Development of clinical practice guidelines for assessment before peripherally inserted central catheter placement: AGREE evaluation

Abstract

<p>Objective To develop evidence-based clinical practice guidelines for assessment before placement of peripherally inserted central catheter (PICC) and to evaluate the guidelines with the AGREE instrument. Methods Based on cross-sectional surveys, a systematic review on assessment before PICC placement was made and content analysis was performed to evaluate clinical practice guidelines related to pre-placement assessment. Then a draft of guidelines was drawn and the Delphi technique was used to revise attachment files of the guidelines. At last, the guidelines were evaluated by using the AGREE instrument. Results The guidelines contained 31recommendations categorized into six aspects: insertion nurse specialist, environment and equipments, patient assessment, catheter selection, insertion technique and site, and informed consent. Standardized scores according to AGREE evaluation were 98%,93%,95%,92%,89%and 100%respectively.All 6PICC experts strongly recommended the guidelines. Conclusion The evidence-based clinical practice guidelines for assessment before PICC placement, which are formulated based on current clinical situation in China, patient’s willingness and preference, and on professional judgments of medical workers, can provide references for assessment before PICC placement.</p>

目的 构建以证据为基础的经外周穿刺中心静脉导管(PICC)置管前评估的临床实践指南并进行AGREE评价。方法 通过现况调查，制作PICC置管前评估的系统评价，对PICC置管前评估相关临床实践指南进行文献内容分析，构建指南草案并通过德尔菲法对指南相关附件进行修订，使用AGREE评估系统进行评价。结果 指南形成包含置管护士、环境与设备、患者评估、导管选择、穿刺技术与穿刺部位、知情同意６个方面共３１项推荐意见。AGREE评价的标准化总分分别为98%、93%、95%、92%、89%、100%，６名PICC护理专家均给予“强烈推荐”评价。结论 该指南是基于我国临床现状、循证证据、患者意愿和偏好、专业人员判断的循证性临床实践指南，可作为PICC置管前评估的依据。