National Clinical Effectiveness Committee (NCEC) Annual Report 2013

This first Annual Report of the NCEC outlines the activity of NCEC and provides information on the development for the first time in Ireland processes for prioritisation and quality assurance of National Clinical Guidelines. The Annual Report sets the agenda for NCEC going forward in line with its terms of reference. Of note two National Clinical Guidelines were quality assured by NCEC and endorsed by the Minister for Health in 2013. These are National Clinical Guideline No. 1 – National Early Warning Score and National Clinical Guideline No. 2 – Prevention and Control Methicillin-Resistant Staphylococcus aureus (MRSA). The implementation of National Clinical Guidelines is a significant patient quality and safety initiative and will improve health outcomes for patients, reduce variation in practice and improve the quality of clinical decisions. Quality assured National Clinical Guidelines will help to further improve the quality, safety and cost effectiveness of healthcare across Ireland. Download the Report  

Metastatic spinal cord compression: Implementing NICE guidance

Metastatic spinal cord compression: Implementing NICE guidanceThis presentation has been written to help you raise awareness of the NICE clinical guideline on Metastatic spinal cord compression: Diagnosis & management of adults at risk of and with MSCC. This guideline has been written for healthcare professionals and other staff who care for people with metastatic spinal cord compression..

Establishing a whole school food policy

This guide has been written to help your school develop, write and implement a whole school food policy. It is designed to be easy to follow and based firmly in the context of real school life. This resource was originally developed and produced by the Health Promotion Agency for Northern Ireland as part of the School food: top marks programme and is now the responsibility of the Public Health Agency. It was jointly funded by the Department of Education and the Department of Heath, Social Services and Public Safety.

Maternal Obesity in the UK: Findings from a national project

In 2008, the Confidential Enquiry into Maternal and Child Health (CEMACH), now known as the Centre for Maternal and Child Enquiries (CMACE), commenced a 3-year UK-wide Obesity in Pregnancy project. The project was initiated in response to a number of factors. At the time, these included: i) growing evidence that obesity is associated with increased morbidity and mortality for both mother and baby, ii) evidence from the CEMACH 'Saving Mothers' Lives' report showed that women with obesity were over-represented among those who died of direct deaths compared to those who died of indirect deaths, 1 iii) unknown national and regional prevalence rates of maternal obesity, and iv) the need for a national clinical guideline for the care of women with obesity in pregnancy.

Psychosis with coexisting substance misuse: assessment and management in adults and young people.

This guideline offers best practice advice on the assessment and management of people with psychosis and coexisting substance misuse. Psychosis is a condition that affects a person’s mental state, including their thoughts, mood and behaviour. The symptoms of psychosis are:• hallucinations – hearing voices and sometimes seeing things that are not really there• delusions – having fixed beliefs that are false but which the person believes in completely. Substance misuse is a broad term encompassing, in this guideline, the harmful use of any psychotropic substance, including alcohol and either legal or illicit drugs. Use of such substances is harmful when it has a negative effect on a person’s life, including their physical and mental health, relationships, work, education and finances or leads to offending behaviour.This resource was contributed by The National Documentation Centre on Drug Use.

Estudi d'usabilitat d'aplicacions informàtiques en un IES

Aquest treball de fi de carrera vol ser una pauta d'usabilitat per a totes les persones que es dediquen professionalment al món de l'ensenyament i, sense tenir preparació formal en l'àmbit de la programació d'aplicacions informàtiques o tenint-ne poca, dediquen el seu temps lliure a implementar recursos informàtics per a fer-los servir, bé en la pràctica docent, bé en la gestió de centres educatius.

Obesity: Guidance on the prevention of overweight and obesity in adults and children [CG43]

This guidance has been partially updated byCG189 Obesity (update), PH53 Managing overweight and obesity in adults – lifestyle weight management services and NG7 Maintaining a healthy weight and preventing excess weight gain among adults and children. Go straight to the recommendations Evidence used to create this guideline (full guideline) Section 1.1.1 of this guideline has been replaced by Maintaining a healthy weight and preventing excess weight gain among adults and children(2015) NICE guideline NG7. Section 1.2 of this guideline has been replaced by Obesity: identification, assessment and management of overweight and obesity in children, young people and adults NICE guideline CG189. Section 1.1.7 of this guideline has been replaced by Managing overweight and obesity in adults – lifestyle weight management services (2014) NICE guideline PH53.

Diabetes in pregnancy: are we providing the best care?

This third and final report of the CEMACH national diabetes programme comes at an important time in the national drive to improve services for women with diabetes in pregnancy. The National Service Framework (NSF) for Diabetes requires the NHS to develop, implement and monitor policies that seek to empower and support women with diabetes to optimise the outcomes of their pregnancy. The CEMACH report shows that, whilst progress has been made in improving services for women with diabetes and their babies, there is much still to be done to meet the standards recommended by the NSF. Too many women continue to be poorly prepared for pregnancy in the critical areas of glycaemic control and folic acid supplementation. The report underlines the need for an increased focus on diabetes preconception care services and the development of strategies to educate women with diabetes of childbearing age. The growing proportion of women with type 2 diabetes during pregnancy, many of whom are from minority ethnic groups, presents an additional challenge for health services in developing responsive and accessible services.This CEMACH report has identifi ed several areas of good clinical practice during pregnancy in women with pre-existing diabetes. However, there continue to be areas where there is room for improvement, including antenatal fetal surveillance, glycaemic control during labour and delivery and postnatal diabetes care. The National Institute for Health and Clinical Excellence (NICE) is currently in the fi nal stages of development of its new guideline for the management of diabetes in pregnancy. This guideline, when taken together with the CEMACH report, will provide local health services with an unprecedented wealth of material on which to base their development of improved services for women with diabetes in pregnancy.��

Policy for annual leave/ leave of absence cover for the Local Supervising Authority Midwifery Officer (LSAMO)

This guideline relating to cover for the absence of the LSAMO for annual leave covers the period from 2012-2015.The policy sets out the arrangements to be put in place for cover for the LSAMO role and the contact details.

Adaptations des recommandations pour la pratique clinique: l'exemple du Programme cantonal Diabète de Vaud [Adaptation of clinical practice guidelines--the example of cantonal Diabetes Program].

With the growing number of scientific publications, practitioners can use scientific knowledge synthesis, including Clinical Practice Guidelines (CPG). The practical use of a CPG implies considering the context, that is the local healthcare system and the patient. Thus, the CPG can never replace the expertise of the practitioner! Diabetes is a wide public health issue and the canton of Vaud established the cantonal Diabetes Program (cDP), to optimize the care of diabetic patients. The cDP has many projects including the adaptation of reliable CPG to local needs. We present the pros and cons of the CPG in the cDP and the methods to adapt it to the regional healthcare context, and also at an individual level.

Issues in blood pressure control and the potential role of single-pill combination therapies.

Hypertension (HTN) is a major risk factor for cardiovascular mortality, yet only a small proportion of hypertensive individuals receive appropriate therapy and achieve target blood pressure (BP) values. Factors influencing the success of antihypertensive therapy include physicians' acceptance of guideline BP targets, the efficacy and tolerability of the drug regimen, and patient compliance and persistence with therapy. It is now well recognised that most hypertensive patients require at least two antihypertensive agents to achieve their target BP. However, complicated treatment regimens are a major contributory factor to poor patient compliance. The use of combination therapy for HTN offers a number of advantages over the use of monotherapy, including improved efficacy, as drug combinations with a synergistic mechanism of action can be used. This additive effect means that lower doses of the individual components can be used, which may translate into a decreased likelihood of adverse events. The use of single-pill combination therapy, in which two or more agents are combined in a single dosage form, offers all the benefits of free combination therapy (improved efficacy and tolerability over monotherapy) together with the added benefit of improved patient compliance because of the simplified treatment regimen. The use of single-pill combination therapy may also be associated with cost savings compared with the use of free combinations for reasons of cheaper drug costs, fewer physician visits and fewer hospitalisations for uncontrolled HTN and cardiovascular events. Thus, the use of single-pill combination therapy for HTN should help improve BP goal attainment through improved patient compliance, leading to reduced costs for cardiovascular-related care.

Recommandations suisses romandes sur la prise en charge de l'asthme de l'adulte [Lake Geneva Region guidelines on management of adult asthma]

Asthma is a major cause of chronic morbidity throughout the world. In Switzerland, 6.9% of the adult population is suffering from asthma. The standards of treatment are unfortunately not met in most western countries, as well as in Switzerland. We put forward a complete guideline on management of adult asthma, inspired from GINA and BTS guidelines, and adapted to the specific needs of general practitioners working in french part of Switzerland. This guideline reflects a consensus between allergy, lung and emergency specialists, working in the 2 university hospitals of the Lake Geneva Region (HUG and CHUV).

Riesgo vascular : proceso asistencial integrado

Publicado en la página web de la Consejería de Igualdad, Salud y Políticas Sociales: www.juntadeandalucia.es/salud (Consejería de Igualdad, Salud y Políticas Sociales/ Profesionales / Nuestro Compromiso por la Calidad / Procesos Asistenciales Integrados)

Enfermedad pulmonar obstructiva crónica: proceso asistencial integrado. 2ª ed

En noviembre de 2015, se ha publicado la 3ª edición de este proceso (http://hdl.handle.net/10668/2125). Existe una guía de información para pacientes "Conozca cómo vivir mejor con la EPOC" basada en la 2ª edición de este Proceso.