Analysis of key steps in the development of nursing clinical practice guidelines_Chinese Journal of Evidence-Based Medicine

Authors：

JIN Yinghui ¹ , WANG Yunyun ¹ , ZENG Tieying ² , CAO Yingjuan ³ , HUANG Di ¹ ,  ZENG Xiantao ¹

1. Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University; Department of Evidence-Based Medicine and Clinical Epidemiology, The Second Clinical College of Wuhan University; Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, 430071, P.R.China;
2. Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P.R.China;
3. Department of Nursing, Qilu Hospital of Shandong University, Jinan, 250012, P.R.China;

Corresponding author：

ZENG Xiantao, Email: zengxiantao1128@163.com

Keywords：

Nursing clinical practice guidelines; Evidence; Recommendation; Primary step

DOI：

10.7507/1672-2531.201807041

Video：

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With the development of evidence-based medicine, an increasing amount of clinical care experts are paying attention to recommendations in the guidelines and the application of guidelines in clinical nursing practice. The demand for clinical practice guidelines is becoming increasingly important. Based on characteristics of nursing, this paper focuses on primary steps in the formulation of nursing-clinical practice guideline, such as clinical problems, outcomes, nursing evidence retrieval and selection, evidence and recommendations classification, methods from evidence to recommendations, patients' preference and value, and provides suggestions for development of nursing-clinical practice guidelines.

Citation： JIN Yinghui, WANG Yunyun, ZENG Tieying, CAO Yingjuan, HUANG Di, ZENG Xiantao. Analysis of key steps in the development of nursing clinical practice guidelines. Chinese Journal of Evidence-Based Medicine, 2019, 19(4): 490-497. doi: 10.7507/1672-2531.201807041 Copy

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2.	靳英辉, 王丹琦, 李艳, 等. 临床实践指南制定方法—国内外临床实践指南制定手册概要. 中国循证心血管医学杂志, 2018, 10(1): 1-10.
3.	WHO. Handbook for guideline development. 2014. Available at: http://www.who.int/publications/guidelines/handbook_2nd_ed.pdf?ua=1.
4.	NICE. Developing nice guidelines the manual. 2017. Available at: https://www.nice.org.uk/process/pmg20/chapter/introduction-andoverview.
5.	傅亮. 艾滋病临床护理实践指南的构建研究. 上海: 复旦大学, 2014.
6.	周英凤, 秦薇, 刘睿艳. 成年住院患者用药差错预防及管理实践指南的构建. 护理学杂志, 2014, 29(10): 1-4.
7.	唐慧婷. 气管插管危重患者口腔护理临床实践指南构建. 上海: 复旦大学, 2013.
8.	中华医学会风湿病学分会. 2016 中国痛风诊疗指南. 中华内科杂志, 2016, 5(11): 892-899.
9.	Richardson WS, Wilson MC, Nishikawa J, et al. The well-built clinical question: a key to evidence-based decisions. ACP J Club, 1995, 123: A12-13.
10.	WHO. WHO handbook for guideline development (2nd edition), 2014. Available from http://www.who.int/publications/guidelines/guidelines_review_committee/en/.
11.	Sinha IP, Gallagher R, Williamson PR, et al. Development of a core outcome set for clinical trials in childhood asthma: a survey of clinicians, parents, and young people. Trials, 2012, 13: 103.
12.	Kirwan JR, Hewlett SE, Heiberg T, et al. Incorporating the patient perspective into outcome assessment in rheumatoid arthritis: progress at OMERACT 7. J Rheumatol, 2005, 32(11): 2250-2256.
13.	Gandhi GY, Murad MH, Fujiyoshi A, et al. Patient-important outcomes in registered diabetes trials. JAMA, 2008, 299(21): 2543-2549.
14.	王行环, 主编. 循证临床实践指南的研发与评价. 北京: 中国协和医科大学出版社, 2016.
15.	Sinha IP, Williamson PR, Smyth RL. Outcomes in clinical trials of inhaled corticosteroids for children with asthma are narrowly focused on short term disease activity. PLoS One, 2009, 4(7): e6276.
16.	万霞, 刘建平, 张宏伟, 等. 临床干预研究中结局指标的选择方法. 中西医结合医学学报, 2007, 5(1): 11-14.
17.	Stewart LA, Tierney JF, Clarke M. Cochrane handbook for systematic reviews of intervention version 5.1.4. Cochrane Database of Systematic Reviews, 2011: 78.
18.	Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926.
19.	Glasziou P, Vandenbroucke JP, Chalmers I. Assessing the quality of research. BMJ, 2004, 328(7430): 39-41.
20.	Campbell DT, Stanley JC. Experimental and quasi-experimental designs for research. Chicago, IL: Rand McNally College, 1963.
21.	Chalmers I, Hedges L, Cooper H. A brief history of research synthesis. Evaluat & the Heal Profes, 2002, 25(1): 12-37.
22.	Canadian Task Force on the Periodic Health Examination. Canadian Task Force on the Periodic Health Examination: the periodic health examination. CMAJ, 1979, 121(19): 1193-1254.
23.	Harbour R, Miller J. A new system for grading recommendations in evidence-based guidelines. BMJ, 2001, 323(7308): 334-336.
24.	李幼平, 主编. 循证医学. 第 3 版. 北京: 高等教育出版社, 2013.
25.	Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490-1494.
26.	陈耀龙, 李幼平, 杜亮, 等. 医学研究中证据分级和推荐强度的演进. 中国循证医学杂志, 2008, 8(2): 127-133.
27.	The Joanna Briggs Institute. Supporting document for the Joanna Briggs institute levels of evidence and grade of recommendation, 2014. Available at: http://joannabriggs.org/jbi-approach.htmlhttp://joannabriggs.org/jbi-approach.html#tabbed-nav=Levels-of-Evidencehttp://joannabriggs.org/jbi-approach.html#tabbed-nav=Grades-of-Recommendation.
28.	Balshem H, Helf M, Schünemann HJ, et al. GRADE: guidelines: 3. Rating the quality of evidence of evidence. J Clin Epidemiol, 2011, 64(4): 401-406.
29.	王春青, 胡雁. JBI 证据预分级及证据推荐级别系统. 护士进修杂志, 2015, 30(11): 964-967.
30.	Lewin S, Glenton C, Noyes J, et al. CerQual approach: assessing how much certainty to place in findings from qualitative evidence syntheses. The 21st Cochrane Colloquium. Quebec, Canada, 2013.
31.	拜争刚, 刘少堃, 黄崇斐, 等. 定性系统评价证据分级工具—CERQual 简介. 中国循证医学杂志, 2015, 15(12): 1465-1470.
32.	USPSTF. US preventive services task force procedure manual, 2015. Available at: https://www.uspreventiveservicestaskforce.org/Page/Name/procedure-manual.
33.	Alonso-Coello P, Schünemann HJ, Moberg J, et al. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ, 2016, 353: i2016.
34.	Alonso-Coello P, Schünemann HJ, Moberg J, et al. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. BMJ, 2016, 353: i2089.
35.	Moberg J, Alonso-Coello P, Oxman AD. GRADE Evidence to Decision (EtD) frameworks guidance. Version 1.1 [update May 2015]. The GRADE Working Group, 2015. Available from https://ietd.epistemonikos.org/#/help/guidance.
36.	王云云, 靳英辉, 陈耀龙, 等. 循证临床实践指南推荐意见形成的方法分析. 中国循证医学杂志, 2017, 17(9): 1-8.
37.	陈耀龙. GRADE 在系统评价和实践指南中的应用. 兰州: 兰州大学出版社, 2017: 167-180.
38.	Neumann I, Brignardellopetersen R, Wiercioch W, et al. The GRADE evidence-to-decision framework: a report of its testing and application in 15 international guideline panels. Implementation Science, 2015, 11(1): 1-8.
39.	Eccles M, Clapp Z, Grimshaw J, et al. North of England evidence-based guidelines development project: methods of guideline development. BMJ, 1996, 312(7033): 760-762.
40.	廖星, 谢雁鸣. 共识法在传统医学临床实践指南制定过程中的应用探讨. 结合医学学报, 2008, 6(6): 555-560.
41.	Eikelboom JW, Hirsh J, Spencer FA, et al. Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest, 2012, 141(2 Suppl): 7S-47S.
42.	解染, 陈耀龙, 陈昊, 等. 循证指南制定中患者价值观和偏好的研究方法. 中国循证医学杂志, 2015, 15(5): 586-591.
43.	Lin OS, Kozarek RA, Gluck M, et al. Preference for colonoscopy versus computerized tomographic colonography: a systematic review and meta-analysis of observational studies. J Gen Intern Med, 2012, 27(10): 1349-1360.
44.	Mohiuddin S, Payne K. Utility values for adults with unipolar depression: systematic review and meta-analysis. Med Decis Mak, 2014, 34(5): 666-685.
45.	Peeters Y, Stiggelbout AM. Health state valuations of patients and the general public analytically compared: a meta-analytical comparison of patient and population health state utilities. Value Health, 2010, 13(2): 6-9.
46.	Sadique MZ, Legood R. Women’s preferences regarding options for management of atypical, borderline or low-grade cervical cytological abnormalities: a review of the evidence. Cytopathology, 2012, 23(3): 161-166.
47.	Zhang Y, Alonso-Coello P, Brożek J, et al. Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach. Health Qual Life Outcomes, 2017, 15(1): 52.

1. IOM (Institute of Medicine). Clinical practice guidelines we can trust. Washington, DC: The National Academies Press, 2011.
2. 靳英辉, 王丹琦, 李艳, 等. 临床实践指南制定方法—国内外临床实践指南制定手册概要. 中国循证心血管医学杂志, 2018, 10(1): 1-10.
3. WHO. Handbook for guideline development. 2014. Available at: http://www.who.int/publications/guidelines/handbook_2nd_ed.pdf?ua=1.
4. NICE. Developing nice guidelines the manual. 2017. Available at: https://www.nice.org.uk/process/pmg20/chapter/introduction-andoverview.
5. 傅亮. 艾滋病临床护理实践指南的构建研究. 上海: 复旦大学, 2014.
6. 周英凤, 秦薇, 刘睿艳. 成年住院患者用药差错预防及管理实践指南的构建. 护理学杂志, 2014, 29(10): 1-4.
7. 唐慧婷. 气管插管危重患者口腔护理临床实践指南构建. 上海: 复旦大学, 2013.
8. 中华医学会风湿病学分会. 2016 中国痛风诊疗指南. 中华内科杂志, 2016, 5(11): 892-899.
9. Richardson WS, Wilson MC, Nishikawa J, et al. The well-built clinical question: a key to evidence-based decisions. ACP J Club, 1995, 123: A12-13.
10. WHO. WHO handbook for guideline development (2nd edition), 2014. Available from http://www.who.int/publications/guidelines/guidelines_review_committee/en/.
11. Sinha IP, Gallagher R, Williamson PR, et al. Development of a core outcome set for clinical trials in childhood asthma: a survey of clinicians, parents, and young people. Trials, 2012, 13: 103.
12. Kirwan JR, Hewlett SE, Heiberg T, et al. Incorporating the patient perspective into outcome assessment in rheumatoid arthritis: progress at OMERACT 7. J Rheumatol, 2005, 32(11): 2250-2256.
13. Gandhi GY, Murad MH, Fujiyoshi A, et al. Patient-important outcomes in registered diabetes trials. JAMA, 2008, 299(21): 2543-2549.
14. 王行环, 主编. 循证临床实践指南的研发与评价. 北京: 中国协和医科大学出版社, 2016.
15. Sinha IP, Williamson PR, Smyth RL. Outcomes in clinical trials of inhaled corticosteroids for children with asthma are narrowly focused on short term disease activity. PLoS One, 2009, 4(7): e6276.
16. 万霞, 刘建平, 张宏伟, 等. 临床干预研究中结局指标的选择方法. 中西医结合医学学报, 2007, 5(1): 11-14.
17. Stewart LA, Tierney JF, Clarke M. Cochrane handbook for systematic reviews of intervention version 5.1.4. Cochrane Database of Systematic Reviews, 2011: 78.
18. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926.
19. Glasziou P, Vandenbroucke JP, Chalmers I. Assessing the quality of research. BMJ, 2004, 328(7430): 39-41.
20. Campbell DT, Stanley JC. Experimental and quasi-experimental designs for research. Chicago, IL: Rand McNally College, 1963.
21. Chalmers I, Hedges L, Cooper H. A brief history of research synthesis. Evaluat & the Heal Profes, 2002, 25(1): 12-37.
22. Canadian Task Force on the Periodic Health Examination. Canadian Task Force on the Periodic Health Examination: the periodic health examination. CMAJ, 1979, 121(19): 1193-1254.
23. Harbour R, Miller J. A new system for grading recommendations in evidence-based guidelines. BMJ, 2001, 323(7308): 334-336.
24. 李幼平, 主编. 循证医学. 第 3 版. 北京: 高等教育出版社, 2013.
25. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490-1494.
26. 陈耀龙, 李幼平, 杜亮, 等. 医学研究中证据分级和推荐强度的演进. 中国循证医学杂志, 2008, 8(2): 127-133.
27. The Joanna Briggs Institute. Supporting document for the Joanna Briggs institute levels of evidence and grade of recommendation, 2014. Available at: http://joannabriggs.org/jbi-approach.htmlhttp://joannabriggs.org/jbi-approach.html#tabbed-nav=Levels-of-Evidencehttp://joannabriggs.org/jbi-approach.html#tabbed-nav=Grades-of-Recommendation.
28. Balshem H, Helf M, Schünemann HJ, et al. GRADE: guidelines: 3. Rating the quality of evidence of evidence. J Clin Epidemiol, 2011, 64(4): 401-406.
29. 王春青, 胡雁. JBI 证据预分级及证据推荐级别系统. 护士进修杂志, 2015, 30(11): 964-967.
30. Lewin S, Glenton C, Noyes J, et al. CerQual approach: assessing how much certainty to place in findings from qualitative evidence syntheses. The 21st Cochrane Colloquium. Quebec, Canada, 2013.
31. 拜争刚, 刘少堃, 黄崇斐, 等. 定性系统评价证据分级工具—CERQual 简介. 中国循证医学杂志, 2015, 15(12): 1465-1470.
32. USPSTF. US preventive services task force procedure manual, 2015. Available at: https://www.uspreventiveservicestaskforce.org/Page/Name/procedure-manual.
33. Alonso-Coello P, Schünemann HJ, Moberg J, et al. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ, 2016, 353: i2016.
34. Alonso-Coello P, Schünemann HJ, Moberg J, et al. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. BMJ, 2016, 353: i2089.
35. Moberg J, Alonso-Coello P, Oxman AD. GRADE Evidence to Decision (EtD) frameworks guidance. Version 1.1 [update May 2015]. The GRADE Working Group, 2015. Available from https://ietd.epistemonikos.org/#/help/guidance.
36. 王云云, 靳英辉, 陈耀龙, 等. 循证临床实践指南推荐意见形成的方法分析. 中国循证医学杂志, 2017, 17(9): 1-8.
37. 陈耀龙. GRADE 在系统评价和实践指南中的应用. 兰州: 兰州大学出版社, 2017: 167-180.
38. Neumann I, Brignardellopetersen R, Wiercioch W, et al. The GRADE evidence-to-decision framework: a report of its testing and application in 15 international guideline panels. Implementation Science, 2015, 11(1): 1-8.
39. Eccles M, Clapp Z, Grimshaw J, et al. North of England evidence-based guidelines development project: methods of guideline development. BMJ, 1996, 312(7033): 760-762.
40. 廖星, 谢雁鸣. 共识法在传统医学临床实践指南制定过程中的应用探讨. 结合医学学报, 2008, 6(6): 555-560.
41. Eikelboom JW, Hirsh J, Spencer FA, et al. Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest, 2012, 141(2 Suppl): 7S-47S.
42. 解染, 陈耀龙, 陈昊, 等. 循证指南制定中患者价值观和偏好的研究方法. 中国循证医学杂志, 2015, 15(5): 586-591.
43. Lin OS, Kozarek RA, Gluck M, et al. Preference for colonoscopy versus computerized tomographic colonography: a systematic review and meta-analysis of observational studies. J Gen Intern Med, 2012, 27(10): 1349-1360.
44. Mohiuddin S, Payne K. Utility values for adults with unipolar depression: systematic review and meta-analysis. Med Decis Mak, 2014, 34(5): 666-685.
45. Peeters Y, Stiggelbout AM. Health state valuations of patients and the general public analytically compared: a meta-analytical comparison of patient and population health state utilities. Value Health, 2010, 13(2): 6-9.
46. Sadique MZ, Legood R. Women’s preferences regarding options for management of atypical, borderline or low-grade cervical cytological abnormalities: a review of the evidence. Cytopathology, 2012, 23(3): 161-166.
47. Zhang Y, Alonso-Coello P, Brożek J, et al. Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach. Health Qual Life Outcomes, 2017, 15(1): 52.

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