Updating clinical guidelines
We conducted a systematic review to identify and describe the updating guidance provided by CPG methodological handbooks and included handbooks that provide updating guidance for CPGs.
We searched in the Guidelines International Network library, US National Guidelines Clearinghouse and MEDLINE (Pub Med) from 1966 to September 2013.
The majority of handbooks do not provide guidance for the literature search, evidence selection, assessment, synthesis, and external review of the updating process.
The Clinical Practice Guidelines have been prepared by Health Canada's First Nations and Inuit Health Branch (FNIHB) for use by community health nurses employed by Health Canada providing primary care in isolated, semi-isolated, and remote First Nations communities.
However, these goals generally have not been translated into explicit operational methods.
New evidence continues to emerge and requires attention after the release of a clinical practice guideline (CPG).
The guidelines do not delineate the legal scope of practice of nurses.
They are not intended to constitute a comprehensive, authoritative text and should under no circumstances be used as a substitute for clinical judgment or for consultation with other health care professionals.
We used descriptive statistics to analyze the extracted data and conducted a narrative synthesis. Most handbooks (97.1%) focus mainly on developing CPGs, including variable degrees of information about updating.
A single organization (USPSTF) was sampled through the author's one-month practicum experience developing and applying review methods to guidelines possibly requiring update.
Results: All organizations were very concerned with the rapidly changing healthcare environment and have goals of keeping their guidelines up to date.
While the Guidelines may be referred to by persons who are not employed by Health Canada, Health Canada takes no responsibility for any use of these guidelines other than by community health nurses employed by Health Canada and for their intended purposes.
These guidelines contain information to assist in the identification, diagnosis, and treatment of illness and other health issues in a primary care setting and may be used for reference and education purposes.