Adherence to XXXX Guidelines for Medical and Surgical Inpatients of Teaching Hospitals, Shiraz-Iran.

@entity1 @entity1211
BACKGROUND: @entity1211 ( @entity1211 ) exerts a considerable burden on the health care systems. Although many practice guidelines have been developed regarding prophylaxis and treatment of @entity1211 , there is a large gap between the recommendations and the medical practice in health care centers. In this study, we tried to assess adherence of the medical team to guidelines for @entity1211 in medical and surgical wards of teaching hospitals affiliated to Shiraz University of Medical Sciences. MATERIALS AND METHODS: In this cross-sectional descriptive study, a total number of 500 @entity1 were recruited among hospitalized @entity1 in neurosurgery, orthopedics, general surgery, internal medicine, and obstetrics _ gynecology departments and surgical and medical intensive care units. Afterwards, adherence to thromboprophylaxis guidelines was assessed by comparing the medical records of @entity1 with proper indications extracted from the American College of Chest Physicians Guidelines for @entity1211 prophylaxis (ACCP, 9(th) edition). In other words, for each @entity1 a comparison between proper indications of receiving thromboprophylaxis and the regimen used in practice was made. RESULTS: Out of 472 @entity1 assessed with respect to the appropriateness of the administered prophylaxis, 212 (45.1%) had received proper type of thromboprophylaxis with regard to ACCP guidelines. Orthopedic surgical wards showed the highest rate of appropriateness while neurosurgical wards showed the lowest rate of adherence (76% vs. 1.8%). The overall rate of inappropriateness was 54.9% (260 @entity1 ). Inappropriateness was divided into 3 categories: 1) @entity1 had absolute indications to receive thromboprophylaxis but were not provided with any type of prophylaxis in practice (171 @entity1 , 36.2% of total), 2) in presence of absolute indications, incorrect type of prophylaxis was administered (52 @entity1 , 11% of total), 3) in absence of indications for thromboprophylaxis, @entity1 received some forms of prophylaxis (35 @entity1 , 7.4% of total). CONCLUSION: The findings of the present study showed that prophylaxis are not properly utilized and physicians' practices vary considerably among different specialties.
