Intended for healthcare professionals


Getting knowledge into clinical practice

BMJ 2006; 333 doi: (Published 07 December 2006) Cite this as: BMJ 2006;333:1221
  1. Albert Figueras, manager, international cooperation area1,
  2. Edgar Narváez, manager, technical unit of medical evaluation2
  1. 1Fundació Institut Català de Farmacologia, U Autònoma de Barcelona,08035 Barcelona, Spain
  2. 2Instituto Nicaragüense del Seguro Social, Managua, Nicaragua

    Six years ago the Nicaraguan government asked us to implement treatment guidelines for the most prevalent health problems of the country in six months. After some discussion, a stepwise development of a treatment guideline for postpartum haemorrhage was selected as a training example.

    Several Nicaraguan institutions had already published treatment guidelines for postpartum haemorrhage, but the real management of delivery differs from their recommendations. The causes seemed simple: treatment guidelines are written far from the clinical reality and are usually …

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