Background: The NICE guideline for antibiotic prophylaxis before dental treatment has made a substantive change and fundamental departure from previous practice that affects long-standing beliefs and practice patterns. There is potential difficulty for healthcare professionals explaining the new guidance to patients who have long believed that they must receive antibiotics before their dental treatment.
Aim: To explore clinicians' attitudes towards the NICE guidance on antibiotic prophylaxis, their use of the guideline in clinical practice, barriers to the implementation of the guideline, and how best to overcome any perceived barriers.
Methods: In-depth interviews were conducted with seven dental care professionals, two cardiologists and a cardiac care nurse. The data were analysed using the framework method to extract central themes and opinions.
Results: Clinicians generally perceived that initially patients would be reluctant to follow the NICE guidance. This was felt to be particularly true of the patient cohort that had previously been prescribed prophylactic antibiotics. They found it difficult to explain the new guidance to patients who have had infective endocarditis and have long believed that they must receive antibiotics before their dental treatment. Concerns were also raised about the legal position of a clinician who did not follow the guidance. Clinicians generally suggested that the provision of accurate information in the form of leaflets and valid websites would be the best way to advise patients about the new guidance.
Conclusions: Clinicians anticipated difficulties in explaining to patients the change in clinical practice necessitated by adherence to the NICE guidance, most notably for patients with a history of infective endocarditis or where the patient's cardiologist did not agree with the NICE guidance. They placed particular emphasis on the provision of accurate information in order to reassure patients.
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http://dx.doi.org/10.1038/sj.bdj.2011.524 | DOI Listing |
PLoS One
January 2025
Academic Medicine Education Institute, Duke-NUS Medical School, Singapore, Singapore.
Introduction: Clinical medicine is becoming more complex and increasingly requires a team-based approach to deliver healthcare needs. This dispersion of cognitive reasoning across individuals, teams and systems (termed "distributed cognition") means that our understanding of cognitive biases and errors must expand beyond traditional "in-the-head" individual mental models and focus on a broader "out-in-the-world" context instead. To our knowledge, no qualitative studies thus far have examined cognitive biases in clinical settings from a team-based sociocultural perspective.
View Article and Find Full Text PDFAsia Pac J Oncol Nurs
December 2025
School of Nursing, Hangzhou Normal University, Hangzhou, China.
Objective: This study aims to summarize the best available evidence on the effectiveness of pelvic floor muscle training (PFMT) in preventing and managing low anterior resection syndrome (LARS) among patients with rectal cancer, with the goal of enhancing quality of care.
Methods: A systematic search was conducted across databases, including BMJ Best Practice, UpToDate, WHO, GIN, UK NICE, NGC, SIGN, RNAO, NCCN, JBI Library, Cochrane Library, CINAHL, Web of Science, Embase, OVID, PubMed, Chinese Wanfang, CNKI, SinoMed, and VIP, covering publications from inception through June 30, 2024. We targeted clinical decisions, guidelines, evidence summaries, expert consensus statements, systematic reviews, and randomized controlled trials related to PFMT for LARS in patients with rectal cancer.
Arthrosc Tech
November 2024
iULS-University Institute for Locomotion and Sports, Hôpital Pasteur 2, University Côte d'Azur, Nice, France.
Chronic exertional compartment syndrome is a well-described potential cause of leg pain in high-level athletes and soldiers. Surgical treatment of chronic exertional compartment syndrome usually involves fasciotomy, with a reported rate of complications of up to 16%, including failure of complete compartmental release and delayed return to normal daily activity, which can take up to 6 to 12 weeks. The use of a minimally invasive approach under ultrasound guidance seems to improve clinical outcomes in young active patients.
View Article and Find Full Text PDFPsychol Psychother
December 2024
Northumbria University, Newcastle Upon Tyne, UK.
Background: NICE guidelines advocate that healthcare professionals should aim to use non-pharmacological and person-centred approaches as primary strategies to reduce or prevent distress in people living with dementia who reside within care settings. However, despite these recommendations, recent studies have illustrated that there is still a requirement for healthcare professionals to have adequate opportunities to access training programmes and guidance on how to effectively use non-pharmacological approaches in dementia care settings. Communication and Interaction Training (CAIT) was developed to train healthcare professionals in dementia care on how to apply person-centred principles to effectively reduce or negate distress in people living with dementia in a non-invasive manner.
View Article and Find Full Text PDFNeuromodulation
December 2024
CHU de Poitiers, Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery Lab, Poitiers, France; CHU de Poitiers, Spinal Neurosurgery, Neuromodulation & Surgery for Handicap, Poitiers, France; Université de Poitiers, Prime Institute UPR 3346, CNRS, ISAE-ENSMA, Poitiers, France.
Background: Peripheral nerve stimulation (PNS) has emerged as a minimally invasive percutaneous procedure addressing neuropathic pain. However, the percutaneous cylindrical lead ultrasound-guided implantation procedure requires expertise that limits widespread PNS utilization. To overcome these challenges, a microinvasive endoscopy device has very recently been developed, enhancing the precision of PNS implantation by providing accurate visualization of the targeted nerve.
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