scholarly journals IMPLEMENTAÇÃO DE EVIDÊNCIAS CIENTÍFICAS NA ASSISTÊNCIA AO PARTO NORMAL: ESTUDO LONGITUDINAL

2017 ◽  
Vol 8 (1) ◽  
pp. 27
Author(s):  
Rafael Cleison Silva Dos Santos
Keyword(s):  
Clinical Practice ◽  
Longitudinal Study ◽  
Educational Intervention ◽  
Medical Records ◽  
Clinical Audit ◽  
Scientific Evidence ◽  
Maternity Hospital ◽  
The State ◽  
The Impact ◽  
Childbirth Care

Objetivo: avaliar o impacto de uma intervenção educativa sobre práticas obstétricas e desfechos perineais. Método: estudo longitudinal, segundo a metodologia de implementação de evidências científicas na prática clínica, realizado com enfermeiros e médicos, puérperas e prontuários em uma maternidade pública de referência no estado do Amapá. Resultado: após a intervenção educativa, mais profissionais recomendaram as posições lateral e verticais no período expulsivo do parto; mais puérperas relataram as práticas de puxo dirigido e manobra de Kristeller; menos prontuários indicaram a laceração espontânea e graus de lacerações maiores. Conclusão: a intervenção educativa proporcionou resultados melhores, mas não estatisticamente significativos.Descritores: Auditoria clínica, Períneo, Pesquisa translacional.IMPLEMENTATION OF SCIENTIFIC EVIDENCES IN NORMAL CHILDBIRTH CARE: LONGITUDINAL STUDYObjective: to evaluate the impact of an educational intervention on obstetric practices and perineal outcomes. Method: longitudinal study, according to the methodology of implementation of scientific evidence in clinical practice, performed with nurses and doctors, puerperas and medical records in a referred public maternity hospital in the state of Amapá. Result: after the educational intervention, more professionals recommended the lateral and vertical positions in the expulsive period of childbirth; More puerperas reported the practices of directed pull and maneuver of Kristeller; Less medical records indicated spontaneous laceration and higher degrees of lacerations. Conclusion: the educational intervention provided better results, but not statistically significant.Descriptors: Clinical audit, Perineum, Translational research.IMPLEMENTACIÓN DE LA EVIDENCIA CIENTÍFICA EN LA ATENCIÓN DE PARTO NORMAL: UN ESTUDIO LONGITUDINALObjetivo: Evaluar el impacto de una intervención educativa sobre las prácticas obstétricas y resultados perineales. Método: Estudio longitudinal, de acuerdo con la metodología de implementación de la evidencia científica en la práctica clínica, realizada con las enfermeras y los médicos, las madres y los registros en una referencia maternidad pública en el estado de Amapá. Resultado: Después de la intervención educativa, la mayoría de los profesionales recomiendan las posiciones laterales y verticales en la segunda etapa del parto; más madres reportaron las prácticas de extracción y maniobra dirigida Kristeller; a menos que los registros que se indican las laceraciones espontáneas y un mayor grado de laceraciones. Conclusión: La intervención educativa poca mejora de las prácticas y los resultados perineales.Descriptores: Auditoría clínica, Perineo, Investigación traslacional.

scholarly journals Implementation methodology of practices based on scientific evidence for assistance in natural delivery: a pilot study

2015 ◽  
Vol 49 (5) ◽  
pp. 716-725 ◽  
Author(s):  
Clodoaldo Tentes Côrtes ◽  
Rafael Cleison Silva dos Santos ◽  
Adriana de Souza Caroci ◽  
Sheyla Guimarães Oliveira ◽  
Sonia Maria Junqueira Vasconcelos de Oliveira ◽  
...  
Keyword(s):  
Medical Records ◽  
Best Practice ◽  
Statistical Difference ◽  
Clinical Audit ◽  
Scientific Evidence ◽  
Phase 1 ◽  
Maternity Hospital ◽  
Vertical Position ◽  
Significance Level ◽  
Exact Test

AbstractOBJECTIVEPresenting methodology for transferring knowledge to improve maternal outcomes in natural delivery based on scientific evidence.METHOD: An intervention study conducted in the maternity hospital of Itapecerica da Serra, SP, with 50 puerperal women and 102 medical records from July to November 2014. The PACES tool from Joanna Briggs Institute, consisting of pre-clinical audit (phase 1), implementation of best practice (phase 2) and Follow-up Clinical Audit (phase 3) was used. Data were analyzed by comparing results of phases 1 and 3 with Fisher's exact test and a significance level of 5%.RESULTSThe vertical position was adopted by the majority of puerperal women with statistical difference between phases 1 and 3. A significant increase in bathing/showering, walking and massages for pain relief was found from the medical records. No statistical difference was found in other practices and outcomes. Barriers and difficulties in the implementation of evidence-based practices have been identified. Variables were refined, techniques and data collection instruments were verified, and an intervention proposal was made.CONCLUSIONThe study found possibilities for implementing a methodology of practices based on scientific evidence for assistance in natural delivery.

scholarly journals 1309. The Impact of Clinical Practice Guideline Using Educational Intervention for Improvement of Diabetic Foot Infections Treatment Outcomes

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S400-S400
Author(s):  
Mullika Phangmuangdee ◽  
Oranich Navanukroh ◽  
Pornpan Koomanachai
Keyword(s):  
Clinical Practice ◽  
Educational Intervention ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Diabetic Foot ◽  
Unfavorable Outcome ◽  
Secondary Outcome ◽  
Diabetic Foot Infections ◽  
The Impact ◽  
Microbiological Data

Abstract Background Diabetic foot infections (DFIs) are important cause of lower-extremity amputation. The inappropriate empirical antimicrobial therapy for DFI was associated with amputation. We created the Clinical Practice Guideline (CPG) of empirical antimicrobial (ATB) therapy for in-patients with DFIs. The primary outcome of present study was to evaluate the intervention using educate and training the surgeons to adhere with CPG. The secondary outcome was the decreasing of unfavorable outcome (amputations). Methods A prospective study of CPG implementation for treatment in adult in-patients who had DFIs was conducted at surgical and orthopedics wards. The CPG was developed by the investigator team based on the data from our previous study (submitted to publish). CPG was presented monthly to train the orthopedic and vascular surgeons for 1 year. The empirical ATB regimens were prescribed by the responsible surgeon who was trained to use CPG. Demographics data, wound characteristics, microbiological data, ATB therapy, and clinical outcome were recorded. The appropriate empirical ATB treatment was determined by investigators weather CPG matched or microbiological matched. The adherence to CPG, the appropriate empirical ATB, and the unfavorable outcome were analyzed. All data were reported by descriptive and inferential statistics. Results A total of 85 DFIs patients were enrolled. The patients received the appropriate empirical ATB matched to CPG and matched to microbiological data, were 87% and 67%, respectively. The unfavorable outcome was 26% while previously was 72.4% (submitted to publish data) before CPG implementation. The independent factors associated with unfavorable outcomes were (1) an inappropriate ATB and (2) infections with drug-resistant pathogens (adjusted relative ratio; aRR 2.98; 95% CI: 1.36–6.55, P = 0.007 and aRR 1.90; 95% CI: 1.05–3.43, P = 0.034, respectively). Conclusion The current study demonstrated that mothly training of CPG resulting in the high adherence (87%) of CPG use and resulting in high rate of appropriate empirical ATB. Educational intervention insisted the responsible physician for administration the appropriate ATB with the improvement of unfavorable outcome in DFIs. Disclosures All authors: No reported disclosures.

scholarly journals Implementation of evidence-based practices in normal delivery care

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Clodoaldo Tentes Côrtes ◽  
Sonia Maria Junqueira Vasconcellos de Oliveira ◽  
Rafael Cleison Silva dos Santos ◽  
Adriana Amorim Francisco ◽  
Maria Luiza Gonzalez Riesco ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Medical Records ◽  
Positive Impact ◽  
Phase 1 ◽  
Lithotomy Position ◽  
Delivery Care ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Normal Delivery ◽  
The Impact

ABSTRACT Objective: to evaluate the impact of the implementation of evidence-based practices on normal delivery care. Method: quasi-experimental, before-and-after intervention study conducted in a public maternity hospital, Amapá. Forty-two professionals and 280 puerperal women were interviewed and data from 555 medical records were analyzed. The study was developed in three phases: baseline audit (phase 1), educational intervention (phase 2) and post-intervention audit (phase 3). Results: after the intervention, there was an increase of 5.3 percentage points (p.p.) in the normal delivery rate. Interviews with the women revealed a significant increase of the presence of companions during labor (10.0 p.p.) and of adoption of the upright or squatting position (31.4 p.p.); significant reduction of amniotomy (16.8 p.p.), lithotomy position (24.3 p.p.), and intravenous oxytocin (17.1 p.p.). From the professionals’ perspective, there was a statistical reduction in the prescription/administration of oxytocin (29.6 p.p.). In the analysis of medical records, a significant reduction in the rate of amniotomy (29.5 p.p.) and lithotomy position (1.5 p.p.) was observed; the rate of adoption of the upright or squatting position presented a statistical increase of 2.2 p.p. Conclusions: there was a positive impact of the educational intervention on the improvement of parturition assistance, but the implementation process was not completely successful in the adoption of scientific evidence in normal delivery care in this institution.

scholarly journals Good practice for guidance development – review of consensus methods

2019 ◽  
Vol 17 (4) ◽  
pp. 217-229
Author(s):  
Jacek Siwiec ◽  
Magdalena Konieczna ◽  
Magdalena Koperny
Keyword(s):  
Clinical Practice ◽  
Formal Methods ◽  
Scientific Evidence ◽  
Methodological Approach ◽  
Good Practice ◽  
Consensus Conference ◽  
Nominal Group ◽  
Consensus Methods ◽  
Wide Range ◽  
The Impact

Introduction. The process of synthesizing scientific evidence and translating elaborate scientific research findings into recommendations for clinical practice is one of the most complex and significant initiatives in health care. In connection with the increasing number of recommendations, previously unformalised elements such as the process of consensus decision-making require developing a methodological approach. The use of consensus methods serves to reduce the impact of psychosocial factors in the formulation of recommendations and to increase the degree of process transparency. The aim of the publication is to present formal methods of achieving consensus used in the process of developing clinical practice guidelines. Materials and methods. The review focuses on results of reports analyzing the procedure and methods of developing clinical recommendations, with particular emphasis on the identification of consensus methods. Results. Many international and national organizations and institutions develop recommendations or adapt guidelines developed by others. They use both informal and formal instruments to deal with divergent expert opinions. The most popular formal methods of achieving consensus identified in the review are the Delphi method, the nominal group technique, the RAND/UCLA method, the consensus conference, and the combinations of individual approaches. Formal methods have been shown to lead to less biased and more reliable recommendations. Regardless of the method used, the guidelines should clearly define the quorum and document the process of agreeing a common standpoint on recommendations, guidelines and recommendations. Conclusions. Clinical guidelines have become an important tool influencing clinical practice. The participation of many experts representing the opinions and interests of different groups makes it necessary to apply a methodological and structured approach so that all participants have the opportunity to voice their opinion and to ensure process transparency, deal with misunderstandings and achieve a consensual position. The consensus methods allow to provide a wide range of stakeholders clinicians, policy makers, patients – with agreed rules of conduct in a given topic. The formal consensus methods and recommendations based on these methods combine scientific evidence with the practice and experience of experts.

scholarly journals Factors Impacting Use of Information Technology by Physicians in Private Practice

2012 ◽  
Vol 7 (2) ◽  
pp. 17-28 ◽  
Author(s):  
Jim P. DeMello ◽  
Satish P. Deshpande
Keyword(s):  
Information Technology ◽  
Clinical Practice ◽  
Electronic Medical Records ◽  
Patient Information ◽  
Private Practice ◽  
Medical Records ◽  
The United States ◽  
National Sample ◽  
Group Practice ◽  
The Impact

This research examines the impact of various factors on the use of IT in clinical practice, prescriptions, and patient information. This was done using a national sample of 3425 physicians who worked in a solo or group practice in the United States. Besides the extent of use of electronic medical records by physicians and number of physicians in practice, none of the other factors consistently impacted the use of IT in clinical practice, prescriptions, and patient information, respectively. The results of this study highlight the need to develop specific strategies to increase the use of information technology in healthcare.

scholarly journals Adherence to Clinical Practice Guidelines

2017 ◽  
Vol 157 (4) ◽  
pp. 548-550 ◽  
Author(s):  
Marisa A. Ryan
Keyword(s):  
Clinical Practice ◽  
American Academy ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Scientific Evidence ◽  
Quality Care ◽  
Neck Surgery ◽  
Relevant Research ◽  
High Quality ◽  
The Impact

Clinical practice guidelines are designed to synthesize and disseminate the best available evidence to guide clinical practice. The goal is to increase high-quality care and reduce inappropriate interventions. Clinical practice guidelines that systematically review evidence and synthesize it into recommendations are important because the available scientific evidence is normally neither rapidly nor broadly incorporated into practice. It is important to understand and improve the impact of our American Academy of Otolaryngology—Head and Neck Surgery Foundation clinical practice guidelines on this uptake of scientific knowledge. Considering the barriers to guideline adherence is a central part of this. This understanding can guide clinicians, future guideline authors, and researchers when using guidelines, writing them, and planning clinically relevant research.

scholarly journals PLACE OF INFORMATION TECHNOLOGY IN THE PERFORMANCE OF MEDICAL ACTIVITIES

2021 ◽  
Author(s):  
Sibilla Buletsa
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Information Systems ◽  
Medical Records ◽  
Computer Modelling ◽  
The State ◽  
Central Component ◽  
Medical Field ◽  
Ministry Of Health ◽  
The Impact

The state's policy is to integrate information systems into a single information space within the electronic health care system. The state plans and coordinates information systems that are implemented at the expense of the state or local budgets in order to rationalize the use of available resources and to avoid duplication of information systems functionality. With regard to information systems implemented through private funds, the function of the state is to build infrastructure (standardization, certification, market surveillance) for quality management in the market. The state provides single entry of information and its further processing in many information systems, storage of basic patient information within the central component of the WHO, and expanded information (eg data in clinical registers) in decentralized specialized information systems. The purpose of this study is to study the place of information technology in the implementation of medical activities. I would point out that medical activity is a set of actions of medical and pharmaceutical workers in providing medical care or service to a patient within the legal (subject to obtaining a license) and ethical (oath of Hippocrates) norms, ie compliance with the stages of treatment in accordance with the established standards of the Ministry of Health. We used in research scientific methods to analise in an objective and systematic way the information technology in the performance of medical activities, describe it with empirical. formal-logical, comparative-legal methods. It should be noted that e-Health is an electronic system that helps patients to receive and to doctors to provide quality medical services. All medical records throughout 2019 will be transmitted electronically. The main purpose of implementing an electronic healthcare system is to minimize fraud and corruption. In the future, e-Health will enable everyone to get their medical information quickly and doctors will be able to diagnose correctly with a holistic picture of the patient's health. The aim of the MoH is to launch a full-fledged eHealth by 2020, which would not only reflect the relationship between the hospital and the state but also be a register of medical records of all Ukrainians. Results. Thus, with the advancement of information technology, the growing share of medical research that relies on mathematical (computer) modelling has become commonplace in clinical practice, making it clear that IT capabilities are becoming a major contributor to medicine and health care. To date, many serious studies and projects are being implemented in the world to implement IT in the medical field. Due to medical reform, continuous computerization necessitated the need for medical staff to have computer skills. Today, in the medical field, services such as electronic medical record, electronic prescription, electronic referral, etc. are included in daily life. Electronic automated preparation of appointments, prescriptions, statements, hospital letters and other standardized documents for patients. In particular, there are automated databases of medical, pharmaceutical and scientific-pedagogical staff of the Ministry of Health of Ukraine. Conclusion. The impact of IT on health care plays an extremely important role, as with the implementation of health care reform in Ukraine there is complete computerization of all branches of the medical field.

scholarly journals Economics of Criminal Proceedings in View of Procedural Principles

2021 ◽  
Vol 5 (1) ◽  
pp. 1-12
Author(s):  
Dobrosława Szumiło-Kulczycka
Keyword(s):  
Economic Analysis ◽  
Scientific Evidence ◽  
Empirical Studies ◽  
The State ◽  
Criminal Trial ◽  
Economic Factors ◽  
District Courts ◽  
Economic Analysis Of Law ◽  
Criminal Proceedings ◽  
The Impact

This article was written as part of the Costs of a Criminal Trial in View of an Economic Analysis of Law research project. Part one contains deliberations on the impact of economic factors on the regulations concerning the criminal procedure. One needs to answer the question of whether such factors should be considered as affecting the principles on the basis of which the model of the criminal trial is being developed and whether there are any solutions that have been introduced specifically because of the profit and loss account related to the prosecution of a perpetrator. Part two focuses on the fundamental results and the conclusions of empirical studies carried out with respect to the expenses incurred by the State Treasury in criminal proceedings, considering the expenses incurred in serious cases, i.e., those examined in the first instance by regional courts, and in minor cases, which in the first instance are handled by district courts. Results and Conclusions: The article points out three fundamental factors determining the amount of the expenses, i.e., the fact of the accused being imprisoned during the proceedings, the use of scientific evidence (opinions produced by expert witnesses), and the participation of a public defender remunerated by the State Treasury.

Cancer and depression: Integrating scientific evidence with clinical practice

2011 ◽  
Vol 26 (S2) ◽  
pp. 2210-2210
Author(s):  
D. Eraslan
Keyword(s):  
Clinical Practice ◽  
Everyday Life ◽  
Clinical Setting ◽  
Scientific Evidence ◽  
The Body ◽  
Normal Reaction ◽  
Patients With Cancer ◽  
Existential Crisis ◽  
Diagnosis Of Cancer ◽  
The Impact

A diagnosis of cancer is one of the most distressing events in life. It changes the course of everyday life and causes an existential crisis. This makes some clinicians think that depression is a normal reaction to a diagnosis of cancer. However, the body of evidence suggests that not all people diagnosed with cancer develop depression, but patients with cancer have an increased rate of depression. This presentation will try to combine the latest data on depression and cancer, including the mechanisms underlying depression in these patients and the impact of psychiatric diagnosis on the outcome of cancer. We will then focus on the implications of these data on the diagnosis and management of depression in the clinical setting.

scholarly journals Intervenção educacional para melhoria na assistência ao trabalho de parto normal

2020 ◽  
Vol 19 (2) ◽  
pp. 226-256
Author(s):  
Ivana Mayra da silva Lira ◽  
Simone Santos e Silva Melo ◽  
Marcia Teles De Oliveira Gouveia ◽  
Verbenia Cipriano Feitosa ◽  
Tatiana Maria Melo Guimarães
Keyword(s):  
Educational Intervention ◽  
Scientific Evidence ◽  
Maternity Hospital ◽  
Research Committee ◽  
Obstetric Nurses ◽  
Before And After ◽  
Post Test ◽  
Quasi Experimental ◽  
Las Mujeres ◽  
Nursing Professionals

Introducción: El desempeño de la enfermería obstétrica en el escenario del parto y el parto, ha ido ganando protagonismo por ser una profesional considerada una figura indispensable para el logro de un parto humanizado, con el objetivo de rescatar la autonomía de las mujeres. Materiales y métodos: Este es un estudio cuasi experimental, antes y después, que desarrolló una intervención educativa, realizada a través de un curso de capacitación aplicado al personal de enfermería. Celebrada del 01 al 03 de agosto de 2018 en la sala de partos de un hospital de maternidad en Teresina-PI. Se solicitó la autorización del comité de enseñanza e investigación de la institución, con una opinión favorable para llevar a cabo. Resultados: Treinta y dos profesionales participaron en la intervención, con la mayoría del personal de enfermería del centro obstétrico, con 87.50% de técnicos de enfermería y 85.71% de enfermeras obstétricas. Se puede observar que en la prueba previa hubo un mayor número de errores en las preguntas, 5 con 46.87% de error y 10 con 32.50% de error en el tema de cuidados de enfermería en trabajo de parto y parto, con mejoría después de la aplicación de la intervención con 18.75 y 9.25 errores respectivamente en el examen posterior. Discusión: Frente a varias opciones de estrategias de instrucción, la educación continua tiene un lugar destacado en enfermería, porque a partir de los resultados, podemos ver la mejora del conocimiento de profesionales después de aplicar la intervención educativa. Conclusión: La intervención permitió a los profesionales ampliar sus conocimientos y proporcionar al binomio madre-RN una atención humanizada respaldada por evidencia científica. Introduction: The performance of obstetric nursing in the scenario of labor and childbirth has gained prominence because nursing professionals are considered indispensable actors for the achievement of humanized birth, to rescue the autonomy of women. Materials and methods: This is a quasi-experimental study of the before and after type, in which an educational intervention was developed, conducted through a training course applied to the nursing staff. The study was accomplished from August 01 to 03, 2018, in the childbirth room of a maternity hospital in Teresina-PI. Authorization from the teaching and research committee of the institution was requested, with a favorable Opinion for its realization. Results: Thirty-two professionals participated in the intervention. The majority was from the obstetric center; 87.50% were nursing technicians and 85.71% obstetric nurses. There was a greater number of errors in questions 5 (46.87% of error) and 10 (32.50% of error) in the pre-test, in the theme nursing care in labor and childbirth, and an improvement of to 18.75 and 9.25 of error, respectively, in the post-test. Discussion: Among the several options of instructional strategies, continuing education has a prominent place in nursing, as the results of this study showed an improvement in the knowledge of professionals after application of the educational intervention. Conclusion: The intervention allowed the professionals to broaden their knowledge and provide the mother-newborn binomial with a humanized care supported by scientific evidence.

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