CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Clinical trials have demonstrated the superiority of coordinated interdisciplinary stroke unit care over conventional treatment of stroke patients on general medical wards. The evidence is so strong that several national bodies have recommended that stroke unit care be widely implemented. ⋯ By replicating and adapting the core characteristics identified in the randomized trials, we have been able to demonstrate the effectiveness of stroke unit care in a routine clinical setting. Our experience may help facilitate the development of organized stroke care in Canada.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Fetal health surveillance: a community-wide approach versus a tailored intervention for the implementation of clinical practice guidelines.
The decreased use of electronic fetal monitoring (EFM) for healthy women in labour and the increased provision of professional support to all women in labour is recommended by experts. We evaluated the effectiveness of a community-wide approach to transferring research results to practice using a regional committee, newsletter articles and annual conference presentations compared with an additional tailored hospital intervention involving workshops to enhance self-efficacy for nurses, policy review, multidisciplinary meetings, rounds and unit discussions. ⋯ The results are mixed, and the tailored intervention thus appeared to have limited effects. No association was found between the reduction in the use of EFM and an increase in nurses' time spent providing labour support.