Table 1 Contents of the practice guideline
From: Improving comfort in people with dementia and pneumonia: a cluster randomized trial
The intervention | ||
A consensus- and literature-based practice guideline for optimal symptom relief for residents with pneumonia and dementia | ||
Practice guideline components: | ||
 1. Checklist of symptoms | ||
 2. Observational instruments to monitor symptoms* | ||
 3. Tailored treatment recommendations | ||
 4. Poster displaying key points and action plan | ||
*Respiratory distress | RDOS: | Respiratory Distress Observation Scale |
*Pain | PAINAD: | Pain Assessment in Advanced Dementia |
| Â | PACSLAC: | Pain Assessment Checklist for Seniors with Limited Ability to Communicate |
| Â | REPOS: | Rotterdam Elderly Pain Observation Scale |
Action plan: | ||
 A. Suspected pneumonia in resident with pneumonia and dementia | ||
 B. Right away: complete checklist | ||
 C. Optional: use the RDOS to asses respiratory distress | ||
 D. Optional: observe pain using one of three instruments | ||
 E. Consult relevant treatment recommendations | ||
 F. Re-use the checklist on days 1, 2, and 3 and 7 days after pneumonia diagnosis | ||
 G. Repeat steps at a later time and monitor symptoms using the checklist and observational instruments | ||
Key points: | ||
 - Treatment advice is grouped into supportive care and (non)pharmacological treatments | ||
 - The practice guideline is suitable for all treatment goals, including cure or palliation | ||
 - The practice guideline is intended as a decision aid; the physician is of course free to deviate from it if there are good clinical reasons | ||
 - Administering a low dose of opioids can provide relief of the overall condition of the resident, regardless of the treatment goal | ||
The practice guideline was expected to enhance comfort by: | ||
 - Enhancing awareness with regard to discomfort | ||
 - Providing a more structured treatment approach | ||
 - Ensuring regular observations to monitor symptoms | ||