Methodological quality of nursing guidelines in China: an AGREE II and RIGHT appraisal (2023-2024)

To systematically evaluate the methodological and reporting quality of clinical guidelines and expert consensus statements in the Chinese nursing field published in journals from 2023 to 2024.

We searched databases including CNKI, WanFang Data, SinoMed/CBM, PubMed, Embase, Web of Science, supplemented by searches of guideline repositories (e.g., GIN) and academic organization websites. The search period spanned from January 1, 2023, to December 31, 2024. Two researchers independently screened the literature, extracted data, and assessed quality using AGREE II and RIGHT tools.

A total of 28 guidelines and consensus statements were included. The mean standardized percentages for AGREE II domains were: Scope and Purpose, 46.74%; Stakeholder, Involvement 32.13%; Rigor of Development, 30.64%; Clarity of Presentation, 39.22%; Applicability, 29.42%; and Editorial Independence, 42.77%. RIGHT reporting rates were highest for items 1a, 1b, 3, 4, 18a, and 19a 28/28 (100%). Although the small number of guidelines (n = 5) limits inferential strength, descriptive comparisons suggested consistently higher scores in guidelines than in consensus statements across all AGREE II domains and in total RIGHT score (P < 0.05), and these findings should be regarded as exploratory. Evidence-based documents outperformed expert opinion-based documents (P < 0.05). Team size was positively correlated with the RIGHT score (P < 0.05).

Current guidelines and consensus statements in the domestic nursing field exhibit significant shortcomings in methodological rigor, reporting completeness, and clinical applicability. Future development processes should strictly adhere to AGREE II and RIGHT standards, strengthen evidence-based methodology, emphasize multidisciplinary collaboration and patient involvement, and enhance reporting transparency and clinical translation support.