Mead P
Department of Primary Health Care, University of Newcastle/Northumbria Health Care NHS Trust, England.
J Adv Nurs. 2000 Jan;31(1):110-6. doi: 10.1046/j.1365-2648.2000.01254.x.
The development of clinical guidelines as one means of implementing evidence-based practice is currently a topical issue. The recent Government White Paper, The New NHS. Modern. Dependable, proposes the establishment of a National Institute for Clinical Excellence whose expressed aim will be to produce and disseminate guidelines based upon evidence of clinical effectiveness in health care. There will be an expectation that practitioners adapt these national guidelines for local needs and particularize them to individual patients. There has been considerable debate in the medical press between the critics and advocates of evidence-based medicine surrounding the relative usefulness of clinical guidelines. However, there has been limited corresponding debate within the nursing literature, which has largely limited itself to descriptions of the implementation of guidelines. This paper examines some of the advantages and limitations of clinical guidelines as a means of operationalizing research evidence to promote effective health care. Finally, some recommendations surrounding the implementation of guidelines will be made.
制定临床指南作为实施循证医学实践的一种手段，目前是一个热门话题。最近的政府白皮书《新国民保健服务体系：现代、可靠》提议设立一个国家临床优化研究所，其明确目标是制定并传播基于卫生保健临床疗效证据的指南。预计从业者会根据当地需求调整这些国家指南，并针对个体患者进行细化。围绕临床指南的相对实用性，医学媒体上的循证医学批评者和支持者之间展开了大量辩论。然而，护理文献中的相应辩论有限，主要局限于对指南实施情况的描述。本文探讨了临床指南作为将研究证据转化为实际行动以促进有效卫生保健的一种手段的一些优点和局限性。最后，将围绕指南的实施提出一些建议。
