Gillespie Brigid M, Latimer Sharon, Walker Rachel M, McInnes Elizabeth, Moore Zena, Eskes Anne M, Li Zhaoyu, Schoonhoven Lisette, Boorman Rhonda J, Chaboyer Wendy
School of Nursing & Midwifery, Griffith University, Brisbane, QLD, Australia; Menzies Institute of Health Queensland, Griffith University, Brisbane, QLD, Australia; Gold Coast University Hospital and Health Service, Gold Coast, QLD, Australia.
School of Nursing & Midwifery, Griffith University, Brisbane, QLD, Australia; Menzies Institute of Health Queensland, Griffith University, Brisbane, QLD, Australia.
Int J Nurs Stud. 2021 Mar;115:103857. doi: 10.1016/j.ijnurstu.2020.103857. Epub 2020 Dec 23.
Pressure injuries are one of the most frequently occurring, yet preventable hospital-acquired adverse events. Given there are many clinical practice guidelines available on the prevention and treatment of pressure injuries, it is useful to understand the quality of these guidelines and the clinical application of their recommendations.
To critically evaluate the quality and applicability of the recommendations in pressure injury prevention and treatment clinical practice guidelines.
Systematic review, reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
We systematically searched the literature published from 2005 to 2020 using MEDLINE, EMBASE, CINAHL, the Cochrane Library, ProQuest and PubMed electronic databases, and nine guideline repositories.
We assessed overall quality using the validated Appraisal of Guidelines for Research and Evaluation II (AGREE II) and AGREE Recommendation Excellence (AGREE-REX) tools. Overall % mean scores across AGREE II and AGREE-REX domains were calculated for each guideline. Clinical practice guidelines were then ranked in tertiles based on "high", "moderate" or "low" quality. The review protocol was registered in the International Prospective Register of Systematic Reviews.
Initial combined database and repository searches yielded 3247 documents. Of these,73 full text documents were reviewed. The final analysis included 12 complete guidelines and 14 related documents. Overall AGREE II scores ranged from 32% to 96% while AGREE-REX scores were generally lower ranging from 10% to 75%. Combined % mean scores across AGREE II and AGREE-REX criteria suggest that four guidelines were ranked as "high" (range 69% to 85%) and are recommended without modification. These included; the 2019 International Guideline, the 2016 Canadian Guideline, the 2014 NICE Guideline, and the 2013 Belgian Guideline.
There is disparity in the quality of the included guidelines, however four high quality guidelines are available. These guidelines could ideally be implemented in daily practice and adapted to local policies.
压疮是最常发生但可预防的医院获得性不良事件之一。鉴于有许多关于压疮预防和治疗的临床实践指南，了解这些指南的质量及其建议的临床应用很有用。
严格评估压疮预防和治疗临床实践指南中建议的质量和适用性。
系统评价，按照系统评价和Meta分析的首选报告项目指南进行报告。
我们使用MEDLINE、EMBASE、CINAHL、Cochrane图书馆、ProQuest和PubMed电子数据库以及九个指南库，系统检索了2005年至2020年发表的文献。
我们使用经过验证的《研究与评价指南评估II》（AGREE II）和《AGREE卓越推荐》（AGREE-REX）工具评估总体质量。计算每个指南在AGREE II和AGREE-REX领域的总体平均得分百分比。然后根据“高”“中”或“低”质量将临床实践指南分为三个等级。该综述方案已在国际前瞻性系统评价注册库中注册。
最初对数据库和知识库的联合检索产生了3247篇文献。其中，对73篇全文文献进行了审查。最终分析包括12份完整指南和14份相关文献。AGREE II的总体得分范围为32%至96%，而AGREE-REX的得分通常较低，范围为10%至75%。AGREE II和AGREE-REX标准的综合平均得分百分比表明，有四份指南被评为“高”（范围为69%至85%），无需修改即可推荐。这些包括：2019年国际指南、2016年加拿大指南、2014年英国国家卫生与临床优化研究所指南和2013年比利时指南。
纳入的指南质量存在差异，但有四份高质量指南可供使用。这些指南理想情况下可在日常实践中实施并根据当地政策进行调整。
