Cent Eur J Nurs Midw 2016, 7(4):549-557 | DOI: 10.15452/CEJNM.2016.07.0028

Assessing the methodological quality of clinical guidelines for preventing falls of patients

Kamila Majkusová1,*, Darja Jarošová2, Renáta Zeleníková2, Radka Kozáková2
1 Municipal hospital Ostrava, Department of Nursing, Czech Republic
2 Depatment of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Czech Republic

Aim: The study aimed to assess the methodological quality of selected clinical practice guidelines (CPGs) for preventing risk of falling in adult patients in acute and long-term institutional care.

Design: Descriptive study using qualitative research techniques.

Methods: CPGs were systematically searched in databases of clinical guidelines, systematic reviews, electronic databases, and websites of organizations and professional societies, based on predefined criteria and keywords fo the period 2000-2015. After sorting and analysing 53 documents, the methodological quality of seven selected CPGs were assessed with the AGREE II generic instrument.

Results: All CPGs obtained highest domain scores in the dimensions Clarity and Framework, and Purpose, while the lowest standardized scores were achieved by the Applicability and Editorial independence domains. The Rigor of development and Stakeholder Involvement domains achieved an average score. A total of three recommended guidelines showed high methodological quality: Falls. Assessment and prevention of falls in older people - 572 b., 84 % (NICE, 2013); Preventing Falls and Harm From Falls in Older People. Best Practice Guidelines for Australian Hospitals - 556 b., 84 % (ACSQHC, 2009); and Prevention of falls and fall injuries in the older adult - 559 b., 82 % (RNAO, 2005).

Conclusion: Assessing the methodological quality of clinical guidelines using the AGREE instrument is one of the key steps in the process of their adaptation for other socio-cultural and organizational conditions. It would be possible to adapt and use all of the three most highly-rated CPGs to reduce risk of falling of inpatients in the Czech organizational and socio-cultural context.

Keywords: prevention of patient falls, clinical practice guidelines, methodological quality, AGREE II instrument

Received: August 2, 2016; Accepted: October 4, 2016; Published: September 30, 2016  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Majkusová K, Jarošová D, Zeleníková R, Kozáková R. Assessing the methodological quality of clinical guidelines for preventing falls of patients. Central European Journal of Nursing and Midwifery. 2016;7(4):549-557. doi: 10.15452/CEJNM.2016.07.0028.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. ADAPTE Collaboration. Guideline adaptation: a resource toolkit. Version 2.0. Prepared by the ADAPTE Collaboration, 2009. [cited 2014 Oct 30]. Available from: http://www.g-in.net/document-store/working-groupsdocuments/adaptation/adapte-resource-toolkit-guidelineadaptation-2-0.pdf
    2. AGREE II. Appraisal of guidelines for research & evaluation II instrument. The AGREE next steps Consortium. May 2009. [cited 2015 Apr 26]. Available from: http://www.agreetrust.org/wpcontent/uploads/2013/10/AGREE-II-Users-Manual-and-23item-Instrument_2009_UPDATE_2013.pdf
    3. Australian Commission on Safety and Quality in Health Care (ACSQHC). Preventing falls and harm from falls in older people: Best practice guidelines for Australian hospitals 2009. Sydney: ACSQHC; 2009. Available from: http://www.safetyandquality.gov.au/publications/preventing-falls-and-harm-from-falls-in-older-people-best-practiceguidelines-for-australian-hospitals-2009/
    4. Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, Fervers B, Graham ID, Grimshaw J, Hanna SE, Littlejohns P, Makarski J, Zitzelsberger L; AGREE Next Steps Consortium. AGREE II: advancing guideline development, reporting and evaluation in health care. Canadian Medical Association Journal. 2010; 182(18):E839-842. Go to original source... Go to PubMed...
    5. Council of Europe. Developing a metodology for drawing up guidelines on best medical practice. Recommenadation (2001)13 and explanatory memorandum. Zeitschrift für ärztliche Fortbildung und Qualitätssicherung. 2002;96(Suppl 3):5-59. Go to PubMed...
    6. Česká asociace sester. Pády. © 2008 ČAS [cited 2015 Apr 26]. Available from: http://www.cnna.cz/narodni-indikatorykvality-pece/pady (in Czech)
    7. Field MJ, Lohr KN. Guidelines for clinical practice. From development to use. Washington: National Academy; 1992.
    8. Hitcho EB, Krauss MJ, Birge S, Claiborne Dunagan W, Fischer I, Johnson S, Nast PA, Costantinou E, Fraser VJ. Characteristics and circumstances of falls in a hospital setting: a prospective analysis. Journal of General Internal Medicine. 2004;19(7):732-739. Go to original source... Go to PubMed...
    9. Jarošová D, Zeleníková R. Ošetřovatelství založené na důkazech. Evidence Based Nursing. 1. vyd. Praha: Grada Publishing; 2014. (in Czech)
    10. Jarošová D, Majkusová K, Zeleníková R, Kozáková R. Klinické doporučené postupy v ošetřovatelství. 1. vyd. Praha: Grada Publishing; 2015. (in Czech)
    11. Keffer JH. Guidelines and algorithms: perceptions of why when they are successful and how to improve them. Clinical Chemistry. 2001;47(8):1563-1572. Go to original source...
    12. Líčeník R, Kliková K, Osinová D, Doubravská S, Ivanová K. Hodnocení kvality klinických doporučených postupů České neurologické společnosti ČLS JEP. Česká a Slovenská Neurologie a Neurochirurgie. 2014;77/110(1):64-69. (in Czech)
    13. Líčeník R, Kurfürst P, Ivanová K. AGREE II: Nástroj pro hodnocení doporučených postupů pro výzkum a evaluaci. Olomouc: Univerzita Palackého; 2013. (in Czech)
    14. McMaster P, Rogers D, Kerr M, Spencer A. Getting guidelines to work in practice. Archives of Disease in Childhood. 2007;92(2):104-106. Go to original source... Go to PubMed...
    15. National Institute for Health and Clinical Excelence. The guidelines manual. London: National Institute for Health and Clinical Excellence. 2012. [cited 2015 Nov 30]. Available from: https://www.nice.org.uk/process/pmg6/resources/theguidelines-manual-pdf-2007970804933
    16. Nurmi I, Lüthje P. Incidence and costs of falls and fall injuries among elderly in institutional care. Scandinavian Journal of Primary Health Care. 2002;20(2):118-122. Go to original source...
    17. Qaseem A, Forland F, Macbeth F, Ollenschläger G, Phillips S, van der Wees P; Board of Trustees of the Guidelines International Network. Guidelines International Network: toward international standards for clinical practice guidelines. Annals of Internal Medicine. 2012;156(7):525- 531. Go to original source... Go to PubMed...
    18. Registered Nurses' Association of Ontario (RNAO). Prevention of falls and fall injuries in the older adult. Toronto, Canada: Registered Nurses' Association of Ontario; 2005 [cited 2015 Nov 30]. Available from: http://rnao.ca/sites/rnaoca/files/Prevention_of_Falls_and_Fall_Injuries_in_the_Older_Adult.pdf
    19. Roudsari BS, Ebel BE, Corso PS, Molinari NA, Koepsell TD. The acute medical care costs of fall-related injuries among the U.S. older adults. Injury. 2005;36(11):1316-1322. Go to original source... Go to PubMed...
    20. Seifer B, Bourek A, Forýtková L. Standardy léčebných postupů a kvalita ve zdravotní péči: manuál zvyšování kvality péče pro nemocnice, polikliniky, praktické lékaře a specialisty. 1. vyd. Praha: Verlag Dashöfer; 2008. (in Czech)
    21. Steinbrook R. Guidance for guidelines. The New England Journal of Medicine. 2007;356(4):331-333. Go to original source... Go to PubMed...
    22. Suchý M, Bednařík J et al. Klinické doporučené postupy v neurologii I. 1. vyd. Olomouc: Univerzita Palackého; 2012. (in Czech)
    23. Tingle J, Foster Ch. Clinical guidelines: law, policy and practice. 1st ed. London: Routledge; 2002. Go to original source...
    24. World Health Organization (WHO). WHO global report on falls prevention in older age. Geneva: World Health Organization; 2007.
    25. Zeleníková R. Tvorba a adaptace klinických doporučených postupů. In: Jarošová D, Majkusová K, Zeleníková R, Kozáková R. Klinické doporučené postupy v ošetřovatelství. 1. vyd. Praha: Grada Publishing; 2015. p. 38-67. (in Czech)
    26. Zvolský M. The database of the catalogue of clinical practice guidelines published via internet in the Czech language - the current state. European Journal for Biomedical Informatics. 2010;6(1):83-89.

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content