Are therapeutic decisions made on the medical admissions unit any more evidence-based than they used to be?

作者：Ayre Stephen^*; Walters Gareth

来源：Journal of Evaluation in Clinical Practice, 2009, 15(6): 1180-1186.

DOI：10.1111/j.1365-2753.2009.01345.x

• clinical audit
• clinical librarian
• district general hospital
• evidence-based medicine
• medical admissions unit
• UK

Rationale, aims and objectives
To determine whether inpatients in a medical admissions unit in a UK district general hospital received evidence-based therapies in 2008.
Methods
The diagnoses of and therapies received by inpatients at the George Eliot Hospital National Health Service Trust in Nuneaton were recorded. A clinical librarian searched the literature (Clinical Knowledge Summaries, Cochrane Library, Medline and Embase) for the best evidence for each diagnosis-therapy pair. Evidence was graded on the following scale: systematic review, randomized controlled trial, non-experimental evidence and no or contrary evidence.
Results
One hundred and two patients generated 150 diagnosis-therapy pairs. Of these 61 (41%) had systematic review level evidence supporting them, 17 (11%) randomized controlled trial evidence, 48 (32%) non-experimental evidence and 24 (16%) no evidence.
Conclusions
Results were comparable with previous studies. Care in a medical admissions unit in 2008 is still evidence-based, but, despite the vast growth in medical literature, no more than it was. The process was a useful collaboration between medical and library staff to audit the quality of patient care.

• 出版日期2009-12