Journal of evaluation in clinical practice
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Observational Study
The influence of body mass index on temperature management during general anaesthesia-A prospective observational study.
During general anaesthesia, body core temperature is influenced by several factors that are either anaesthesia-related (type and duration of anaesthesia and fluid management), surgery-related (type of surgery and extent of the surgical procedure), or patient-related (age, gender, body weight, and preoperative body core temperature). Interestingly, data concerning body mass index (BMI) and its influence on patients' temperature are sparse. The aim of this study was to evaluate the impact of BMI on body core temperature under general anaesthesia. ⋯ Current guidelines provide effective protection against perioperative hypothermia. In the current study, this was true for obese as well as normal weight patients.
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The risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence-based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence-based practice for UI in patients aged 65 or older undergoing hip surgery. ⋯ To promote evidence-based practice related to safe procedures for older people in hospital care, there is a need to better understand strategies that successfully facilitate knowledge implementation. This study suggests that a multiprofessional team approach is promising for instigating a process towards evidence-based management of UI.
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The practice of glycaemic control of critically ill patients admitted to intensive care units (ICUs) is guided by clinical management protocols, designed locally by the ICUs. These protocols differ significantly in their aims and methods. The aim of this study was to develop a standardized methodology for the systematic and objective analysis and comparison of protocols for glycaemic control implemented in any ICU. ⋯ The methodology developed in this study will allow for any future work analysing the contents of glycaemic control protocols to be carried out in a structured and standardized way. This may be done either as a standalone study, or as the essential first step in any investigation on the impact of new protocols. In turn, the methodology will facilitate the performance of regional, national, and international comparisons, demonstrating the usefulness of this study at a global scale.
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Telemedicine applications, such as a mobile radiography service, provide a new way of organizing healthcare services. In order to provide safe and personalised care for nursing home residents during X-ray examinations, mobile radiography services have been implemented. The objective of this study was to analyse the costs of X-ray examinations and treatments for nursing home residents when comparing hospital-based imaging with a combination of hospital-based imaging and a mobile radiography service in Southeast Norway. ⋯ A mobile radiography service in nursing homes provides a safe, high quality health care service. The result of this study showed there was a 30% cost-reduction by implementing the mobile radiography service.
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Multicenter Study
A multicenter cross-sectional study of episiotomy practice in Romania.
The aim of this study was to focus attention on episiotomy practice in Romanian maternity units in order to identify factors associated with the very high rate of the procedure in Romania and to consider strategies to reduce it. ⋯ In conclusion, routine episiotomy is the norm in Romanian maternity units, with episiotomy rates among the highest in Europe. Episiotomy use is mainly driven by local professional norms, experiences, previous training, and practitioners' decisions rather than evidence, guidelines, or variations in patient needs at the time of vaginal birth.