title: Nursing Practice Guidelines in China do Need Reform: A Critical Appraisal Using the AGREE II Instrument.
abstract: BACKGROUND
  An increasing number of nursing practice guidelines (NPGs) of varying methodological and reporting quality have been issued and published in international journals. Currently, the quality of NPGs in mainland China has not been explored.
  
  
  OBJECTIVE
  To assess the quality of NPGs in China mainland using the AGREE II (Advancing Guideline Development, Reporting and Evaluation in Health Care) instrument.
  
  
  METHODS
  The authors searched the electronic databases of Chinese Biomedical Literature Database, China National Knowledge Infrastructure, The VIP Database, Wan Fang Database, Chinese Master's Theses Full-Text Database, China Doctor Dissertation Full-Text Database, and China Proceedings of Conference Full-Text Database and the web of China Guideline Clearinghouse for NPGs in China published from the inception of databases to December, 2013. Four independent assessors rated the quality of each guideline using AGREE II. The authors classified NPGs into two types: evidence-based NPG (EB-NPG) and consensus-based NPG (CB-NPG), and compared their quality. The authors also considered whether the quality of NPGs changed over time.
  
  
  RESULTS
  Forty-two NPGs were appraised. Methodological rigor and reporting of NPGs were poor. Across all guidelines, the appraisers assigned the highest scores to the domain "scope and purpose," and the lowest scored to the domain of "editorial independence." EB-NPGs were significantly superior to the CB-NPGs in the domains of "stakeholder involvement," "rigor of development," and "editorial independence." There was no improvement over time for all domains.
  
  
  CONCLUSIONS
  This research found an absence of a systematic guideline development methodology and a tendency to rely on expert opinion in the process of developing NPGs. The readers should consider these flaws and limitations when using recommendations in those NPGs.
authors.affiliation: Nursing Department, Tianjin University of Traditional Chinese Medicine, TianJin, China.
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Nursing Department, Tianjin University of Traditional Chinese Medicine, TianJin, China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Nursing Department, Tianjin University of Traditional Chinese Medicine, TianJin, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Nursing Department, Tianjin University of Traditional Chinese Medicine, TianJin, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Nursing Department, Tianjin University of Traditional Chinese Medicine, TianJin, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Nursing Department, Tianjin University of Traditional Chinese Medicine, TianJin, China.
authors.forename: Cui
authors.initials: C
authors.lastname: Lu
authors.affiliation: Nursing Department, Tianjin University of Traditional Chinese Medicine, TianJin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Public Health Department, Tianjin University of Traditional Chinese, Medicine, TianJin, China.
authors.forename: Ge
authors.initials: G
authors.lastname: Li
authors.affiliation: Key Laboratory of Chinese Internal Medicine (Beijing University of Chinese Medicine), Ministry of Education, China.
authors.forename: Hongcai
authors.initials: H
authors.lastname: Shang
mesh_terms: D002681:China; D017408:Guidelines as Topic / Q000592:standards*; D018166:Health Care Reform / Q000639:trends*; D006801:Humans; D009732:Nursing Care / Q000379:methods* / Q000592:standards*
keywords: AGREE II; China; appraisal; guideline; nursing