Evaluating evidence-based practice within critical care.

Area of Science:

• Healthcare quality improvement
• Evidence-based practice in critical care
• Action research methodology

Background:

• A corporate practice development strategy was evaluated using action research from 2002-2005.
• Clinicians engaged as practitioner-researchers to assess practice development influences.
• Evaluation of evidence-based guidelines was a key focus within critical care.

Purpose of the Study:

• To evaluate the effectiveness of the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument in critical care.
• To improve the quality of evidence-based guidelines and streamline appraisal processes.
• To foster a sustainable cultural change in guideline development.

Main Methods:

• Utilized the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument for guideline appraisal.
• Employed a two-cycle action research approach to evaluate and improve guidelines.
• Established critical care multidisciplinary guideline development groups.

Main Results:

• Initial evaluation (cycle 1) identified areas for guideline improvement and learning opportunities.
• Subsequent evaluation (cycle 2) demonstrated improved guideline quality post-implementation of action plans.
• The guideline appraisal process was streamlined across the Trust.

Conclusions:

• The AGREE instrument facilitated a cultural shift towards structured guideline development.
• Sustained improvements were achieved through multidisciplinary guideline groups and electronic systems.
• The study highlights the benefits of structured appraisal tools for future guideline development.