Related Experiment Video
Updated: May 4, 2026
The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
From international guidelines to practice: a multimethod evaluation of BMJ Rapid Recommendations focusing on
Siri Schøyen Seterelv1,2,3, Samir Gupta4,5,6, Andrew Kouri4,6,7
1Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway siri@magicevidence.org.
Objectives:
We aimed to assess usage and explore factors influencing the suitability of British Medical Journal (BMJ) Rapid Recommendations-a set of international guidelines meeting standards of trustworthiness-for adaptation and implementation, further defined as implementability.
Design:
Qualitative descriptive study with a multimethod approach.
Participants:
We used citation screening and a survey to identify groups that had used any of a sample of 14 BMJ Rapid Recommendations in adoption, adaptation, de novo guideline development or implementation.
Setting:
12 participants from a range of country income levels were interviewed, using semistructured interviews.
Methods:
Interviews were analysed using thematic analysis to identify themes related to implementability of the guidelines. We compared these findings with those from a critical appraisal conducted using three different appraisal tools.
Results:
BMJ Rapid Recommendations are used in high-income, middle-income and low-income countries. We identified 33 instances of use. Our thematic analysis of the interviews uncovered 14 challenges to implementability, categorised under perceived trustworthiness, comprehensibility and practical relevance. The critical appraisals gave the BMJ Rapid Recommendations high scores on validity, but low scores on implementability and measurability. The challenges found in the interviews were generally corroborated by the appraisals, but the comparison also exposed tensions such as the complex interaction between methodological rigour and perceived credibility, the balance between novelty and compatibility with current practice, and the difficulty of offering globally applicable yet locally practical guidance.
Conclusion:
Implementability challenges may limit effective use of international guidelines globally. Recognising and reflecting on tensions between rigour, credibility and contextual feasibility may help improve their uptake and value. The next phase of this research will explore strategies to enhance guideline implementability during their development.
Related Concept Videos
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:19Guidelines For Measuring Vital Signs
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...