1School of Nursing 2School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa 3Trent/Fleming School of Nursing, Peterborough, Ontario, Canada.
Int J Evid Based Healthc. 2019 Jun;17(2):92-105. doi: 10.1097/XEB.0000000000000160.
In this article, the authors discuss a multiphase approach for developing quality indicators based on pain practice guidelines, and the challenges associated with the process. The presentation is based on previously published reporting standards for guideline-based quality indicators.
The following steps of the indicator development process were undertaken: topic selection; guideline selection; extraction of recommendations; quality indicator selection and practice test.
Eleven practice guidelines were reviewed for quality, and three high-quality guidelines were compared for pertinent recommendations. From these three guidelines, 12 recommendations were extracted and judged appropriate to examine the practice gap for nursing students and clinicians on an oncology and palliative care unit. Quality indicators were then identified by a consensus process, resulting in 24 discrete indicators that were included in the practice test.
Quality indicators can be used to examine gaps in pain management practice, and to evaluate change after guideline implementation. However, their development can be challenging, and guideline developers could facilitate uptake of guidelines by including clear, relevant quality indicators as part of guideline creation and presentation.
本文作者讨论了一种基于疼痛实践指南开发质量指标的多阶段方法，以及该过程中所面临的挑战。本报告基于先前发布的基于指南的质量指标报告标准。
进行了以下指标开发过程的步骤：主题选择；指南选择；建议提取；质量指标选择和实践测试。
对 11 项实践指南进行了质量评估，并对 3 项高质量指南进行了相关建议的比较。从这三个指南中，提取了 12 条建议，并判断其适合检查肿瘤学和姑息治疗病房护理学生和临床医生的实践差距。然后通过共识过程确定了质量指标，从而确定了 24 个离散指标，这些指标包含在实践测试中。
质量指标可用于检查疼痛管理实践中的差距，并评估指南实施后的变化。然而，其开发可能具有挑战性，指南制定者可以通过在指南创建和呈现中包含清晰、相关的质量指标来促进指南的采用。
