International journal of evidence-based healthcare
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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 · Dec 2013
Validity and reliability of the aneroid sphygmomanometer using a paediatric size cuff for craniocervical flexion test.
The craniocervical flexion test (CCFT) is generally undertaken using a pressure biofeedback unit. However, the high costs of the device limits its availability in poorly resourced healthcare settings. The use of alternate measures such as the aneroid sphygmomanometer to undertake CCFT need to be investigated. ⋯ This study has confirmed high concurrent validity, intra- and inter-rater reliability of the aneroid sphygmomanometer using a paediatric cuff for CCFT in asymptomatic adults. Its use in people with neck pain warrants investigation.
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Int J Evid Based Healthc · Dec 2013
Evidence utilisation project: Management of inadvertent perioperative hypothermia. The challenges of implementing best practice recommendations in the perioperative environment.
The prevention of inadvertent perioperative hypothermia (IPH) remains an important issue in perioperative healthcare. The aims of this project were to: (i) assess current clinical practice in the management of IPH and (ii) promote best practice in the management of IPH in adult operating theatres. ⋯ Temperature monitoring, warming and rates of normothermia improved; however, barriers to best practice of IPH management were experienced, which negatively impacted on the project. Further stages of implementation and audit were added to further address IPH management in this department.