Variable compliance with clinical practice guidelines identified in a 1-day audit at 66 French adult intensive care units*
Critical Care MedicinePublished 12 September 2012
Marc Léone, Benoit Ragonnet, Sandrine Alonso, Bernard Allaouchiche, Jean-Michel Constantin, Samir Jaber
Citations100
SJR quartileQ1
SJR score2.12
SNIP2.15
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TL;DR
The results showed that only 24% of patients in this cohort received fully compliant care, which underlines the need to both improve the process of implementation and become cognizant of excessive proliferation of clinical guidelines.
Abstract
At the bedside, clinical guidelines are fully applied in 24% of patients. Our study underlines the need to both improve the process of implementation and become cognizant of excessive proliferation of clinical guidelines.
Keywords
PsychologyMedicine
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