Author | Magluta, Cynthia | |
Author | Gomes, Maria Auxiliadora de Sousa Mendes | |
Author | Wuillaume, Susana Maciel | |
Access date | 2012-12-19T17:46:58Z | |
Available date | 2012-12-19T17:46:58Z | |
Document date | 2011 | |
Citation | MAGLUTA, Cynthia; GOMES, Maria Auxiliadora de Sousa Mendes; WUILLAME, Susana Maciel. Difficulties in the dissemination and implementation of clinical guidelines in government Neonatal Intensive Care Units in Brazil: how managers, medical and nursing, position themselves. Journal of Evaluation in Clinical Practice, v. 17, n. 4, p. 744-748, Aug. 2011. | pt_BR |
ISSN | 1356-1294 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/6039 | |
Language | eng | pt_BR |
Publisher | Blackwell Publishing Ltd | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Woolf, S. H., Grol, R., Hutchinson, A., Eccles, M. & Grimshaw, J.
(1999) Potential benefits, limitation and harms of clinical guidelines.
BMJ, 3 (7182), 527–530. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Atallah, A. N. (2002) Medicina baseada em evidências: o elo entre a
boa ciência e a boa prática clínica [Medicine based on evidence:
the link between the good science and the good clinic practice]. In
Caminhos do Pensamento: epistemologia e método [The Thought
Path: Epistemology and Method] (eds M. C. de Souza Minayo & S. F.
Deslandes), pp. 325–344. Rio de Janeiro: Coleção Criança, Mulher e
Saúde, Editora Fiocruz. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Grimshaw, J., Thomas, R., MacLennan, G., et al. (2004) Effectiveness
and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment, 8 (6), iii–352. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Cabana, M. C., Rand, C., Powe, N. E., Wu, A. W., Wilson, M. H.,
Abbound, P. A. & Rubin, H. R. (1999) Why don’t physicians follow
clinical practice guidelines?: a framework for improvement. JAMA,
282 (15), 1458–1465. Available at: http://jama.ama-assn.org/cgi/
content/full/282/15/1458 (last accessed 26 July 2007). | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Rede Brasileira de Pesquisas Nacionais (2004) Uso de cortidosteróides e condições de nascimentos de pré-termos nos hospitais da
Rede Brasileira de Pesquisas Nacionais. Revista Brasileira De Ginecologia E Obstetrícia (RBGO), 26 (3), 177–184. [Brazilian Neonatal
Research Network. The use of corticosteroids and premature birth
conditions in the Brazilian Neonatal Research Network hospitals.
Gynecology and Obstetrics Brazilian Magazine]. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Prestes, A. C. Y., Guinsburg, R., Balda, R. C. X., Marba, S. T. M.,
Rugolo, L. M. S. S., Pachi, P. R. & Bentlin, M. R. (2005) Freqüência
do emprego de analgésicos em unidades de terapia intensiva neonatal universitárias. Journal of Pediatrics (Rio J), 81 (5), 405–410.
[Frequency of analgesics in universities’ neonatal intensive care units.
Pediatrics Journal]. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Medeiros, M. L. B. (2006) Conhecimentos e práticas da displasiabroncopulmonar em unidade neonatal pública do município do RJ (dissertação). Rio de Janeiro: Pós-Graduação em Saúde da Criança e da
Mulher do Instituto Fernandes Figueira da Fundação Oswaldo Cruz.
[Knowledge and practices of bronchopulmonarydysplasia in neonatal
government units in the city of Rio de Janeiro (thesis). Rio de Janeiro:
Woman and Child Health Post-Graduation Center of Fernandes
Figueira Institute, Oswaldo Cruz Foundation]. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Committee on Fetus and Newborn, American Academy of Pediatrics
(2004) Levels of neonatal care. Pediatrics, 114, 1341–1347. doi:
10.1542/peds.2004-1697. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Cochrane, L. J., Olson, C. A., Muray, S., Dupuis, M., Tooman, T. &
Hayes, S. (2007) Gaps between knowing and doing: understanding
and assessing the barriers to optimal health care. Journal of Continuing Education in the Health Professions, 27 (2), 94–102. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Brazil, Ministry Of Health. Government Decree of Ministry of Heath
332, 24 March 2000, rectification of former decree GM/MS 3432, 12
August 1998. Dealing with criteria for Neonatal Intensive Care Units. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Motta, P. R. (1991) Gestão Contemporânea: a ciência e a arte de ser
dirigente, 16
a
edn. Rio de Janeiro: Editora Record. [Contemporary
Management: The Art and Science of Being Manager. Record
Publishers]. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Michie, S. & Johnston, M. (2004) Changing clinical behavior by
making guidelines specific. BMJ, 328, 343–345. | pt_BR |
xmlui.metadata.dc.relation.isbasedon | Erhardt, L. R. (2005) Barriers to effective implementation of guideline
recommendations. The American Journal of Medicine, 118 (12A),
36–41. | pt_BR |
Rights | restricted access | |
Title | Difficulties in the dissemination and implementation of clinical guidelines in government Neonatal Intensive Care Units in Brazil: how managers, medical and nursing, position themselves | pt_BR |
Type | Article | |
DOI | 10.1111/j.1365-2753.2011.01681.x | |
Abstract | Rationale, aims and objectives Clinical guidelines are tools that systematize scientific evidence and help to achieve proper care. Several difficulties are reported regarding the effective use, such as the shortcomings in the level of knowledge and attitudes by the professionals, the service structure and the preferences appointed by patients. An analysis of these difficulties was the objective of this study in the context of government Neonatal Intensive Care Units (NICU) in Brazil. Method A semi-structured survey was carried out with 53 managers (medical and nursing) of the 15 NICU in a convenient sample of two groups of government units in Brazil. The managers chose their answers from a list of difficulties to implement the guidelines based on the analytical model of Cabana and graded the difficulties found on a 5-point scale with no reference to quality. Results Respondents have reported several difficulties with the following priority: lack of professionals to provide care, being perceived as more critical within the nursing and physiotherapy crews, minor participation of professionals in the discussion process and inadequate infrastructure. The lack of acquaintance with the guidelines by the professionals has been reported by few of the surveyed. Conclusion These findings show some common ground to literature pointing the importance of adequate infrastructure. Managers showed a low valuation of both the level of knowledge and the professionals’ adhesion to the guidelines. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Unidade de Pesquisa Clínica. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Unidade de Pesquisa Clínica. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Subject | Clinical Guidelines | pt_BR |
Subject | Implementation | pt_BR |
Subject | Neonatology | pt_BR |
DeCS | Guia Clínico | pt_BR |
DeCS | Regionalização | pt_BR |
DeCS | Neonatologia | pt_BR |
e-ISSN | 1365-2753 | pt_BR |