Using evidence-based medicine to protect healthcare workers from pandemic influenza: Is it possible?
OBJECTIVE: To use evidence-based principles to develop infection control algorithms to ensure the protection of healthcare workers and the continuity of health service provision during a pandemic. DESIGN: : Evidence-based algorithms were developed from published research as well as 'needs and values...
| Publicado en: | Critical Care Medicine Vol. 39; no. 1; pp. 170 - 179 |
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| Autores principales: | , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Jan2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104969536&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104969536 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00903493 04O jtl: Critical Care Medicine issn: 00903493 maglogo: N pubinfo: dt: Jan2011 vid: 39 iid: 1 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 104969536 2010890997 10.1097/CCM.0b013e3181fa3c28 NLM21037474 104969536 ppf: 170 ppct: 9 formats: tig: atl: Using evidence-based medicine to protect healthcare workers from pandemic influenza: Is it possible? aug: au: Gralton J McLaws ML affil: From the School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia. sug: subj: Infection Control Medical Practice, Evidence-Based Disease Transmission, Patient-to-Professional Prevention and Control Influenza, Human Prevention and Control Occupational Health Disease Outbreaks Prevention and Control Female Health Personnel Statistics and Numerical Data Human Influenza, Human Transmission Male Masks New South Wales Sensitivity and Specificity Female Male ab: OBJECTIVE: To use evidence-based principles to develop infection control algorithms to ensure the protection of healthcare workers and the continuity of health service provision during a pandemic. DESIGN: : Evidence-based algorithms were developed from published research as well as 'needs and values' assessments. Research evidence was obtained from 97 studies reporting the protectiveness of antiviral prophylaxis, seasonal vaccination, and mask use. Needs and values assessments were undertaken by international experts in pandemic infection control and local healthcare workers. Opportunity and resources costs were not determined. SETTING: The Australian government commissioned the development of an evidence-based algorithm for inclusion in the 2008 revision of the Australian Health and Management Plan for Pandemic Influenza. PARTICIPANTS: Two international infection control teams responsible for healthcare worker safety during the Severe Acute Respiratory Syndrome outbreak reviewed the evidence-based algorithms. The algorithms were then reviewed for needs and values by eight local clinicians who were considered key frontline clinicians during the contain and sustain phases. The international teams reviewed for practicability of implementation, whereas local clinicians reviewed for clinician compliance. RESULTS: Despite strong evidence for vaccination and antiviral prophylaxis providing significant protection, clinicians believed they required the additional combinations of both masks and face shields. Despite the equivocal evidence for the efficacy of surgical and N95 masks and the provision of algorithms appropriate for the level of risk according to clinical care during a pandemic, clinicians still demanded N95 masks plus face shields in combination with prophylaxis and novel vaccination. CONCLUSIONS: Conventional evidence-based principles could not be applied to formulate recommendations due to the lack of pandemic-specific efficacy data of protection tools and the inherent unpredictability of pandemics. As an alternative, evidence-based principles have been used to formulate recommendations while giving priority to the needs and values of healthcare workers over the research evidence. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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