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首页> 外文期刊>Internal medicine journal >Implementing evidence-based guidelines:inpatient management of chronic obstructive pulmonary disease.
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Implementing evidence-based guidelines:inpatient management of chronic obstructive pulmonary disease.

机译：实施基于循证指南：慢性阻塞性肺病的住院治疗。

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BACKGROUND: Evidence-based guidelines exist to guide inpatient management of chronic obstructive pulmonary disease (COPD) exacerbations, but we do not know how well these recommendations are adhered to. AIMS: The aims of this study were: (i) to examine concordance with evidence based guidelines for inpatient management of COPD and (ii)to address deficiencies in compliance with guidelines by feedback of audit results and distribution of an education package. Methods: Retrospective chart reviews were performed using a data collection tool based on current guidelines. Forty-nine consecutive COPD admissions were audited, and results presented to medical staff. An education package was distributed directly after the presentation. One month later,35 consecutive separations were reviewed. Concordance with recommendations supported by the highest level of evidence was calculated. RESULTS: Data were complete for 84 cases. Concordance rates ranged from 0 to 100%. Apart from initiation of systemic steroids (80-83%)and avoidance of intravenous aminophylline (100%),concordance rates were less than 60%. The only significant improvement post-intervention was for steroid duration (10 vs 29%,95% confidence interval for difference (-36.2, -1.8)). CONCLUSION: Recommendations for steroid initiation and avoidance of aminophylline are well adhered to. Concordance rates for other recommendations were generally less than 60%. Concordance with recommendations for steroid duration was significantly improved by our intervention.The findings suggest that to facilitate evidence-based practice, alternative interventions should be evaluated.
机译：背景：存在循证指南，以指导慢性阻塞性肺病（COPD）恶化的住院治疗，但我们不知道这些建议遵守了程度。旨在：本研究的目的是：（i）与基于审计管理的基于循证管理准则，遵守审计结果的反馈和教育包的分配，以遵守指导方针的循证管理指令。方法：追溯图表评论是使用基于当前指南的数据收集工具进行的。四十九次连续普遍审计招生以及向医务人员提供的结果。教育包裹在演示后直接分发。一个月后，35次连续分离。计算了最高级别证据支持的建议的一致性。结果：数据已完成84例。一致性范围从0到100％。除了发起全身类固醇（80-83％）和避免静脉内氨基啉基（100％），一致性率小于60％。干预后唯一的显着改善是针对类固醇持续时间（10 vs 29％，差异为95％的置信区间隔（-36.2，-1.8））。结论：对类固醇发育和避免氨基碱的建议良好粘附到。其他建议的一致性率通常不到60％。通过我们的干预，对类固醇持续时间的建议进行了一致性，我们的干预显着改善。该研究结果表明，为了促进基于循证的做法，应评估替代干预措施。

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