Journal of evaluation in clinical practice
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The development of clinical practice guidelines (CPG) has evolved into a rigorous and complex process. There is a need for training of CPG developers including methodologists, panel members and patient representatives. This study explored the educational needs and experiences of CPG developers, with specific attention to the patient perspective and economic considerations. ⋯ This study underscores the importance of tailored CPG development training programmes addressing the specific competencies required for the different roles in CPG development. Thereby, recognising a holistic approach encompassing both content- and process-related aspects. Addressing economic considerations and the patient perspective in training will contribute to CPGs that support a patient-centred and sustainable healthcare system.
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Implementation of clinical practice guidelines, an important strategy in the prevention of pressure injuries, enables the nurse to interpret evidence-based guideline recommendations, reduce errors, ensure compliance and standardisation of complex processes, manage patient-related risks and systematically regulate all preventable conditions. ⋯ This study demonstrated that the SPIPP- Adult Checklist 2.0 is a valid tool. Interventions using the evidence-based checklist should be integrated into the workflow and provide the best opportunity for successful and sustainable pressure injury prevention.
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This commentary on Sturmberg and Mercuri's paper 'Every Problem is Embedded in a Greater Whole' [1] argues that those authors have approached complexity from a largely mathematical perspective, drawing on the work of Sumpter. Whilst such an approach allows us to challenge the simple linear causality assumed in randomised controlled trials, it is itself limited. ⋯ It overlooks, for example, how science itself is historically and culturally shaped and how values-driven misunderstandings and conflicts are inevitable when people with different world views come together to try to solve a problem. This paper argues that the mathematical version of complexity thinking is necessary but not sufficient in medical research, and that we need to enhance such thinking further with attention to human values.
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To apply the Ottawa Model of Research Use to translate the Guidelines for the Prevention and Control of Vascular Catheter-Associated Bloodstream Infections. ⋯ Through this clinical change, a perfect prevention and control system has been established, and the level of knowledge, belief, and behavior of medical staff in preventing CLABSI has been improved, while the incidence of CLABSI has been reduced.
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The potential applications of large language models (LLMs)-a form of generative artificial intelligence (AI)-in medicine and health care are being increasingly explored by medical practitioners and health care researchers. ⋯ Accordingly, this paper finds a strong case for the incorporation of LLMs into clinical practice and, if their risk of patient harm is sufficiently mitigated, this incorporation might be ethically required, at least according to principlism.