412 research outputs found
Expediency and indication of laparoscopic cholecystectomy - ln uncomplicated symptomatic cholecystolithiasis and gallbladder polyps
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207785.pdf (Publisher’s version ) (Closed access)Radboud University, 31 oktober 2019Promotores : Laarhoven, C.J.H.M. van, Drenth, J.P.H., Boermeester, Marja A. Co-promotor : Reuver, P.R. d
ENGINE—An EHS Project for Future Guidelines
No full textClinical guidelines are evidence-based recommendations developed by healthcare organizations or expert panels to assist healthcare providers and patients in making appropriate and reliable decisions regarding specific health conditions, aiming to enhance the quality of healthcare by promoting best practices, reducing variations in care, and at the same time, allowing tailored clinical decision-making. European Hernia Society (EHS) guidelines aim to provide surgeons a reliable set of answers to their pertinent clinical questions and a tool to base their activity as experts in the management of abdominal wall defects. The traditional approach to guideline production is based on gathering key opinion leader in a particular field, to address a number of key questions, appraising papers, presenting evidence and produce final recommendations based on the literature and consensus. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method offers a transparent and structured process for developing and presenting evidence summaries and for carrying out the steps involved in developing recommendations. Its main strength lies in guiding complex judgments that balance the need for simplicity with the requirement for complete and transparent consideration of all important issues. EHS guidelines are of overall good quality but the application of GRADE method, began with EHS guidelines on open abdomen, and the increasing adherence to the process, has greatly improved the reliability of our guidelines. Currently, the need to application of this methodology and the creation of stable and dedicated group of researchers interested in following GRADE in the production of guidelines has been outlined in the literature. Considering that the production of clinical guidelines is a complex process, this paper aim to highlights the primary features of guideline production, GRADE methodology, the challenges associated with their adoption in the field of hernia surgery and the project of the EHS to establish a stable guidelines committee to provide technical and methodological support in update of previously published guideline or the creation of new ones
Effect spoedinterventieteam nog onduidelijk. Meer bewijs is nodig
No full textChanges in health care culture are accompanied by a flood of initiatives with respect to patient safety and quality of care. These initiatives are incentives from government, laymen press, health insurance companies and health care providers. This makes evidence-based patient safety an absolute necessity to guide the priorities of policy makers. A medical emergency team (MET), also referred to as a rapid response team (RRT), is an example of a good initiative to improve health care quality that is being embraced rapidly worldwide, but solid evidence of its effectiveness is lacking. The number of cardiopulmonary arrests seems to have decreased, but adequate correction for case mix confounders has not been done and the effect on patient outcome, i.e. in-hospital mortality, has not been convincingly demonstrate
Interleukin-1 Blockade Attenuates Mediator Release and Dysregulation of the Hemostatic Mechanism During Human Sepsis
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Een woud aan checklists
No full textThe steps of any procedure can be summed up in a checklist. The question is whether that is efficient and effective. A patient safety checklist must be more than a collection of tick boxes. An effective safety checklist in healthcare should cover only complex procedures with an inherent risk hazard, being performed in a complex environment, where memory and situational awareness of a team can be channelled by using a checklist. It is counterproductive to have separate checklists, each covering an isolated part of a process. The use of technical equipment by medical personnel is prone to error. Knowledge of how to use that piece of equipment is essential; medical specialists have their own responsibility in terms of possession of adequate skills. Maintenance and function checks are key to safe use. Checks of equipment or devices prior to surgery should be done as part of a generic perioperative checklis
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