scholarly journals Factors that influence adherence to surgical antimicrobial prophylaxis (SAP) guidelines: a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sarah Hassan ◽  
Vincent Chan ◽  
Julie Stevens ◽  
Ieva Stupans
Keyword(s):  
Systematic Review ◽  
Guideline Adherence ◽  
Treatment Guidelines ◽  
Antimicrobial Prophylaxis ◽  
Local Level ◽  
Theoretical Domains Framework ◽  
Control Measures ◽  
Eligibility Criteria ◽  
Barriers And Enablers ◽  
Surgical Antimicrobial Prophylaxis

Abstract Background Despite the extensive research that has been conducted to date, practice often differs from established guidelines and will vary between individuals and organisations. It has been noted that the global uptake of local and international surgical antimicrobial prophylaxis (SAP) guidelines is poor with limited research investigating factors that affect guideline adherence. The purpose of this systematic review was to determine the reported barriers and enablers to the adherence of SAP guidelines. Methods A search of the literature was performed using four electronic databases (CINAHL, EMBASE, PubMed and SCOPUS) for articles published in the English language from January 1998 to December 2018. Articles were included if they were solely related to SAP and discussed the barriers or enablers to SAP guideline adherence. Articles that assessed the adherence to a range of infection control measures or discussed adherence to antibiotic treatment guidelines rather than SAP guidelines were excluded from this review. Barriers and enablers were mapped to the Theoretical Domains Framework (TDF). The Mixed Methods Appraisal Tool was used to assess the quality of included studies. Results A total of 1489 papers were originally retrieved, with 48 papers meeting the eligibility criteria. Barriers and enablers were mapped to 11 out of 14 TDF domains: knowledge, skills, social/professional role and identity, beliefs about capabilities, beliefs about consequences, reinforcement, memory, attention and decision processes, environmental context and resources, social influences, emotion and behavioural regulation. Barriers were further categorised into personal or organisational barriers, while enablers were arranged under commonly trialled interventions. Conclusions There are numerous factors that can determine the uptake of SAP guidelines. An identification and understanding of these factors at a local level is required to develop tailored interventions to enhance guideline adherence. Interventions, when used in combination, can be considered as a means of improving guideline use.

Systematic review of barriers and enablers to the delivery of palliative care by primary care practitioners

2019 ◽  
Vol 33 (9) ◽  
pp. 1131-1145 ◽  
Author(s):  
Mariko L Carey ◽  
Alison C Zucca ◽  
Megan AG Freund ◽  
Jamie Bryant ◽  
Anne Herrmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Palliative Care ◽  
Care Delivery ◽  
Primary Care Providers ◽  
Healthcare Services ◽  
Care Providers ◽  
Eligibility Criteria ◽  
Barriers And Enablers ◽  
Primary Care Practitioners

Background: There is increasing demand for primary care practitioners to play a key role in palliative care delivery. Given this, it is important to understand their perceptions of the barriers and enablers to optimal palliative care, and how commonly these are experienced. Aim: To explore the type and prevalence of barriers and enablers to palliative care provision reported by primary care practitioners. Design: A systematic review of quantitative data-based articles was conducted. Data sources: Medline, Embase and PsychINFO databases were searched for articles published between January 2007 and March 2019. Data synthesis: Abstracts were assessed against the eligibility criteria by one reviewer and a random sample of 80 articles were blind coded by a second author. Data were extracted from eligible full-texts by one author and checked by a second. Given the heterogeneity in the included studies’ methods and outcomes, a narrative synthesis was undertaken. Results: Twenty-one studies met the inclusion criteria. The most common barriers related to bureaucratic procedures, communication between healthcare professionals, primary care practitioners’ personal commitments, and their skills or confidence. The most common enablers related to education, nurses and trained respite staff to assist with care delivery, better communication between professionals, and templates to facilitate referral to out-of-hours services. Conclusion: A holistic approach addressing the range of barriers reported in this review is needed to support primary care providers to deliver palliative care. This includes better training and addressing barriers related to the interface between healthcare services.

scholarly journals Challenges Faced by Patients with Dyslipidemia and Systemic Arterial Hypertension in Brazil: A Design of the Patient Journey

2021 ◽  
Author(s):  
José Rocha Faria Neto ◽  
Carlos Rodolfo Yarleque ◽  
Luiz Fernando Vieira ◽  
Eliane Naomi Sakane ◽  
Raul Dias dos Santos Filho
Keyword(s):  
Systematic Review ◽  
Arterial Hypertension ◽  
English Language ◽  
Treatment Guidelines ◽  
Lifestyle Modification ◽  
Evidence Synthesis ◽  
Local Level ◽  
Disease Diagnosis ◽  
Patient Journey ◽  
Systemic Arterial Hypertension

Abstract Background & Objective: Non-communicable diseases like systemic arterial hypertension (SAH) and dyslipidemia are poorly studied in terms of patient journey aspects. This semi-systematic review provides evidence synthesis for the management of SAH and dyslipidemia in Brazil and also discusses challenges faced by patients at the local level along with a suggested care approach by local experts.Methods: A semi-systematic review using both structured literature databases (Embase and Medline) and unstructured scientific records (WHO, IPD, MOH and Google) on hypertension and dyslipidemia in the English language from 2010–2019 was performed by reviewers. After two-level screening based on pre-defined criteria, patient journey touchpoints and prevalence information were extracted from the included articles. Data gaps were bridged through the insights of local experts.Conclusion: Limited patient education, regional disease distribution, and treatment allocation, along with limited resources for diagnosis and treatment are the key challenges. To improve overall patient journey considering critical touchpoints, timely and strict adoption of pharmacological treatment guidelines, campaigns for increased patient literacy about healthy diet and lifestyle modification, about the importance of self-reporting for early disease diagnosis, and benefits of treatment adherence are strongly recommended. Also, it is suggested to ensure the availability of skilled resources through continued education to render quality care to cardiovascular patients in Brazil.

scholarly journals Developing Surgical Antimicrobial Prophylaxis Interventions Using Theoretical Domains Framework

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S276-S276
Author(s):  
Paul E Bonnar ◽  
Arrani Senthinathan ◽  
Yoshiko Nakamachi ◽  
David J Backstein ◽  
Marilyn Steinberg ◽  
...  
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Theoretical Domains Framework ◽  
Surgical Antimicrobial Prophylaxis

scholarly journals The roles of transportation and transportation hubs in the propagation of influenza and coronaviruses: a systematic review

2016 ◽  
Vol 23 (1) ◽  
Author(s):  
Annie Browne ◽  
Sacha St-Onge Ahmad ◽  
Charles R. Beck ◽  
Jonathan S. Nguyen-Van-Tam
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Transportation Systems ◽  
Risk Of Bias ◽  
Control Measures ◽  
Morbidity And Mortality ◽  
Eligibility Criteria ◽  
Sea Transport ◽  
Cruise Ships ◽  
Influenza Transmission

Abstract Background. Respiratory viruses spread in humans across wide geographical areas in short periods of time, resulting in high levels of morbidity and mortality. We undertook a systematic review to assess the evidence that air, ground and sea mass transportation systems or hubs are associated with propagating influenza and coronaviruses. Methods. Healthcare databases and sources of grey literature were searched using pre-defined criteria between April and June 2014. Two reviewers screened all identified records against the protocol, undertook risk of bias assessments and extracted data using a piloted form. Results were analysed using a narrative synthesis. Results. Forty-one studies met the eligibility criteria. Risk of bias was high in the observational studies, moderate to high in the reviews and moderate to low in the modelling studies. In-flight influenza transmission was identified substantively on five flights with up to four confirmed and six suspected secondary cases per affected flight. Five studies highlighted the role of air travel in accelerating influenza spread to new areas. Influenza outbreaks aboard cruise ships affect 2–7% of passengers. Influenza transmission events have been observed aboard ground transport vehicles. High heterogeneity between studies and the inability to exclude other sources of infection means that the risk of influenza transmission from an index case to other passengers cannot be accurately quantified. A paucity of evidence was identified describing severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus transmission events associated with transportation systems or hubs. Conclusion . Air transportation appears important in accelerating and amplifying influenza propagation. Transmission occurs aboard aeroplanes, at the destination and possibly at airports. Control measures to prevent influenza transmission on cruise ships are needed to reduce morbidity and mortality. There is no recent evidence of sea transport accelerating influenza or coronavirus spread to new areas. Further investigation is required regarding the roles of ground transportation systems and transport hubs in pandemic situations.

scholarly journals What factors could influence physicians' management of women of childbearing age with chronic inflammatory disease? A systematic review of behavioural determinants of clinical inertia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Catherine Nelson-Piercy ◽  
Ivo Vlaev ◽  
Katie Harris ◽  
Rebecca Fischer-Betz
Keyword(s):  
Systematic Review ◽  
Inflammatory Disease ◽  
Treatment Guidelines ◽  
Theoretical Domains Framework ◽  
Chronic Inflammatory Disease ◽  
Treatment Setting ◽  
Clinical Inertia ◽  
Childbearing Age ◽  
Behavioural Science ◽  
Pharmacological Management

Abstract Background Pregnancy represents a complex challenge to clinicians treating women with chronic inflammatory disease. Many clinicians face a situation of heightened sensitivity to the potential risks and uncertainties associated with the effect of pharmacological treatment on pregnancy outcomes. This may create an environment vulnerable to clinical inertia, whereby behavioural factors such as cognitive heuristics and biases, and other factors such as attitudes to risk and emotion can contribute. This systematic review was undertaken to assess if clinical inertia has been investigated/identified in this setting and took a behavioural science approach to identify and understand the potential determinants of clinical inertia in this treatment setting. Methods A systematic literature search was conducted to identify publications which investigated or described clinical inertia or its determinants (e.g. heuristics, biases etc.). Results were coded for thematic analysis using two inter-related behavioural models: the COM-B model and the Theoretical Domains Framework. Results Whilst studies investigating or describing clinical inertia in this treatment setting were not identified, the behavioural analysis revealed a number of barriers to the pharmacological management of women of fertile age affected by chronic inflammatory disease. Factors which may be influencing clinician’s behaviour were identified in all domains of the COM-B model. The primary factors identified were a lack of knowledge of treatment guidelines and fears concerning the safety of medications for mother and fetus. Lack of experience of treating pregnant patients was also identified as a contributing factor to undertreatment. Conclusion Using a behavioural approach, it was possible to identify potential factors which may be negatively influencing clinician’s behaviour in this treatment setting, although specific research was limited.

scholarly journals Epidemiology of echinococcosis in Iran: a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Shima Mahmoudi ◽  
Setareh Mamishi ◽  
Maryam Banar ◽  
Babak Pourakbari ◽  
Hossein Keshavarz
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cyst Formation ◽  
Analysis Data ◽  
Diagnostic Methods ◽  
Control Measures ◽  
Clinical Aspects ◽  
Monitoring And Control ◽  
Eligibility Criteria ◽  
Larval Stages

Abstract Background Echinococcosis is a zoonotic disease caused by the larval stages of taeniid cestodes of the genus Echinococcus. The two major types of infection in humans are cystic echinococcosis (CE) or hydatidosis and alveolar echinococcosis (AE). It is endemic in some parts of the world, such as the Middle East, with Iran being a part of it. This systematic review and meta-analysis were conducted to determine the prevalence of CE and AE echinococcosis and their epidemiological and clinical aspects in Iran. Methods Electronic databases, including MEDLINE (via PubMed), SCOPUS, Web of Science, SID and Mag Iran (two Persian scientific search engines) were searched from 1 January 1990 to 8 August 2017. The prevalence of CE and AE echinococcosis was estimated using the random effects meta-analysis. Heterogeneity was evaluated by subgroup analysis. Data were analyzed by STATA version 12. Results Of the 2051 records identified in the mentioned electronic databases, Seventy-eight articles met our eligibility criteria, with a total of 214124individuals. The meta-analysis was performed on only 37 out of 78 included studies. The pooled prevalence of CE and AE in Iran was 5% [95% confidence interval )CI(: 3-6%] and 2% [95% CI: 0-5%], respectively. Subgroup meta-analysis revealed that the prevalence of CE was significantly higher in North [9%, 95% CI: 4-18%] and West of Iran [6%, 95% CI: 3-11%], patients younger than 40 years of age [7%, 95% CI: 4-12%], villagers and nomads [6%, 95% CI: 2-12%], and studies that used the combination of serological, clinical, and imaging diagnostic methods [7%, 95% CI: 5-9%]. There were no significant differences between the prevalence of CE among low and high-quality studies. Housewives were the most affected group by hydatidosis (n=24/77, 31%), followed by illiterate people (n=11/77, 14%) and farmers (n= 9/77, 12%). Liver [55%, 95% CI: 46-65%] and lung [28%, 95% CI, 22-35%] were the most common sites of cyst formation. Conclusions Given to the importance of echinococcosis on human health and domestic animals industry, it is necessary to implement monitoring and control measures in this regard.

scholarly journals A Systematic Review of COVID-19 Epidemiology Based on Current Evidence

2020 ◽  
Vol 9 (4) ◽  
pp. 967 ◽  
Author(s):  
Minah Park ◽  
Alex R. Cook ◽  
Jue Tao Lim ◽  
Yinxiaohe Sun ◽  
Borame L. Dickens
Keyword(s):  
Systematic Review ◽  
Current Model ◽  
Case Fatality ◽  
Control Measures ◽  
Current Evidence ◽  
Future Research ◽  
Eligibility Criteria ◽  
Novel Coronavirus ◽  
Epidemiological Characteristics ◽  
The Impact

As the novel coronavirus (SARS-CoV-2) continues to spread rapidly across the globe, we aimed to identify and summarize the existing evidence on epidemiological characteristics of SARS-CoV-2 and the effectiveness of control measures to inform policymakers and leaders in formulating management guidelines, and to provide directions for future research. We conducted a systematic review of the published literature and preprints on the coronavirus disease (COVID-19) outbreak following predefined eligibility criteria. Of 317 research articles generated from our initial search on PubMed and preprint archives on 21 February 2020, 41 met our inclusion criteria and were included in the review. Current evidence suggests that it takes about 3-7 days for the epidemic to double in size. Of 21 estimates for the basic reproduction number ranging from 1.9 to 6.5, 13 were between 2.0 and 3.0. The incubation period was estimated to be 4-6 days, whereas the serial interval was estimated to be 4-8 days. Though the true case fatality risk is yet unknown, current model-based estimates ranged from 0.3% to 1.4% for outside China. There is an urgent need for rigorous research focusing on the mitigation efforts to minimize the impact on society.

scholarly journals Surgical antimicrobial prophylaxis in open reduction internal fixation procedures at a metropolitan hospital in Australia: a retrospective audit

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Hassan ◽  
Vincent Chan ◽  
Julie Stevens ◽  
Ieva Stupans ◽  
Juliette Gentle
Keyword(s):  
Single Dose ◽  
Guideline Adherence ◽  
Antimicrobial Prophylaxis ◽  
Open Reduction Internal Fixation ◽  
Adherence To Guidelines ◽  
Retrospective Audit ◽  
Therapeutic Guidelines ◽  
Prescribing Practice ◽  
Closed Fractures ◽  
Surgical Antimicrobial Prophylaxis

Abstract Background Open reduction internal fixation (ORIF) of closed fractures is a required indication for surgical antimicrobial prophylaxis (SAP). Guidelines contain recommendations on how best to prescribe SAP, however, adherence to SAP guidelines remains suboptimal. The Australian Therapeutic Guidelines: Antibiotic v16 (updated April 2019) advocates for single dose prophylaxis for ORIF procedures. There is a paucity of information on how SAP is prescribed for ORIF of closed fractures in Australian hospitals. The aim of this study was to identify prescribing practice and to evaluate guideline adherence pre- and post-guideline update. Methods A retrospective audit was conducted for patients undergoing an ORIF of closed fractures at a metropolitan teaching hospital in a 6-month period during 2018 (pre-guideline update) and 2019 (post-guideline update). Data were collected on prescribing practice (perioperative antibiotics prescribed, dose, time and route of administration and duration of prophylaxis) and compared to SAP recommendations in Therapeutic Guidelines: Antibiotic v15 (2018) and v16 (2019). Descriptive statistics and Chi square tests were used to report categorical variables. Binary logistic regression was used to identify factors associated with guideline adherence. A p-value < 0.05 was deemed statistically significant. Results Data were collected for a total of 390 patients (n = 185, 2018; n = 205, 2019). Cefazolin was the most commonly prescribed antibiotic as per guideline recommendations, with variable, yet appropriate doses observed across the two audit periods. While 78.3% of patients received SAP for the correct duration in 2018, only 20.4% of patients received single dose prophylaxis in 2019. Overall adherence to guidelines was 63.2% in the 2018, and 18.0% in the 2019 audit periods respectively. Patient age was significantly associated with an increase in overall guideline adherence, while lower limb fractures, an American Society of Anesthesiologists (ASA) score of 3 and emergency admissions were associated with decreased overall adherence to SAP guidelines. Conclusion Adherence to guidelines was greater with v15 (2018) compared with v16 (2019). Patient factors, including limb fracture site and ASA score, had little impact on guideline adherence. Further research is required to understand what influences guideline adherence in the orthopaedic setting.

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