The methodology for developing nursing clinical practice guidelines over recent decades in China: A critical appraisal using AGREE II

Aim: To appraise the quality of current nursing clinical practice guidelines (N-CPGs) in China and explore the methodology for N-CPGs development.

Background: Implementation of quality improvement projects based on N-CPGs has becoming an hot topic for nursing with proliferation in the number of N-CPGs in China in recent years. The methodology for developing N-CPGs is worthy of exploration.

Methods: A systematic literature search was performed using PubMed, CINAHL, Web of Science, CNKI, Wanfang, VIP and CBM and relevant representative guidelines repositories from inception to July 31, 2019. Two authors independently selected eligible guidelines and performed data extraction. Four appraisers independently assessed the quality of the N-CPGs using the AGREE II tool.

Results: 20 N-CPGs were eventually included in this review. After AGREE II appraisal, the final domain scores ranged between 0.00 and 83.33%. When comparing the total domain scores, "Scope and purpose" and "Clarity of presentation" scored highest with a total of 63.89 (59.37-69.79) (%, median, interquartile range (IQR)), and 63.89 (58.33-75.70) (%), respectively. "Editorial independence" obtained the lowest ranking with a total score of 0 (0-81.25) (%). The total scores of "Stakeholder involvement", "Rigour of development", "applicability" and "editorial independence" were lower than 50%.

Conclusion: The quality of N-CPGs in China is not very high and the process of guideline development still needs to improve.

Implications for nursing management: N-CPGs are important documents used to guide nursing quality improvement. High quality N-CPGs are beneficial for nursing management.