Which nursing issues need a European guideline: proposal for respiratory management

Over the past 30 years, nursing care and health systems have undergone significant changes in many aspects. Particularly, in the last decade, research and the expansion of Evidence-Based Practice (EBP) have played a significant role in this process. EBP is the application of the best available evidence, which in practice means more effective interventions, more efficient use of resources and fewer side effects for patients. From a research point of view, EBP can facilitate the identification of knowledge gaps and thereby help establish research priorities. Furthermore, research evidence may suggest that a change in practice is necessary. When this occurs, one of the best ways to implement such change is through the use of guidelines. Clinical Practice Guidelines (CPG) are "systematically developed statements to assist practitioner decisions about appropriate healthcare for specific clinical circumstances". Whenever possible, CPG help to infuse research into practice and to promote quality and standardisation of care. Nursing care will have a considerably greater impact if evidence-based care is applied. For this reason, it is important to identify the available evidence of respiratory management in order to establish nursing CPG across Europe. The aim of this paper is to analyse the framework in which these guidelines should be applied and to identify which nursing issues should have CPG. Based on the North American Nursing Diagnosis Association (NANDA), Nursing Interventions Classification (NIC) and the Nursing Outcomes Classification (NOC), this study establishes the main nursing diagnoses for a patient with Acute Respiratory Failure (ARF). Moreover, the current situation regarding respiratory management and the safety of nursing practice procedures are described.