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Starr M. Towards national paediatric clinical practice guidelines. Med J Aust 2024; 220:392-393. [PMID: 38532300 DOI: 10.5694/mja2.52272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/22/2023] [Indexed: 03/28/2024]
Affiliation(s)
- Mike Starr
- Royal Children's Hospital, Melbourne, VIC
- University of Melbourne, Melbourne, VIC
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Seed L, Klein A, Kagalwala F. Hospital intranet system is major barrier to paediatric clinical guideline use a cross-sectional single-centre survey of NHS doctors and nurses. Ann Med Surg (Lond) 2022; 75:103385. [PMID: 35194515 PMCID: PMC8850160 DOI: 10.1016/j.amsu.2022.103385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 11/21/2022] Open
Abstract
Across clinical specialties, the use of clinical guidelines is integral to maintaining patient safety, reducing variation in clinical practice and optimising patient care. Identifying specific barriers to the effective use of guidelines within individual healthcare settings allows for the implementation of effective strategies to overcome them, and ultimately improvements in patient care. Here, we report a single-centre survey of paediatric doctors and nurses, which formed part of a quality improvement project within the Acute Paediatrics Department of an NHS district general hospital. The primary aim of the study was to explore the perspective and resource barriers paediatrics healthcare staff experience when using local and national clinical guidelines. The secondary aim of the study was to examine the impact of the Covid-19 pandemic on local and national clinical guideline use. We found that local and national guidelines are frequently used by paediatric doctors and nurses, and that they have positive perceptions of guidelines, overall. However, the NHS Trust's Intranet system was identified as a direct barrier to the use of local paediatric clinical guidelines. Staff throughout the UK in the NHS rely on their Intranet system in order to access local guidelines. Our results provide an impetus for interventions within this NHS Trust, and in the many other NHS Trusts with similar Intranet systems, to increase clinical guideline use and, ultimately, improve patient care.
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Affiliation(s)
- Lydia Seed
- School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0SP, UK
- Corresponding author. Emmanuel College, St Andrews Street, Cambridge, Cambridgeshire, CB2 3AP, UK.
| | - Alannah Klein
- School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0SP, UK
| | - Fatima Kagalwala
- Department of Paediatrics, Lister Hospital, Stevenage, SG1 4AB, UK
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Uppal P, Cardamone M, Webber C, Briggs N, Lawson JA. Management of status epilepticus in children prior to medical retrieval: Deviations from the guidelines. J Paediatr Child Health 2019; 55:1458-1462. [PMID: 30924266 DOI: 10.1111/jpc.14448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 01/20/2019] [Accepted: 02/10/2019] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the influence of adherence to treatment guidelines on outcomes in children presenting with status epilepticus (SE) using the Newborn and Paediatric Emergency Transport Service, New South Wales prospective registry. METHODS We reviewed the treatment of children with SE, transported by the Newborn And Paediatric Emergency Transport Service to a tertiary paediatric hospital, over 1 year. We evaluated variation in management from the New South Wales clinical practice guideline. RESULTS There was excessive administration of benzodiazepines (BZD) and a delay in administration of appropriate second-line treatment of status (median 45 min). There was excessive use of BZD, with five or more doses of BZD associated with significantly higher odds for intubation. CONCLUSION There is considerable scope to improve clinician compliance with the SE clinical practice guidelines.
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Affiliation(s)
- Preena Uppal
- Department of Paediatric Neurology, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Cardamone
- Department of Paediatric Neurology, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Christopher Webber
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.,Emergency Department, Sydney Children's Hospital Randwick, Sydney, New South Wales, Australia.,New South Wales Newborn and Paediatric Emergency Transport Service, Sydney, New South Wales, Australia
| | - Nancy Briggs
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - John A Lawson
- Department of Paediatric Neurology, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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Amer YS, Al Nemri A, Osman ME, Saeed E, Assiri AM, Mohamed S. Perception, attitude, and satisfaction of paediatric physicians and nurses towards clinical practice guidelines at a university teaching hospital. J Eval Clin Pract 2019; 25:543-549. [PMID: 29611621 DOI: 10.1111/jep.12923] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 02/27/2018] [Accepted: 03/02/2018] [Indexed: 01/09/2023]
Abstract
RATIONALE, AIMS, AND OBJECTIVES To explore perception, attitude, and satisfaction of paediatric clinicians, trainees, and nurses at King Khalid University Hospital towards clinical practice guidelines (CPGs) including the locally adapted diabetic ketoacidosis CPG (DKA-CPG). METHODS A cross-sectional survey was distributed to 260 doctors and nurses working in the paediatrics department. RESULTS The response rate was 95.4%. The respondents had a positive perception and attitude towards general CPGs and specifically for the DKA-CPG; 98.7% thought CPGs were useful sources of advice, improved safety, and decreased risk, and reduced variation in practice. A total of 99.2% thought CPGs were good clinical tools, 98.3% satisfied with, had confidence in well-developed CPGs, and would recommend them to their colleagues to use, and 94.6% agreed they were cost-effective. The preferred format for CPGs was paper (46.6%) and electronic (42.9%). The DKA-CPG helped in managing patients and respondents were all satisfied and had confidence with it (100%). The rationale and objectives of the DKA-CPG were clear for 99.25%; 98.5% thought the layout was clear and well organized and user-friendly (96.2%). Compared with nurses, physicians had a higher perception towards CPGs in general (P < .05) and the DKA-CPG (P < .05). CONCLUSIONS The paediatric doctors, and nurses have a great perception and satisfaction and positive attitude towards CPGs in general, towards the paediatric diabetic ketoacidosis CPG in particular, which in turn had a positive impact on the acceptability and implementation of the CPGs. These findings could help in sustaining a safe and high-quality health care environment through implementation of evidence-based CPGs.
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Affiliation(s)
- Yasser Sami Amer
- Quality Management Department, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.,Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.,Alexandria Centre for Evidence-Based Clinical Practice Guidelines, Alexandria University Medical Council, Alexandria University, Alexandria, Egypt
| | - Abdulrahman Al Nemri
- Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed Elfaki Osman
- Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Elshazaly Saeed
- Prince Abdullah Bin Khalid Celiac Disease Research Chair, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia
| | - Asaad Mohamed Assiri
- Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Prince Abdullah Bin Khalid Celiac Disease Research Chair, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia
| | - Sarar Mohamed
- Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Prince Abdullah Bin Khalid Celiac Disease Research Chair, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.,Department of Paediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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