Development of Consensus‐Based Clinical Guidelines in Critical Care Through Standardized Nursing Language

Abstract

PURPOSETo develop regional clinical practice guidelines for nurse decision making in critical care settings.METHODSIn the health department of the Andalusian region in Spain, a critical care nursing expert panel was created to develop clinical practice guidelines. A total of 14 critical care nurses (scholars, clinical nurses, managers) comprised the panel. The first obstacle was a lack of systematic reviews or clinical trials about these concerns. Therefore, the first version of the guidelines was consensus based. In order to strengthen the guidelines' structure, standardized nursing language systems and nursing process were employed as a conceptual frame. Problem identification using collaborative problems or nursing diagnoses (NANDA), literature review, recommendations presented by NIC labels, peer review of the recommendations, drafting the guidelines, and second peer review by the expert panel members resulted in the final version of each guideline.FINDINGSA consensus‐based clinical practice guideline manual prepared for critical care nursing in the health system in the southern region of Spain covered prehospital emergency care, health department services, and ICUs. These guidelines contain nurse‐sensitive situations and are nurse oriented, using standardized nursing languages for clinical decision making.CONCLUSIONSEvidence‐based clinical practice guidelines are needed in nursing decision making, but there is a lack of solid research‐based results for developing recommendations. The use of standardized nursing language for guidelines development decreases the variability of clinical practice, fosters homogeneity in nurses' problem‐solving schemes, and opens new research areas in clinical effectiveness. In future guidelines reviews, NOC and available systematic review‐based recommendations will be included. More quality research is needed in critically ill patient human responses.