scholarly journals Evidence based guidelines for the performance of the sweat test for the investigation of cystic fibrosis in the UK

2003 ◽  
Vol 88 (12) ◽  
pp. 1126-1127 ◽  
Author(s):  
J H Baumer
Keyword(s):  
Cystic Fibrosis ◽  
Sweat Test ◽  
Evidence Based ◽  
The Uk ◽  
Evidence Based Guidelines

scholarly journals Peripheral Intravenous Cannula Usage in the Emergency Department

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Adam K Stanley ◽  
Ashton Barnett-Vanes ◽  
Matthew J Reed
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Regional Variation ◽  
Evidence Based ◽  
Failure Rates ◽  
Intravenous Cannula ◽  
Hospitalised Patients ◽  
The Uk ◽  
Evidence Based Guidelines

Over a billion Peripheral Intra-Venous Cannulas (PIVC) are used globally every year with at least 25 million sold annually in the UK.1,2 The NHS spends an estimated £29m of its annual acute sector budget on PIVC procurement3 and around 70% of all hospitalised patients require at least one PIVC during their stay.4 Despite their extensive and routine use, PIVC failure rates are reported as high as 50-69%.5-7 In addition, many PIVCs remain unused following insertion, particularly in the Emergency Department (ED).8,9 The risk factors for PIVC failure are not well understood and the literature has found extensive regional variation in practice when it comes to PIVC insertion and management.1,7,10 While various technologies have been developed to address these issues, there remains a need for standardised, evidence-based guidelines.

scholarly journals Cystic Fibrosis Foundation Evidence-Based Guidelines for Management of Infants with Cystic Fibrosis

2009 ◽  
Vol 155 (6) ◽  
pp. S73-S93 ◽  
Author(s):  
Drucy Borowitz ◽  
Karen A. Robinson ◽  
Margaret Rosenfeld ◽  
Stephanie D. Davis ◽  
Kathryn A. Sabadosa ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Evidence Based ◽  
Cystic Fibrosis Foundation ◽  
Evidence Based Guidelines

Identification of research gaps from evidence-based guidelines: A pilot study in cystic fibrosis

2011 ◽  
Vol 27 (3) ◽  
pp. 247-252 ◽  
Author(s):  
Karen A. Robinson ◽  
Ian J. Saldanha ◽  
Naomi A. McKoy
Keyword(s):  
Cystic Fibrosis ◽  
Target Population ◽  
The United States ◽  
Future Research ◽  
Evidence Based ◽  
Insufficient Evidence ◽  
Research Gaps ◽  
Consensus Recommendations ◽  
Cystic Fibrosis Population ◽  
Evidence Based Guidelines

Objectives: Evidence-based guideline committees are multidisciplinary and explicitly consider the existing evidence. They are thus in an ideal position to identify research gaps. However, gaps have not been systematically identified through guidelines. We pilot tested a method to systematically identify and classify gaps from evidence-based guidelines.Methods: We reviewed all evidence-based guidelines published by the Cystic Fibrosis Foundation. We identified research gaps as topics for which there was insufficient evidence (recommendations were not made or consensus recommendations were made) and topics specified as needing further research. We characterized gaps using a standard framework and classified them by type of management issue, specificity of target population, and age of target population.Results: We identified sixty-two research gaps in five guidelines (mean = 12.4/guidelines document). While thirteen gaps were topics specified as needing further research, most (n = 49) were topics with insufficient evidence. Of these forty-nine, recommendations were not made for twenty-two topics while consensus recommendations were made for twenty-seven topics. Most gaps were issues of comparative effectiveness (44/62), addressed the general cystic fibrosis population (40/62), and were specific to infants (33/62). Relevant comparisons and outcomes were explicitly stated for only 7 percent and 16 percent of gaps respectively.Conclusions: Almost 80 percent of the gaps were not topics identified as future research needs in the guidelines documents but rather were topics with insufficient evidence for making recommendations. Although we used cystic fibrosis in the United States as an example, the method we developed could be applied in other settings, including other countries and for different diseases.

scholarly journals Indications for Tonsillectomy: Are We Documenting Them?

2009 ◽  
Vol 91 (8) ◽  
pp. 697-699 ◽  
Author(s):  
Alex Toh ◽  
Annemarie Mullin ◽  
Joe Grainger ◽  
Harpreet Uppal
Keyword(s):  
Low Cost ◽  
University Hospital ◽  
Evidence Based ◽  
Scottish Intercollegiate Guideline Network ◽  
Prospective Audit ◽  
Recurrent Tonsillitis ◽  
Number Of Children ◽  
Time Periods ◽  
The Uk ◽  
Evidence Based Guidelines

INTRODUCTION Tonsillectomy is one of the most frequently performed operations in the UK. Documentation of the indications for tonsillectomy is vital, and should fulfil evidence-based guidelines where possible. We present a completed audit, evaluating the documentation of our department's practice in meeting the recommendations made by the Scottish Intercollegiate Guideline Network (SIGN) on indications for tonsillectomy. PATIENTS AND METHODS A prospective audit of 100 children undergoing tonsillectomy for recurrent tonsillitis at a university hospital during two time periods: October 2007 to January 2008 and March to September 2008. Interventions including the production of posters and rubber stamps were agreed and implemented between the two audit periods. RESULTS Following the implementation of simple changes, significant improvements were seen in documentation relating to the SIGN guidelines for tonsillectomy. Overall, the number of children meeting all four SIGN criteria for tonsillectomy rose from 12% to 44% (χ2 = 57.8; P < 0.001). Furthermore, a significant reduction was seen in the number of children below the age of 5 years undergoing tonsillectomy for recurrent tonsillitis (χ2 = 14.66; P < 0.001). CONCLUSIONS With increasing scrutiny on tonsillectomy, it is important to ensure that the reasons for performing tonsillectomy are documented clearly and adhere to evidence-based guidance where possible. We have demonstrated that, with only simple and low-cost interventions, significant improvements in the documentation of tonsillectomy indications can be achieved.

Has the proportion of patients diagnosed with myocardial infarction that receives a 12 ECG in the prehospital setting in the UK changed over time?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Quinn ◽  
A Watkins ◽  
C Hampton ◽  
M Halter ◽  
C Weston ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Attack ◽  
Evidence Based ◽  
Funding Source ◽  
Average Increase ◽  
Patient Refusal ◽  
The Uk ◽  
Evidence Based Guidelines ◽  
Over Time ◽  
Heart Foundation

Abstract Background Two thirds of patients with Acute Myocardial Infarction (AMI) arrive at hospital in the UK by ambulance, usually staffed by paramedics who routinely carry out 12 lead ECGs for patients with suspected heart attack. However, recent research found that prehospital ECGs were missing for 40% of these patients, with better survival prospects in those who had received one. Purpose We are investigating reasons for non-administration of 12 lead ECG for patients diagnosed with AMI, in order to develop an intervention to improve practice. Firstly we explored whether the proportion of patients with AMI that receive a prehospital ECG has changed over time. Methods Interrogation of national UK national heart attack register (MINAP) database, extraction of data related to patients brought by ambulance by year. Results The cohort of patients diagnosed with AMI and taken to hospital by ambulance ranged from 32410 in 2005 to 60265 in 2017; the proportion with a prehospital ECG increased steadily across this period, from 51% to 78%, an average increase of 1.9% per annum. Conclusions Evidence based guidelines supporting the use of 12 lead ECG by ambulance paramedics may have contributed to improvements in care. However, 1 in 5 patients brought to hospital by ambulance still does not receive an ECG prior to arrival, which we know compromises their survival prospects. In order to optimise care we need to establish whether non-administration is a question of misdiagnosis, patient refusal or lack of availability of trained crews/equipment. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): British Heart Foundation

scholarly journals Communicating cystic fibrosis newborn screening results to parents

2020 ◽  
Author(s):  
L. Seddon ◽  
K. Dick ◽  
S. B. Carr ◽  
I. M. Balfour-Lynn
Keyword(s):  
Cystic Fibrosis ◽  
Newborn Screening ◽  
Health Visitor ◽  
Sweat Test ◽  
Nurse Specialist ◽  
Face To Face ◽  
Breaking Bad ◽  
Mixed Response ◽  
The Uk ◽  
The Right

Abstract The way results of cystic fibrosis (CF) newborn screening are communicated to parents is critical yet is done differently across the globe. We surveyed parents of 101 children in our tertiary London paediatric centre with a 48% response rate. Parental responses were as follows: 40/42 (95%) said the information could not have been given over the phone and 39/43 (91%) said they wanted both partners present; 27/42 (64%) said it was helpful having the health visitor also present; and 37/40 (92%) felt it was acceptable to wait until the next day for the sweat test. We have reduced the time from first contact to arriving in the home to 2–3 h. Conclusion: We believe that this survey backs up our approach of a home visit by a CF nurse specialist with the family’s health visitor to break the news. This is challenging in the current COVID-19 pandemic. What is Known:• Breaking bad news can have a lasting impact on parents when not done the right way.• Giving results of cystic fibrosis (CF) newborn screening is done differently within the UK and around the world.What is New:• Our parental survey revealed that the majority (92%) believed this should be done face to face and not over the telephone.• There was a mixed response to whether the parents should be told the genotype (assuming the CF centre knew), and thus the CF diagnosis before the confirmatory sweat test was carried out.

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