Medical College of Wisconsin
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American College of Surgeons Guidelines Program: a process for using existing guidelines to generate best practice recommendations for central venous access. J Am Coll Surg 2008 Nov;207(5):676-82

Date

10/29/2008

Pubmed ID

18954779

DOI

10.1016/j.jamcollsurg.2008.06.340

Scopus ID

2-s2.0-54049122127 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

BACKGROUND: Many professional organizations help their members identify and use quality guidelines. Some of these efforts involve developing new guidelines, and others assess existing guidelines for their clinical usefulness. The American College of Surgeons Guidelines Program attempts to recognize useful surgical guidelines and develop research questions to help clarify existing clinical guidelines. We used existing guidelines about central venous access to develop a set of summary recommendations that could be used by practitioners to establish local best practices.

STUDY DESIGN: A comprehensive literature search identified existing clinical guidelines for short-term central venous access. Two reviewers independently rated the guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Highly scored guidelines were analyzed for content, and their recommendations were compiled into a summary table. The summary table was reviewed by an independent panel of experts for clinical utility.

RESULTS: Thirty-two guidelines were identified, and 23 met inclusion criteria. The AGREE rating resulted in four guidelines that were strongly recommended and five that were recommended with alterations. Three comprehensive tables of recommendations were produced: procedural, maintenance, and infectious assessment. A panel of experts came to consensus agreement on the final format of the best practice recommendations, which included 30 summary recommendations.

CONCLUSIONS: Our process combined assessing existing guidelines methodology with expert opinion to produce a best practice list of guidelines that could be fashioned into local care routines by practicing physicians. The American College of Surgeons guidelines program believes this process will help validate the clinical utility of existing guidelines and identify areas needing further investigation to determine practical validity.

Author List

Freel AC, Shiloach M, Weigelt JA, Beilman GJ, Mayberry JC, Nirula R, Stafford RE, Tominaga GT, Ko CY, American College of Surgeons



MESH terms used to index this publication - Major topics in bold

Benchmarking
Catheterization, Central Venous
Humans
Practice Guidelines as Topic
Reproducibility of Results
United States