Research Guides: Nursing: Practice Guidelines

Find Practice Guidelines

What is a Practice Guideline?

Clinical practice guidelines or practice guidelines are systematically developed statements to assist practitioners and patient decisions about appropriate health care for specific circumstances. —Institute of Medicine (1990)

What is the difference between a "clinical guideline," "practice parameter," and "standard"?

These phrases, as well as terms like "protocol," "critical pathway," "standard," and "consensus statement," are sometimes used synonymously but may not necessarily be a clinical practice guideline.

What is the purpose of Clinical Practical Guidelines?

To describe appropriate care based on the best available scientific evidence and broad consensus;
To reduce inappropriate variation in practice;
To provide a more rational basis for referral;
To promote efficient use of resources;
To act as focus for quality control, including audit;
To highlight shortcomings of existing literature and suggest appropriate future research.

Clinical Practice Guidelines in Article Databases

CINAHL and Medline/PubMed

Use the publication type or article type limits Practice Guideline.

Other Resources for Guidelines

UpToDate

The UpToDate database has assembled society guideline links to organization/society issued guidelines on many topics. Search the database by topic and "guideline" or "society guideline links"

Guidelines Trust (from ECRI)

Create a free account to search the practice guidelines formerly housed and updated by the AHRQ Guideline Clearinghouse.

Nursing Best Practice Guidelines

Developed by Registered Nurses Association of Ontario (RNAO) as part of their nursing best practice guidelines project begun in 1999.

NICE Guidelines

National Institute for Health and Care Excellence (UK) provides national guidance and advice to improve health and social care.

Guideline Central

A guideline clearinghouse for 35 partner medical professional associations and societies.

Appraisal of Guidelines for Research & Evaluation Instrument (Agree II)

For further information, guides, checklists, and resources, go to https://agreetrust.org

Scope and Purpose

Objectives. Are the objectives of the guideline specifically described?
Questions. Is the clinical question covered by the guideline clear?
Population. Are the patients addressed by this guideline specifically described?

Stakeholder Involvement

Group Membership. Does the guideline development group include individuals from relevant professional groups?
Target Population, Preferences, and Views. Have the patients' views and preferences been sought?
Target Users. Has the intended target audience of the guideline been clearly defined? Has the guideline been piloted among target users?

Rigour of Development

Search Methods. Were systematic methods used to search for evidence and are they reported?
Evidence Selection Criteria. Is the criteria for selecting the evidence clearly described?
Stregths and Limitations of the Evidence. Are the designs, methodologies, and relative strengths or limitations of the included individual studies described?
Formuation of Recommendations. Were the methods used for formulating the recommendations adequately described?
Consideration of Benefits and Harms. Were health benefits, side effects, and risks considered in formulating the recommendations?
Link between Recommedations and Evidence. Is there an explicit link between the recommendations and the supporting evidence?
External Review. Has the guideline been externally reviewed by experts prior to its publication?
Updating Procedure. Is there a plan or procedure for updating the guideline?

Clarity and Presentation

Specific and Unambigous Recommendations. Are the recommendations specific and unambiguous?
Management Options. Are different options for management of the condition clearly presented?
Identifiable Key Recommendations. Are key recommendations clearly identifiable and grouped in one section?

Applicability

Facilitators and Barriers to Application. Have the potential organizational barriers to applying the recommendation been discussed?
Implementation Advice or Tools. Is the guideline supported with tools for application?
Resource Implications. Have the potential cost implications of applying the recommendations been considered?
Monitoring and Auditing Criteria. Does the guideline present review criteria for monitoring and/or auditing purposes?

Editorial Independence

Funding Body. Is the guideline editorially independent from the funding body?
Competing Interests. Have conflicts of interest of guideline development members been noted?