Quality Assessment of Clinical Practice Guidelines (CPG) for Management of Paediatric Dental Emergencies Applicable (PDEA) during COVID-19 Pandemic | Chapter 9 | Current Practice in Medical Science Vol. 9

 Utilizing the measurement tool AGREE II, the current study assesses the effectiveness of Clinical Practice Guidelines (CPG) for the COVID-19 pandemic's care of paediatric dental emergencies (Appraisal of Guidelines for Research and Evaluation in Europe).

We did a comprehensive web search for CPG among the best CPG compilers. In order to discover CPG that meet the inclusion criteria, a thorough search was also done among the major national and worldwide dental organisations as well as reliable websites.

According to AGREE II, five (05) out of the twenty-three (23) selected CPG were rated as "acceptable." The "Recommendation degree" of these five guides was assessed.

The AUGE clinical guide for ambulatory dental emergencies—Chile, 2011—was the only CPG that met the quality evaluation criteria and recommendation degree of the AGREEII instrument, and it was exclusively relevant to Spanish-speaking countries. It would be wise to write this manual in English since it is a universal tongue. Using the AGREE II quality assessment and recommendation degrees criteria, high, average, and low quality CPG were identified. Only one CPG received the label "highly recommended" with a score of 75% or higher. Therefore, it is proposed that both current and future CPG updates develop them utilising the available tools and methods in order to ensure their quality.

Author(s) Details:

Jessica Arieta-Miranda,
Faculty of Dentistry, National University of San Marcos. 375 German Amezaga Avenue, Lima, 15081, Peru.

Abad Salcedo Alcaychahua,
Scientific University of the South, Carretera Panamericana Sur 19, Villa EL Salvador, Lima, 15067, Peru.

Gary Pereda Santos,
Department of Second Specialty in Orthodontics and Maxilar Orthopedics, Faculty of Dentistry, National University of San Marcos, 375 German Amezaga Avenue, Lima, 15081, Peru.

Manuel Chavez Sevillano,
Department of Paediatric Stomatology, Faculty of Dentistry, National University of San Marcos. 375 German Amezaga, Lima, 15081, Peru.

Rosa Lara Verastegui,
Faculty of Dentistry, National University of San Marcos, 375 German Amezaga Avenue, 15081, Peru.

Daniel Blanco Victorio,
Cayetano Heredia Peruvian University, 430 Honorio Delgado Avenue, San Martín de Porres, Lima, 15102, Peru.

Gilmer Torres Ramos,
Department of Paediatric Stomatology, Faculty of Dentistry, National University of San Marcos. 375 German Amezaga, Lima, 15081, Peru.

Please see the link here: https://stm.bookpi.org/CPMS-V9/article/view/8016

How a Crowded Emergency Department Became Non-crowded and Crowded Back within 10 Years: Is It an ED Leadership Failure or a Hospital Leadership Failure, or Maybe Both? | Chapter 14 | Current Topics in Medicine and Medical Research Vol.3

 Background: from 1993 until 2013 our Emergency Department (ED) went through three periods, with

different ED manager each. Although the number of beds, visits and admissions during these three
periods didn't change significantly, a change in the ED’s policy, without a change in the hospital’s
policy, converted a very crowded ED to a non-crowded one within few weeks. However, a change in
the ED policy and that of the hospital management policy rendered a non-crowded ED an
overcrowded one back within, 6 months.

Objectives: to describe how we rendered a very crowded ED into a non-crowded one within few
weeks, to try to explain why it turned back to become crowded again, and to suggest some advice
from our experience.

Methods: It is an epidemiolocal cross-sectional retrospective study. all data about the ED and other
departments activities were collected by our hospital’s computerized business intelligence (BI)
system.Because of lack of some data, the study includes 3 equal periods: period “A”, period “B” and
period “C”(1997 -2001, 2001-2006 and 2007-2011 respectively). For statistical comparison of
averages of the different periods, we used the unpaired student T-test.

Results:The average length of stay (LOS) of patients in the ED during period "A", was 5.05 + 0.98
hrs. It dropped to 2.45 + 0.21 during period "B" (P< 0.001).The percent of patients boarding in the ED
more than 10 hours dropped from 11.5 + 2.4% (period “A”) to 2.6 + 0.7% (period “B”) within three
months (P< 0.01). Despite a gradual increase in the number of admissions to the GMD`s, there was a
gradual decrease in the average LOS during period "B", compared to period "A" (6.1 vs. 5.5 days) (P<
0. 5). The death rate among patients in the ED and in the GMD`s decreased significantly during the
period "B" (P< 0.1). During period "C", after both the CEO and the ED manager retired, all these
changes were reversed within a few months.

Conclusions:Rendering a crowded ED into non-crowded, needs the assertiveness of the ED
Managers in implementing their policy, with the personal full backing of the hospital CEO, as a must
condition before managing the ED.

Author(s) Details

Fuad Basis
Chair of Emergency Medicine Division, Medical and Research Development, Israel.

Moshe Michelson
Chair of Emergency Medicine Division, Medical and Research Development, Israel.

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