International journal of evidence-based healthcare
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Int J Evid Based Healthc · Jun 2014
Review Meta AnalysisA qualitative metasynthesis: family involvement in decision making for people with dementia in residential aged care.
Involving people in decisions about their care is good practice and ensures optimal outcomes. Despite considerable research, in practice family involvement in decision making can be challenging for both care staff and families. The aim of this review was to identify and appraise existing knowledge about family involvement in decision making for people with dementia living in residential aged care. ⋯ Results indicate varied and complex experiences and multiple factors influencing decision making. Communication and contacts between staff and families and the support available for families should be addressed, as well as the role of different stakeholders in decisions.
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Int J Evid Based Healthc · Jun 2014
ReviewEfficacy of hospital in the home services providing care for patients admitted from emergency departments: an integrative review.
Increases in emergency department (ED) demand may compromise patient outcomes, leading not only to overcrowding in the ED, increased ED waiting times and increased ED length of stay, but also compromising patient safety; the risk of adverse events is known to rise in the presence of overcrowding. Hospital in the home (HiTH) services may offer one means of reducing ED demand. ⋯ Given evidence suggesting that HiTH services which recruit patients directly from the ED contribute to cost-savings, greater patient satisfaction and safety and efficacy outcomes that are at least equivalent to those associated with hospital-based care, the expansion of such programmes might therefore be considered a priority for policy makers.
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Int J Evid Based Healthc · Mar 2014
Editorial ReviewRecommendations from international clinical guidelines for routine antenatal infection screening: does evidence matter?
Maternal infections in pregnancy may cause severe child morbidity. In this article, we aim to summarise recommendations from international evidence-based clinical guidelines for infection screening in pregnancy. ⋯ The variety of grades of recommendations hamper across-guideline comparison. Nevertheless, the article highlights agreed screening areas based on the best available evidence as well as areas of still existing uncertainty. Local health policy decisions on whether to include or refrain from including screening measures in preventive care programmes can be facilitated by the comparison of recommendations from international evidence-based guidelines. Beyond the availability of evidence each country's health policy makers will have to make a judgement on the value of the test for a population-wide screening.
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Int J Evid Based Healthc · Dec 2013
ReviewInforming clinical policy decision-making practices in ambulance services.
This study aims to identify the processes and frameworks that support an evidence-based approach to clinical policy decision-making practices in ambulance services. ⋯ There is little published literature that describes the processes involved, and frameworks required, to inform clinical policy decision making within ambulance services. This review found that processes were iterative and involved collaborations across many internal and external stakeholders. In several jurisdictions, these were coordinated by a dedicated team. Success appears dependent on committed leadership and purposive human and structural resources. Although time consuming, structured processes have been developed in some jurisdictions to assist decision-making processes. Further insight is likely to be obtained from literature published by those from other disciplines.
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Int J Evid Based Healthc · Jun 2013
ReviewAdjunct ultrasonography for breast cancer screening in women at average risk: a systematic review.
Screening with mammography has the ability to detect breast cancer at an early stage but misses some cancers. Supporters of adjunct ultrasonography to the screening regimen argue that it might be a safe and inexpensive approach to reduce the false-negative rates of screening. Critics are concerned that adjunct ultrasonography will also increase the rate of false-positive findings and can lead to unnecessary biopsies and treatments in women at average risk. ⋯ Clinicians should not use ultrasonography as a screening tool for breast cancer screening on a routine basis. The use should be limited to women with dense breasts for whom the accuracy of mammography is low, or for diagnostic purposes.