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Creating consensus-based practice guidelines with 2000 nurses

12 December 2019
Guideline Development
02 December 2019
Volume 28 · Issue 22

Abstract

Medical professionals follow evidence-based practice guidelines to achieve effective patient outcomes. Traditionally, to develop guidelines, a small group of experts examine evidence then agree on a set of statements, which are then published in journals. However, more than 7000 primary care journal articles are published monthly. This study examined a different way of drawing up practice guidelines, which involved large numbers of nurses from different countries directly in developing then disseminating the guidelines to speed up acceptance and the implementation of best practice. The results were consensus-based best practice guidelines for the treatment of patients with ostomies, which have received a high level of acceptance and enthusiasm from practitioners in 27 countries.

Traditional medical practice has been for clinical research specialists to study an issue and the evidence around it, determine the best practices to reach the desired medical outcome and make recommendations, which are published in journals, for practitioners in the field to follow. However, it is estimated that more than 7000 primary care journal articles are published monthly and that it would take a clinician over 625 hours per month to evaluate these articles (Alper et al, 2004).

MIT professor Edgar H Schein (2013) calls this the ‘culture of do and tell’. Best practice guidance ‘is nothing if it is not used’ (Patton, 1997), a statement that is reinforced by the many examples of evidence-based medical practice changes that fail to be implemented and therefore do not result in improved patient outcomes (Grol et al, 2005). Evidence suggests involving clinicians in the development of an innovation or proposal of change promotes implementation (Grol et al, 2005).

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Ostomy
Stoma
Developing practice guidelines
Consensus building
Optimising patient outcomes
Quality of life