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The Canadian critical care nutrition guidelines in 2013: an update on current recommendations and implementation strategies.

https://arctichealth.org/en/permalink/ahliterature105874
Source
Nutr Clin Pract. 2014 Feb;29(1):29-43
Publication Type
Article
Date
Feb-2014
Author
Rupinder Dhaliwal
Naomi Cahill
Margot Lemieux
Daren K Heyland
Author Affiliation
Daren K. Heyland, MSc, Department of Public Health Sciences, Queen's University, 76 Stuart St, Kingston, ON K7L 2V7, Canada. Email: dkh2@queensu.ca.
Source
Nutr Clin Pract. 2014 Feb;29(1):29-43
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Canada
Critical Care - methods
Enteral Nutrition - methods
Evidence-Based Medicine
Guideline Adherence
Humans
Nutrition Policy
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Abstract
Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioners and patient decisions about appropriate healthcare for specific clinical circumstances, and are designed to minimize practice variation, improve costs, and improve clinical outcomes. The Canadian Critical Care Practice Guidelines (CCPGs) were first published in 2003 and most recently updated in 2013. A total of 68 new randomized controlled trials were identified since the last version in 2009, 50 of them published between 2009 and 2013. The remaining articles were trials published before 2009 but were not identified in previous iterations of the CCPGs. For clinical practice guidelines to be useful to practitioners, they need to be up-to-date and be reflective of the current body of evidence. Herein we describe the process by which the CCPGs were updated. This process resulted in 10 new sections or clinical topics. Of the old clinical topics, 3 recommendations were upgraded, 4 were downgraded, and 27 remained the same. To influence decision making at the bedside, these updated guidelines need to be accompanied by active guideline implementation strategies. Optimal implementation strategies should be guided by local contextual factors including barriers and facilitators to best practice recommendations. Moreover, evaluating and monitoring performance, such as participating in the International Nutrition Survey of practice, should be part of any intensive care unit's performance improvement strategy. The active implementation of the updated CCPGs may lead to better nutrition care and improved patient outcomes in the critical care setting.
PubMed ID
24297678 View in PubMed
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