device-related adverse events and infections with 0.27% and 0.33%, respectively. Therefore, following our internal procedural guidelines has shown to improve standardization and patient safety of intracerebroventricular enzyme replacement therapy for CLN2 disease.

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