Evaluation for Clinical Practical Guideline in Rabies

Abstract

The objective of this experimental study was to develop rabies clinical practical guideline (CPG) improving to be used as the standard. The 30 hospitals (namely, Regional hospital, General hospital, Com munity hospital) in 15 provinces which had reports of human and animal rabies were selected by purposive sampling method. The patients OPD cards in each hospital were selected by random sampling. The record of rabies contact cases were collected for reviewing the before and after CPG applications, during August-December 2004 and repeat in 2005 including the questionnaires for physician and nurse. The result of the study showed that 89.4 % of the doctors and nurses had read CPG, of which 90.2 % appreciated the correct content of CPG, and 90.1% realized the benefit of CPG after using. After providers' use of CPG, it was found that 1. the question about of the history of vaccination of dog bite and people with rabies contacted was used more than before, significantly. (P<0.01) 2. The equine rabies immunoglobulin (ERIG) test and rabies immunoglobulin (RIG) vaccinated were significantly practiced after CPG using. (P<0.01) 3. The application of correct vaccine and intradermal vaccination after providers' application of CPG was significantly higher,(P<0.01) especially intradermal vaccinate of 22202. 3. the accuracy of vaccinating date, full 3-dose vaccination and vaccination for the people with history of receiving 3-dose up was significantly high, compared to before. (P<0.01) These results indicated that the application of CPG is beneficial to the providers in the treatment of rabies contact, and recognized its adjustment to become the standard of nation wide use.