The validation of a clinical algorithm for the prevention and management of pulmonary dysfunction in intubated adults--a synthesis of evidence and expert opinion

Journal of Evaluation in Clinical Practice
Susan D HanekomQuinette Louw

Abstract

Pulmonary dysfunction (PDF) in intubated patients remains a serious and costly complication of intensive care unit care. Optimal cardiopulmonary therapy strategies to prevent and manage PDF need clarification to reduce practice variability. The purpose of this paper is to report on the content validation of an evidence-based clinical management algorithm (EBCMA) aimed at the prevention, identification and management of PDF in critically ill patients. Forty-four draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by research clinicians (n = 7) in an electronic three-round Delphi process. Statements which reached a priori defined consensus [semi-interquartile range (SIQR) <0.5] were collated into the EBCMA. One hundred per cent response rate. Forty-four statements were added after round one. Consensus was reached on rating of 83% (73/88) statements. Differences in interpretation of the existing evidence base, and variations in accepted clinical practice were identified. Four themes were identified where panel failed to reach consensus. The internationally agreed hierarchical framework of current available evidence and clinical expertise developed through this Delphi...Continue Reading

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Citations

Dec 13, 2012·Critical Care : the Official Journal of the Critical Care Forum·Susan D HanekomAndre Coetzee
Nov 29, 2015·Journal of Critical Care·Aymeric Le NeindreBélaïd Bouhemad
Jul 29, 2011·Journal of Evaluation in Clinical Practice·Andrew Miles, Michael Loughlin
Dec 30, 2014·Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy·Maja LeechGeorge Ntoumenopoulos
Feb 12, 2017·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Charissa S L TanKylie Hill
May 25, 2013·Journal of Nursing Management·Marie E Gabe, Sue E Jordan

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