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The process

Bringing Clinical Guidelines to patients bedside


The barriers to guideline implementation can be differentiated into personal factors, guideline-related factors and external factors.

Central for guideline implementation:

  • dissemination
  • education and training
  • social interaction
  • decision support systems and
  • standing orders

Plus feedback in regular intervals on how patients outcomes changed through guideline implementation



Perioperative Neurocognitive Disorders (PND) and SBI

Source: Adopted by Evered et al.

Source: Adopted by Evered et al.

Predisposing factors: ASA-PS, age, cognitive status, lifestyle etc. describe the patient status when arriving to the hospital and are difficult to change. However, it is important to optimize the medical status of the patient prior to surgery.

Surgery and anesthesia are relevant precipitation factors for POD and cerebral outcomes. Optimizing and reducing predisposing and precipitating factors are paramount in terms of decreasing the risk for postoperative neurocognitive disorders.

All of the SBI recommendations are non-invasive in nature. The primary aim is to target the predisposing and precipitating factors for POD, thereby reducing the inflammatory and neuro-inflammatory responses of surgery and anesthesia to the patients.

In summary, the SBI recommendations aim to improve your patient’s outcome by decreasing the gap between up-to-date research and guideline recommendations and your current perioperative practice.

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