2013-2018年国内外护理临床实践指南的质量评价

Quality evaluation of clinical practice guidelines for nursing at home and abroad from 2013 to 2018

目的评价并比较2013-2018年国外安大略注册护士专业协会及国内护理临床实践指南(Nursing clinical practice guidelines,N-CPGs)的质量。方法计算机检索中国生物医学文献数据(CBM)、中国期刊全文数据库(CNKI)、万方数据库(WanFang)、维普中文科技期刊数据库(VIP)、复旦大学循证护理中心循证实践资源、安大略注册护士专业协会循证指南数据库,根据纳入排除标准筛选公开发表的有关的N-CPGs,检索时限为2013年1月1日-2018年7月16日。由2位评价员按照纳入与排除标准独立筛选文献和提取资料后,采用指南质量评价工具第2版(AGREE II)对纳入指南的质量进行评价。结果共纳入指南26篇,两名评价员在AGREE II评分表各所有领域的ICC值均>0.75,评价结果的一致性较高。指南在AGREE II各领域的得分分别为:范围和目的:83.33%(80.56%,86.11%);参与人员80.56%(77.78%,83.33%);严谨性78.13%(73.96%,79.17%);清晰性75.00%(72.22%,77.78%);应用性75.00%(70.31%,77.60%);编辑的独立性79.17%(79.17%,79.17%)。RNAO和国内N-CPGs在参与人员与应用性两个领域得分间差异有统计学意义(P<0.05)。结论近年来国内N-CPGs的质量整体较高,但在对指南参与人员的介绍及指南推荐意见实施建议两个方面仍需规范报告和补充完善。

Objective To evaluate and compare the quality of nursing clinical practice guidelines(N-CPGs) of in worldwide from 2013 to 2018. Methods N-CPGs published in academic journals were screened and retrieved from CBM, CNKI, WanFang, VIP, Fudan university of science and technology resources, evidence-based practice evidence-based nursing center Ontario registered nurses professional association evidence-based guidelines for database, according to published in exclusion standard screening of N-CPGs, The retrieval period is 1 January 2013 to July 16, 2018. After two reviewers independently screened the literature and extracted the data in accordance with inclusion and exclusion criteria.Appraisal of guidelines research and evaluation II(AGREE II) was adopted to evaluate the quality of inclusion guide. Results A total of 26 guidelines were included. The ICC values of the two reviewers in all areas of AGREE II were more than 0.75, and the evaluation results were highly consistent. The scores of 6 domains of AGREE Ⅱ were: 83.33%(80.56%, 86.11%) on scope and purpose;80.56%(77.78%, 83.33%) on stakeholder involvement;78.13%(73.96%, 79.17%)) on rigour of development;75.00%(72.22%, 77.78%) on clarity of presentation;75.00%(70.31%, 77.60%) on applicability;79.17%(79.17%, 79.17%) on editorial independence. RNAO and domestic N-CPGs showed statistically significant differences in scores between participants and applicability(P<0.05). Conclusion The overall quality of N-CPGs in China in recent years is relatively high. However, there are still two aspects to be improved: the introduction of guideline participants and the implementation of recommendations.