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Using consensus methods to develop clinical practice guidelines for intensive care: the intensive care collaborative

Kaye Denise Rolls1, Doug Elliott

  • 1Intensive Care Coordination and Monitoring Unit, NSW Health, Honorary Associate, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia. kayerolls@gmail.com

Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses
|October 17, 2008
PubMed
Summary
This summary is machine-generated.

Developing clinical practice guidelines for intensive care units (ICUs) is challenging. This project created state-based guidelines for six common ICU practices, combining research evidence and clinical expertise for robust recommendations.

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Area of Science:

  • Critical Care Medicine
  • Evidence-Based Practice
  • Nursing Research

Background:

  • Maintaining up-to-date clinical practice manuals in intensive care units (ICUs) is difficult due to time constraints and workload.
  • A collaborative approach was needed to develop evidence-based guidelines for common ICU procedures.

Purpose of the Study:

  • To develop state-based clinical practice guidelines for six common intensive care practices through group synergy.
  • To address the challenges of literature review and guideline development in a resource-intensive environment.

Main Methods:

  • A collaborative project involving 55 senior nurse clinicians, academic facilitators, and coordination unit staff.
  • Utilized systematic literature reviews, working groups, teleconferences, and online forums.
  • Consensus Development Conference (CDC) with Nominal Group Technique (NGT) and External Validation Panels (EVP) for recommendation finalization.

Main Results:

  • Developed 83 recommendations for six clinical practice guidelines (CPGs).
  • 50% of recommendations were evidence-based, with 23% having high levels of evidence; the remainder were based on expert consensus.
  • External validation confirmed 78 out of 83 recommendations.

Conclusions:

  • The project successfully demonstrated a robust method for clinical guideline development.
  • The approach effectively integrated research evidence with clinical expertise using an objective framework.
  • This model can be applied to create and maintain current clinical practice guidelines in ICUs.