Document Detail


The validation of a clinical algorithm for the prevention and management of pulmonary dysfunction in intubated adults--a synthesis of evidence and expert opinion.
MedLine Citation:
PMID:  20630012     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary dysfunction (PDF) in intubated patients remains a serious and costly complication of intensive care unit care. Optimal cardiopulmonary therapy strategies to prevent and manage PDF need clarification to reduce practice variability. The purpose of this paper is to report on the content validation of an evidence-based clinical management algorithm (EBCMA) aimed at the prevention, identification and management of PDF in critically ill patients.
METHODS: Forty-four draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by research clinicians (n = 7) in an electronic three-round Delphi process. Statements which reached a priori defined consensus [semi-interquartile range (SIQR) <0.5] were collated into the EBCMA.
RESULTS: One hundred per cent response rate. Forty-four statements were added after round one. Consensus was reached on rating of 83% (73/88) statements. Differences in interpretation of the existing evidence base, and variations in accepted clinical practice were identified. Four themes were identified where panel failed to reach consensus.
CONCLUSION: The internationally agreed hierarchical framework of current available evidence and clinical expertise developed through this Delphi process provides clinicians with a tool to inform clinical practice. This tool has the potential to reduce practice variability thereby maximizing safety and treatment outcome. The clinical utility of the EBCMA requires further evaluation.
Authors:
Susan Hanekom; Sue Berney; Brenda Morrow; George Ntoumenopoulos; Jennifer Paratz; Shane Patman; Quinette Louw
Publication Detail:
Type:  Journal Article     Date:  2010-07-13
Journal Detail:
Title:  Journal of evaluation in clinical practice     Volume:  17     ISSN:  1365-2753     ISO Abbreviation:  J Eval Clin Pract     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609066     Medline TA:  J Eval Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  801-10     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Division of Physiotherapy, Department of Interdisciplinary Health Sciences, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa. sdh@sun.ac.za
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