Pancreatitis bundles.
Clinical indicators set forth in the guidelines have been found to contribute to the improvement in compliance with the guidelines. On the other hand, it has been shown that clinical indicators are more effective when individual indicators are presented in the form of a bundle than when they are given separately. Accordingly, in the JPN Guidelines 2010 for management of acute pancreatitis, those indicators that are judged to be important on the basis of a recommendation classification of "A or B" are presented as a pancreatitis bundle. Each item includes assessment of severity after a diagnosis of pancreatitis has been made, differentiation of pathogenesis, management of gallstone-induced pancreatitis, a sufficient dose of fluid replacement and monitoring, pain control, prophylactic administration of wide-spectrum antibiotics and cholecystectomy following resolution of pancreatic symptoms caused by cholecystolithiasis. Hereafter, the efficacy of these indicators and the significance of their achievement should be examined carefully. Then, the assessment of the compliance rate with the guidelines as well as the assessment of the guidelines and pancreatitis itself should become possible.
Mayumi
Toshihiko
T
Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8560, Japan. mtoshi@med.nagoya-u.ac.jp
Takada
Tadahiro
T
Hirata
Koichi
K
Yoshida
Masahiro
M
Sekimoto
Miho
M
Hirota
Masahiko
M
Kimura
Yasutoshi
Y
Takeda
Kazunori
K
Amano
Hodaka
H
Wada
Keita
K
Gabata
Toshifumi
T
Arata
Shinjyu
S
Hirota
Morihisa
M
Yokoe
Masamichi
M
Kiriyama
Seiki
S
Shikata
Satoru
S
Shirai
Kunihiro
K
Nakayama
Takeo
T
Ohtomo
Kuni
K
Tanaka
Masao
M
Shimosegawa
Tooru
T
D019983:Guideline Adherence / Q000458:organization & administration*; D006801:Humans; D033181:Information Dissemination; D010195:Pancreatitis / Q000175:diagnosis / Q000628:therapy*; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care / Q000458:organization & administration