Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with ...

Nursing Best Practice GuidelineGuideline Development ProcessIn January of 2004, a panel of nurses with expertise in practice, education and research related tochronic obstructive pulmonary disease was established by the RNAO. At the onset, the panel discussed andcame to consensus on the scope of the best practice guideline.A search of the literature for systematic reviews, clinical practice guidelines and relevant articles andwebsites was conducted. See Appendix A for a detailed outline of the search strategy employed.The panel identified a total of thirteen clinical practice guidelines related to chronic obstructive pulmonarydisease and dyspnea. These guidelines were reviewed according to a set of initial inclusion criteria, whichresulted in elimination of four guidelines. The inclusion criteria were:■Guideline was in English, international in scope.■ Guideline was dated no earlier than 1997.■■■Guideline was strictly about the topic area.Guideline was evidence-based (e.g., contained references, description of evidence, sources of evidence).Guideline was available and accessible for retrieval.Nine guidelines met these criteria and were critically appraised with the intent of identifying existingguidelines that were current, developed with rigour, evidence-based and which addressed the scopeidentified by the panel for the best practice guideline. A quality appraisal was conducted on these nineclinical practice guidelines using the Appraisal of Guidelines for Research and Evaluation Instrument (AGREECollaboration, 2001). This process yielded a decision to work primarily with six existing guidelines. These were:Clinical Epidemiology and Health Service Evaluation Unit (1999). Evidence based guidelines RoyalMelbourne Hospital – Hospital management of an acute exacerbation of chronic obstructivepulmonary disease. Melbourne: National Health and Medical Research Council.Institute for Clinical Systems Improvement (2003). Health care guideline: Chronic obstructivepulmonary disease. Institute for Clinical Systems Improvement [Electronic version]. Available:www.icsi.orgMcKenzie, D. K., Frith, P. A., Burdon, J. G. W., & Town, I. (2003). The COPDX Plan: Australian and NewZealand guidelines for the management of chronic obstructive pulmonary disease 2003. MedicalJournal of Australia, 178(6 Suppl), S1-S40.O’Donnell, D. E., Aaron, S., Bourbeau, J., Hernandez, P., Marciniuk, D., Balter, M. et al. (2003).Canadian Thoracic Society recommendations for management of chronic obstructive pulmonarydisease - 2003. Canadian Respiratory Journal, 10(Suppl. A), 11A-65A.15