NICE to HELP: operationalizing National Institute for Health and Clinical Excellence guidelines to improve clinical practice.
NICE to HELP: operationalizing National Institute for Health and Clinical Excellence guidelines to improve clinical practice.
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DOI：
10.1111/jgs.12768
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发表时间：
2014-04
影响因子：
6.3
通讯作者：
Inouye SK
中科院分区：
文献类型：
--
作者：
Yue J;Tabloski P;Dowal SL;Puelle MR;Nandan R;Inouye SK
英国国家健康与临床卓越研究所（NICE）于2010年7月制定了谵妄诊断、预防和管理指南，其中包括10项谵妄预防建议。医院老年人生活方案是一项有针对性的多方面战略，已被证明对预防住院老年人的功能和认知能力下降是有效和具有成本效益的。HELP为7/10（70%）的NICE建议提供了大部分基础。考虑到新HELP研究中心对满足NICE指南的兴趣，我们开发了3种以前未纳入HELP计划的新方案，解决缺氧、感染和疼痛问题。此外，NICE脱水指南包括便秘，这在HELP方案中没有具体解决。该项目描述了3个新协议（缺氧，感染和疼痛）的系统开发和现有HELP协议（便秘/脱水）的扩展，以实现HELP协议和NICE指南之间的一致性。根据医学研究所关于制定值得信赖的指南的建议，我们由一个跨学科的专家组对当前文献进行了系统的回顾，对证据的质量进行了评级，根据最高质量的证据制定了干预方案，并将方案首先提交给内部审查，然后由一个跨学科的专家小组进行外部审查。根据审查过程对方案进行了修订，并将其纳入HELP材料。纳入这些协议增强了HELP计划的范围，并允许实现NICE指南对谵妄预防的建议。我们应用的严格过程可能为更新现有指南或方案提供有用的示例，这些指南或方案可能适用于广泛的临床应用。
The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom developed guidelines for the diagnosis, prevention, and management of delirium in July, 2010, which included 10 recommendations for delirium prevention. The Hospital Elder Life Program (HELP) is a targeted multicomponent strategy which has proven effective and cost-effective to prevent functional and cognitive decline in hospitalized older persons. HELP provided much of the basis for 7/10 (70%) of the NICE recommendations. Given interest by new HELP sites to meet NICE guidelines, we developed 3 new protocols which were not previously included in the HELP program, addressing hypoxia, infection, and pain. Additionally, the NICE dehydration guideline included constipation, which was not specifically addressed in the HELP protocols. This project describes the systematic development of 3 new protocols (hypoxia, infection, and pain) and the expansion of an existing HELP protocol (constipation/dehydration) to achieve alignment between the HELP protocols and NICE guidelines. Following the Institute of Medicine recommendations for developing trustworthy guidelines, we undertook a systematic review of current literature by an interdisciplinary group of experts, rated the quality of the evidence, developed intervention protocols based on the highest quality evidence, and submitted the protocols first to internal review, then external review by an interdisciplinary panel of experts. The protocols were revised based on the review process, and were incorporated into the HELP materials. Inclusion of these protocols enhances the scope of the HELP program, and allows fulfillment of NICE guideline recommendations for delirium prevention. The rigorous process we applied may provide a useful example for updating existing guidelines or protocols, which may be applicable to a broad range of clinical applications.
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影响因子：
158.5
作者：
Inouye, SK;Bogardus, ST;Cooney, LW
通讯作者：
Cooney, LW
DOI：
10.1016/j.jamcollsurg.2011.05.004
发表时间：
2011-08-01
影响因子：
5.2
作者：
Chen, Cheryl Chia-Hui;Lin, Ming-Tsan;Inouye, Sharon K.
通讯作者：
Inouye, Sharon K.
影响因子：
3
作者：
Rizzo, JA;Bogardus, ST;Inouye, SK
通讯作者：
Inouye, SK
DOI：
10.1046/j.1532-5415.2001.49108.x
发表时间：
2001-05-01
影响因子：
6.3
作者：
Marcantonio, ER;Flacker, JM;Resnick, NM
通讯作者：
Resnick, NM
DOI：
10.1111/j.1532-5415.2005.53156.x
发表时间：
2005-03-01
影响因子：
6.3
作者：
Leslie, DL;Zhang, Y;Inouye, SK
通讯作者：
Inouye, SK