The development of a national guideline on the management of leg ulcers.
This paper describes the development of an evidence-linked clinical guideline for the management of uncomplicated venous leg ulcers. Guidelines are developed to provide recommendations for clinical practice which are based on summaries of good quality research evidence. The aim of the guideline discussed in this article is to direct primary health care practitioners to the most effective method of assessment and treatment of venous leg ulcers and to discourage practices that do not have convincing or sufficient evidence of effectiveness. The three most important steps to the development of a valid clinical guideline are: basing recommendations on the best available evidence; explicit linkage between guideline recommendations and quality of evidence; and the involvement of a multidisciplinary group. The steps are discussed in relation to the development of the guideline alongside an introductory presentation on the role guidelines can play in improving practice. Issues arising from guideline development such as valid ways of obtaining patient input and lack of evidence are also discussed.
McInnes
E
E
RCN Dynamic Quality Improvement Programme, RCN Institute, London, UK.
Cullum
N
N
Nelson
E A
EA
Luker
K
K
Duff
L A
LA
D000465:Algorithms; D003663:Decision Trees; D019317:Evidence-Based Medicine; D006801:Humans; D007587:Job Description; D007871:Leg Ulcer / Q000175:diagnosis / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods* / Q000592:standards*; D017592:Skin Care / Q000379:methods / Q000451:nursing / Q000592:standards; D006113:United Kingdom