Guías de práctica clínica: una introducción a su elaboración e implementación

Pantoja, Tomás; Soto, Mauricio

doi:10.4067/s0034-98872014000100015

Cited by 7 publications

(4 citation statements)

References 38 publications

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“…Although the availability of trained providers on IPC and personal protective equipment significantly improved in 2021 due to COVID-19 response efforts, the availability of IPC guidelines is also low, and the overall IPC status is inadequate. The low readiness for IPC found in this study is comparable to HFs in Bangladesh, where only 16.4% of the standard precaution elements were available for delivery and newborn care services in 2017 [ 29 ], and another analysis of 17 LMICs where the median national availability of sterilization equipment was 51.0% in 2018 [ 34 ]. Items such as waste receptacles and needle destroyers were often not available in HFs, indicating a need to strengthen supply chain systems and put into place quality improvement teams [ 13 , 39 ].…”

Section: Discussionmentioning

confidence: 70%

“…Nevertheless, during the COVID-19 pandemic, digital guidelines, particularly on COVID-19 topics, were provided to HFs. Program guidelines comprise evidence-informed recommendations intended to standardize and optimize care for patients, and their use during clinical decision-making is intended to improve healthcare outcomes [ 29 , 30 ]. Even though both paper and digital guidelines were included in this analysis, the low results in 2021 suggest little or no effort made to improve guideline availability since 2015.…”

Section: Discussionmentioning

confidence: 99%

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Changes in health facility readiness for obstetric and neonatal care services in Nepal: an analysis of cross-sectional health facility survey data in 2015 and 2021

Tuladhar,

Paudel,

Rehfuess

et al. 2024

BMC Pregnancy Childbirth

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Background Nepal is committed to achieving the Sustainable Development Goal (SDG) 2030 target 3.1 of reducing the maternal mortality ratio to 70 deaths per 100,000 live births. Along with increasing access to health facility (HF)-based delivery services, improving HF readiness is critically important. The majority of births in Nepal are normal low-risk births and most of them take place in public HFs, as does the majority of maternal deaths. This study aims to assess changes in HF readiness in Nepal between 2015 and 2021, notably, if HF readiness for providing high-quality services for normal low-risk deliveries improved; if the functionality of basic emergency obstetric and neonatal care (BEmONC) services increased; and if infection prevention and control improved. Methods Cross-sectional data from two nationally representative HF-based surveys in 2015 and 2021 were analyzed. This included 457 HFs in 2015 and 804 HFs in 2021, providing normal low-risk delivery services. Indices for HF readiness for normal low-risk delivery services, BEmONC service functionality, and infection prevention and control were computed. Independent sample T-test was used to measure changes over time. The results were stratified by public versus private HFs. Results Despite a statistically significant increase in the overall HF readiness index for normal low-risk delivery services, from 37.9% in 2015 to 43.7%, in 2021, HF readiness in 2021 remained inadequate. The availability of trained providers, essential medicines for mothers, and basic equipment and supplies was high, while that of essential medicines for newborns was moderate; availability of delivery care guidelines was low. BEmONC service functionality did not improve and remained below five percent facility coverage at both time points. In private HFs, readiness for good quality obstetrical care was higher than in public HFs at both time points. The infection prevention and control index improved over time; however, facility coverage in 2021 remained below ten percent. Conclusions The slow progress and sub-optimal readiness for normal, low-risk deliveries and infection prevention and control, along with declining and low BEmONC service functionality in 2021 is reflective of poor quality of care and provides some proximate explanation for the moderately high maternal mortality and the stagnation of neonatal mortality in Nepal. To reach the SDG 2030 target of reducing maternal deaths, Nepal must hasten its efforts to strengthen supply chain systems to enhance the availability and utilization of essential medicines, equipment, and supplies, along with guidelines, to bolster the human resource capacity, and to implement mechanisms to monitor quality of care. In general, the capacity of local governments to deliver basic healthcare services needs to be increased.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Changes in health facility readiness for obstetric and neonatal care services in Nepal: an analysis of cross-sectional health facility survey data in 2015 and 2021

Tuladhar,

Paudel,

Rehfuess

et al. 2024

BMC Pregnancy Childbirth

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“…UU., Japón han demostrado categóricamente que intervenciones que promueven la adopción de estilos de vida saludables reducen hasta un 58 % el desarrollo de DT2 en personas de alto riesgo. Siguiendo recomendaciones basadas en la evidencia encaminadas en medidas y estrategias para la adopción de estilos de vida saludables (5,6).…”

Section: Introductionunclassified

Cuidados de los Estilos de Vida para Prevenir la Diabetes Mellitus Tipo II: Una Síntesis de Evidencias

Vázquez¹

2024

ceyes

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Introducción: La Diabetes es una enfermedad metabólica compleja y crónica que requiere atención médica continua, caracterizadas por hiperglucemia resultante de defectos en la secreción de insulina. Existen en el mundo aproximadamente 280 millones de personas con riesgo identificable de desarrollar la enfermedad y se puede retrasar su aparición, a través de recomendaciones dirigidas a optimizar el cuidado de las personas y que están informadas por una revisión sistemática de la evidencia llamadas Guías de Práctica Clínica (GPC). Objetivos: Describir la mejor evidencia y recomendaciones disponibles en las Guías de la Práctica Clínica en el cuidado de los estilos de vida en personas con riesgo de diabetes mellitus. Metodología: Se realizó una revisión integradora de artículos de GPC con nivel de evidencia científica y grados de recomendación, provenientes de diferentes países, publicadas del 2012 al 2016. La búsqueda se realizó usando los descriptores en español e inglés Diabetes Mellitus, Guía de Practica Clínica, Prevención, Actividad Física (Clinical Practice Guideline, Prevention, Physical Activity). Resultados: Se identificaron en la mayoría de las GPC, algunas similitudes con relación al cuidado en los estilos de vida para la prevención de diabetes mellitus con niveles de evidencia (A), lo que indica que las recomendaciones pueden ser utilizadas. Conclusiones: Cada uno de los cuidados descritos en las tablas contribuyen ampliamente a la reducción del riesgo de enfermar por Diabetes mellitus tipo 2.

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“…Documents that compile recommendations for the treatment of disorders like VEOS and EOS, such as clinical practice guidelines (CPGs), can help decision-making and lead the practitioners to more evidence-based decisions in their practice 11 12. However, there is still a deficiency in the use of such documents by health professionals, due to the overwhelming number of documents, conflicting recommendations, the lack of knowledge on how they can be implemented, resistance to changing their practices and also a perception of the guidelines’ use as a ‘too rigid and simplified’ way of doing medicine 11 13 14…”

Section: Introductionmentioning

confidence: 99%

Critical appraisal and comparison of recommendations of clinical practice guidelines for the treatment of schizophrenia in children and adolescents: a methodological survey

et al. 2023

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IntroductionThe production of clinical practice guidelines (CPGs) has grown in the past years. Notwithstanding, the quality of these documents and their recommendations for the treatment of schizophrenia in children and adolescents is still unknown.ObjectiveTo assess the quality of the guidelines and recommendations for the treatment of schizophrenia in this population.MethodsCPGs from 2004 to December 2020 were identified through a systematic search on EMBASE, MEDLINE, PsycINFO, PubMed, Epistemonikos, VHL, Global Index Medicus and specific CPG databases. The CPGs’ quality was independently assessed by three reviewers using AGREE II and they were considered of high quality if they scored ≥60% in domains 3 and 6. The evidence classification systems were described, the quality of recommendations was assessed in pairs using AGREE-REX and the recommendations were compared.ResultsThe database search retrieved 3182 results; 2030 were screened and 29 were selected for full-text reading. Four guidelines were selected for extraction. Two CPGs were considered of high quality in the AGREE II assessment. We described the commonly agreed recommendations for each treatment phase. The pharmacological recommendations were described in all treatment phases. Scores of AGREE-REX were lower for psychosocial recommendations.ConclusionThere are still few clinical studies and CPGs regarding schizophrenia in children and adolescents. The quality of the documents was overall low, and the quality of the recommendations report has much to improve. There is also a lack of transparency about the quality of the evidence and the strength of the recommendations.Protocol registration numberCRD42020164899.

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Guías de práctica clínica: una introducción a su elaboración e implementación

Abstract: (Rev Med Chile 2014; 142: 98-104)

Cited by 7 publications

References 38 publications

Changes in health facility readiness for obstetric and neonatal care services in Nepal: an analysis of cross-sectional health facility survey data in 2015 and 2021

Changes in health facility readiness for obstetric and neonatal care services in Nepal: an analysis of cross-sectional health facility survey data in 2015 and 2021

Cuidados de los Estilos de Vida para Prevenir la Diabetes Mellitus Tipo II: Una Síntesis de Evidencias

Critical appraisal and comparison of recommendations of clinical practice guidelines for the treatment of schizophrenia in children and adolescents: a methodological survey

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